Yet another genetic/genomic test (this one developed by Metamark Genetics) may have value in the assessment of risk for biochemical progression after first-line surgery for prostate cancer.
According to an article by Saad et al. in the Journal of Urology (and as also reported on the MedPage Today web site), it appears that MetaMark has developed a new 12-protein biomarker-based test that can be used to analyze biopsy tissue and categorize patients into those who are at low, intermediate, and high risk for biochemical recurrence after first-line treatment.
For the 288 men to whose biopsy samples this test was applied, at an average (median) follow-up of 68.5 months post-treatment,
- Biochemical relapse was evident in 47 (16.3 percent)
- Metastases were identified in 5 (1.7 percent).
- On univariate analysis, assay scores predicted biochemical relapse significantly better than other preoperative prognostic parameters (HR = 1.724, p = 0.0002 per 20 percent change in score),.
- The assay score had a significantly higher p value when combined with clinical National Comprehensive Cancer Network stage compared to stage alone (HR = 1.579, p = 0.0017 per 20 percent change in score).
This new test appears to be an evolution of the ProMark™ test that we had first discussed back in 2014 (which was based on only eight protein biomarkers).
In an associated editorial in the Journal of Urology, Eric Klein of the Clevekand Clinic writes that this study:
adds to the growing body of evidence that clinically useful information about the aggressiveness of prostate cancer can be obtained from needle biopsies despite known issues with sampling error and genetic heterogeneity.
He continues by stating that
As such, we are on the threshold of being able to exploit biological information beyond that contained in the classic triad of grade, stage, and PSA to allow for a tailored management approach for newly diagnosed patients, including who to put on active surveillance, who is likely to respond to radiation or androgen deprivation, and the choice of specific drugs for individual patients.