Molecular Subtyping Signature Predicts Benefit from Chemotherapy in Men with Metastatic Prostate Cancer

 
In a phase III randomized controlled trial, a Decipher genomics resource information database (GRID) molecular subtyping signature from Decipher Biosciences, San Diego, successfully predicted which patients diagnosed with metastatic hormone-sensitive prostate cancer (mHSPC) benefited from adding chemotherapy to androgen deprivation hormone therapy.¹

The standard of care for patients with mHSPC is androgen deprivation hormone therapy, with an option for such additional systemic therapies as taxane chemotherapy. Without knowledge of how each patient will respond to such therapies, however, optimizing treatment for mHSPC patients remains challenging.

The Decipher GRID signature has demonstrated that patients with specific molecular subtypes have varying responses to systemic therapies. Investigators from the chemohormonal therapy versus androgen ablation randomized trial for extensive disease in prostate cancer (Chaarted) used the signature to profile tumor tissue from trial participants and to identify which patients would receive the greatest benefit from the addition of taxane chemotherapy.

The investigators found that patients with the luminal B molecular subtype of mHSPC derived the greatest benefit from the addition of taxane chemotherapy, adding a median of 22 months of survival with a 55% reduction in risk of death. In the trial population tested, 48% of the patients were found to have the luminal B molecular subtype. Patients with the remaining molecular subtypes received no significant survival benefit from the addition of taxane chemotherapy.

“Identifying which patients will benefit from chemotherapy is one of the most important clinical questions in the management of metastatic prostate cancer,” says Christopher Sweeney, MBBS, a medical oncologist and professor of medicine at the Dana-Farber Cancer Institute. “The ability to identify these patients at diagnosis is a very important step toward improving patient outcomes and accelerating the inclusion of novel drugs into the standard of care.”

For more information, visit Decipher Biosciences.

Reference

1. Bernstein A. Luminal B subtype as a predictive biomarker of docetaxel benefit for newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC): a correlative study of E3805 Chaarted [press release for session presented by Anis Hamid, MBBS, at the ASCO Genitourinary Cancer Symposium, San Francisco, February 13–15, 2020, online]. UroToday. Available at: www.urotoday.com/conference-highlights/asco-gu-2020/asco-gu-2020-prostate-cancer/119151-asco-gu-2020-luminal-b-subtype-as-a-predictive-biomarker-of-docetaxel-benefit-for-newly-diagnosed-metastatic-hormone-sensitive-prostate-cancer-mhspc-a-correlative-study-of-e3805-chaarted.html. Accessed April 10, 2020.

Featured image: PC-3 human prostate cancer cells, stained with Coomassie blue, under differential interference contrast microscope. Image © Heiti Paves, Dreamstime (ID 71915237).