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CCR score offers treatment guidance for post-radiation prostate cancer

Key clinical point: The clinical cell-cycle risk score (CCR) that combines clinical and genetic factors, was an accurate predictor of metastases risk in prostate cancer patients with intermediate and high-risk disease for whom androgen deprivation therapy (ADT) would provide no additional benefit to radiation therapy (RT).

Major finding: Over a median follow-up of 5.9 years, CCR was a significant predictor of metastases overall (hazard ratio 2.21). Patients with CCR scores either below or above the threshold of 2.112 had a 10-year metastasis risk of 4.2% and 25.3%, respectively; those below the threshold had a 10-year metastasis risk of 4.2% when they received RT alone and 3.9% when they received RT+ADT.

Study details: The data come from a retrospective study of 741 prostate cancer patients with intermediate or high-risk disease who received dose-escalated radiation therapy alone or with androgen deprivation therapy.

Disclosures: The study was supported by Myriad Genetics. Lead author Dr. Tward disclosed relationships with Myriad Genetics, Bayer, Blue Earth Diagnostics, Janssen Scientific Affairs, and Merck.

Commentary

“Ongoing improvements in the accurate prediction of prostate cancer aggressiveness are needed to better select appropriate treatments for patients in order to maximize treatment efficacy while minimizing adverse effects. The clinical cell-cycle risk score (CCR) combines the gene panel-based cell cycle progression score (CCP) with the UCSF Cancer of the Prostate Risk Assessment score (CAPRA). In this study, Tward et al evaluated the performance of the CCR in a retrospective cohort of patients who received radiation therapy (RT) with or without androgen deprivation therapy (ADT). The CCR was a better predictor of metastases than the CCP, CAPRA, or National Comprehensive Cancer Network risk group scores. While promising, large prospective studies are needed to assess the performance of the CCP more definitively.”

Mark Klein, MD

Citation:

Tward JD et al. 2021 Genitourinary Cancers Symposium, Abstract 195.