<--GAT-->

Gene Assay Can Help Determine Active Surveillance Usefulness

by U.S. Medicine

March 20, 2018

BEDFORD, MA—Active surveillance (AS) has been widely implemented at the VA as a standard of care for low-risk prostate cancer (PCa). A study in the American Journal of Managed Care posits, however, that patient characteristics such as age, race and Agent Orange (AO) exposure may influence advisability of AS in veterans.1

A study team led by researchers from the Bedford, MA, VAMC also suggested that the 17-gene assay could improve risk stratification and management selection. Their objective was to compare management strategies for PCa at six VAMCs before and after introduction of the Oncotype DX Genomic ProstateScore (GPS) assay.

To do that, researchers reviewed records of patients diagnosed with PCa between 2013 and 2014 to identify management patterns in an untested cohort. From 2015 to 2016, these patients received GPS testing in a prospective study, and charts from six months post biopsy were analyzed for both cohorts to compare management received in the untested and tested cohorts. Included in the study were men who were newly-diagnosed with prostate cancers and have National Comprehensive Cancer Network (NCCN) very low-, low- and select cases of intermediate-risk PCa.

Results indicated that patient characteristics were generally similar in the untested and tested cohorts, although AS use was 12% higher in the tested cohort compared with the untested cohort. At the same time, in men younger than 60 years, utilization of AS in tested men was 33% higher than in untested men.

The study found that AS in tested men was higher across all NCCN risk groups and races, particular in low-risk men—72% vs. 90% for untested vs. tested, respectively. As for veterans exposed to AO, they were less likely to receive less AS than untested veterans, with tested nonexposed veterans receiving 19% more AS than untested veterans. Race or AO exposure was not found to have a significant effect on median GPS.

“Men who receive GPS testing are more likely to utilize AS within the year post diagnosis, regardless of age, race, and NCCN risk group,” the study authors wrote. “Median GPS was similar across racial groups and AO exposure groups, suggesting similar biology across these groups. The GPS assay may be a useful tool to refine risk assessment of PCa and increase rates of AS among clinically and biologically low-risk patients, which is in line with guideline-based care.”

1.    Lynch JA, Rothney MP, Salup RR, Ercole CE, et. al. Improving risk stratificationamong veterans diagnosed with prostate cancer: impact of the 17-gene prostatescore assay. Am J Manag Care. 2018 Jan;24(1 Suppl):S4-S10. PubMed PMID: 29337486.


Related Articles

VA/National Cancer Institute Partnership Increases Veteran Access to Trials

Thanks to a new partnership between the National Cancer Institute and the VA, veterans with cancer will now have greater access to potentially lifesaving clinical trials.

VA Continues Hepatocellular Screening, but Study Questions the Value

Although a recent study determined that screening veterans with cirrhosis for hepatocellular carcinoma did not reduce the risk of death associated with liver cancer, the VA has no plans to change its screening practices.


U.S. Medicine Recommends


More From oncology

Oncology

VA/National Cancer Institute Partnership Increases Veteran Access to Trials

Thanks to a new partnership between the National Cancer Institute and the VA, veterans with cancer will now have greater access to potentially lifesaving clinical trials.

Oncology

VA Continues Hepatocellular Screening, but Study Questions the Value

Although a recent study determined that screening veterans with cirrhosis for hepatocellular carcinoma did not reduce the risk of death associated with liver cancer, the VA has no plans to change its screening practices.

Oncology

Testosterone Therapy Not Linked to Aggressive Prostate Cancer in Veterans

Clinicians prescribing supplemental testosterone in men with low levels always have a nagging concern about the possible link between increasing hormone levels and prostate cancer.

Oncology

Side-effects Differ Between Radiation Therapies for Prostate Cancer

A recent study compared patient-reported disease-specific functional outcomes after external beam radiation therapy (EBRT) and EBRT combined with low-dose-rate brachytherapy prostate boost (EB-LDR) among men with localized prostate cancer.

Oncology

Parkinson's Drug Not Associated With Higher Prostate Cancer Risk

An increased incidence of prostate cancer was observed in Parkinson's disease (PD) patients treated with entacapone during a pre-approval randomized clinical trial, according to a new study which noted that the relationship had not yet been intensely investigated.

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up