Scottsdale, Arizona—In combination with standard clinicopathologic parameters, the cell cycle progression (CCP) risk assessment score is a validated assay that provides an estimate of the risk of progression of prostate cancer–specific disease and mortality. PROCEDE-1000 is a large, clinically controlled, prospective registry designed to evaluate the impact of the CCP test toward personalization of treatment for prostate cancer.
Neal Shore, MD, and colleagues presented results of the final analysis of the 1206 patients in the PROCEDE-1000 trial during a poster session at the 94th Annual Meeting of the South Central Section of the American Urological Association. The poster was titled Significant Reduction in Therapeutic Burden from Use of CCP Test in Treatment Decisions among Newly Diagnosed Prostate Cancer Patients in a Large Prospective Registry.
Untreated patients whose diagnosis of clinically localized prostate adenocarcinoma was made within the prior 6 months were enrolled in PROCEDE-1000. The pre-CCP physician recommendations regarding therapy decisions based on clinicopathologic parameters were recorded on the initial questionnaire. The CCP test was then conducted on prostate biopsy tissue.
The physician’s revised treatment recommendation, physician/patient agreed upon treatment decision, and the actual treatment administered were recorded on three consecutive post-CCP questionnaires. The impact of CCP testing on treatment decisions at each stage was assessed by changes in treatment between the pre-CCP recommendations and post-CCP questionnaires.
The final analysis of data demonstrated a significant reduction in the treatment burden recorded at each successive evaluation (P<.001). Mean number of treatments per patient decreased from 1.72 prior to the CCP test to 1.16 in actual follow-up.
The CCP risk score was associated with a change in therapy recommendation in 48% of patients. Of those changes, 72% were in reductions in treatment. The reductions were in radical prostatectomy (34%), radiation therapy (39% primary; 55% adjuvant), brachytherapy (46% interstitial; 63% high-dose rate), and hormonal therapy (30% neoadjuvant; 50% concurrent) treatments.
Pre-CCP, conservative management was recommended for 34.6% of patients (n=417/1206); during actual follow-up, a further increase of 2.6% overall was recorded for non-interventional treatments.
“The CCP risk assessment score has a significant impact in helping physicians and patients reach consensus on an appropriate personalized treatment decision, often with major reductions in interventional treatment burden,” the researchers said.
Source: Shore N, Boczko J, Kella N, et al. Significant reduction in therapeutic burden from use of CCP test in treatment decisions among newly diagnosed prostate cancer patients in a large prospective registry. Abstract of a poster presented at the 94th Annual Meeting of the South Central Section of the American Urological Association, October 29, 2015, Scottsdale, Arizona.