Cycle Cell Progression Score Influences Prostate Cancer Treatment Decisions

Rancho Mirage, CA—The cell cycle progression (CCP) score report adds meaningful information for clinicians making treatment decisions for patients with prostate cancer.

That was among the findings of a prospective study conducted by E. David Crawford, MD, and colleagues. Study results were reported during a poster session at the South Central Section of the American Urological Association 93rd Annual Meeting. The poster was titled Cell Cycle Progression (CCP) Score Significantly Modifies Treatment Decisions in Prostate Cancer: Results of an Ongoing Registry Trial.

In combination with standard clinicopathologic parameters, the CCP progression test (Polaris) is a novel prognostic assay that provided accurate risk of disease progression specific to prostate cancer as well as mortality specific to prostate cancer. This ongoing study was designed to assess the impact to the CCP report on clinicians’ treatment recommendations for prostate cancer patients.

Surveys of physicians who ordered the CCP test in clinical practice were conducted. Questions included treatment recommendations prior to and following the receipt of the CCP score and discussions with the patient. Respondents were also asked to rate the influence of the test result on their treatment recommendations. Third-party audits of patient charts after final survey responses were utilized to confirm treatment selections.

Results demonstrated that 65% of cases had a change between treatment that was indicated before and after CCP test score results. Prior to CCP tests, 164 of 305 cases were given recommendations for interventional treatment. Following CCP testing, there was a reduction in the number of cases given interventional treatment (n=103/305 cases).

Prior to CCP testing, 141 of 305 cases were recommended for non-interventional treatment. Of those, 108 continued with non-interventional treatment while 33 were shifted to interventional regimens, an increase of 23.4%. Surgical interventions were reduced by 49.5% and there was a 29.6% reduction in radiation treatment.

The third-party audits identified a concordance of 80.2% between the post-CCP recommendations for treatment and the actual treatment provided. There was general correlation between the reassignment to intervention or non-intervention with the results of the CCP report.

Limitations to the study cited by the authors included physician selection of patients for testing, lack of evaluation of patient input to choice of treatment, and other factors influencing treatment decision making not included in the survey instrument.

In summary, the authors said, “Based on responses of ordering physicians, the CCP report adds meaningful new information to risk assessment for localized prostate cancer patients. Test results led to changes in treatment with reductions and increases in interventional treatment that were directionally aligned with prostate cancer risk specified by the test.”