Abstract
Objective
To validate the 17-gene Oncotype DX Genomic Prostate Score (GPS) as a predictor of
adverse pathology (AP) in African American (AA) men and to assess the distribution
of GPS in AA and European American (EA) men with localized prostate cancer.
Methods
The study populations were derived from 2 multi-institutional observational studies.
Between February 2009 and September 2014, AA and EA men who elected immediate radical
prostatectomy after a ≥10-core transrectal ultrasound biopsy were included in the
study. Logistic regressions, area under the receiver operating characteristics curves
(AUC), calibration curves, and predictive values were used to compare the accuracy
of GPS. AP was defined as primary Gleason grade 4, presence of any Gleason pattern
5, and/or non-organ-confined disease (≥pT3aN0M0) at radical prostatectomy.
Results
Overall, 96 AA and 76 EA men were selected and 46 (26.7%) had AP. GPS result was a
significant predictor of AP (odds ratio per 20 GPS units [OR/20 units] in AA: 4.58;
95% confidence interval (CI) 1.8-11.5, P = .001; and EA: 4.88; 95% CI 1.8-13.5, P = .002). On multivariate analysis, there was no significant interaction between GPS
and race (P >.10). GPS remained significant in models adjusted for either National Comprehensive
Cancer Network (NCCN) risk group or Cancer of the Prostate Risk Assessment (CAPRA)
score. In race-stratified models, area under the receiver operating characteristics
curves for GPS/20 units was 0.69 for AAs vs 0.74 for EAs (P = .79). The GPS distributions were not statistically different by race (all P >.05).
Conclusion
In this clinical validation study, the Oncotype DX GPS is an independent predictor
of AP at prostatectomy in AA and EA men with similar predictive accuracy and distributions.
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Article info
Publication history
Published online: April 08, 2020
Footnotes
Financial Disclosure: This study was funded by the NIHHYB (grant no. R21CA202552).
Identification
Copyright
Published by Elsevier Inc.
