학술논문

Genetic factors associated with prostate cancer conversion from active surveillance to treatment
Document Type
article
Author
Yu JiangTravis J. MeyersAdaeze A. EmekaLauren Folgosa CooleyPhillip R. CooperNicola LanckiIrene HelenowskiLinda KachuriDaniel W. LinJanet L. StanfordLisa F. NewcombSuzanne KolbAntonio FinelliNeil E. FleshnerMaria KomisarenkoJames A. EasthamBehfar EhdaieNicole BenfanteChristopher J. LogothetisJustin R. GreggCherie A. PerezSergio GarzaJeri KimLeonard S. MarksMerdie DelfinDanielle BarsaDanny VespriniLaurence H. KlotzAndrew LoblawAlexandre MamedovS. Larry GoldenbergCelestia S. HiganoMaria SpillaneEugenia WuH. Ballentine CarterChristian P. PavlovichMufaddal MamawalaTricia LandisPeter R. CarrollJune M. ChanMatthew R. CooperbergJanet E. CowanTodd M. MorganJaved SiddiquiRabia MartinEric A. KleinKaren BrittainPaige GotwaldDaniel A. BarocasJeremiah R. DallmerJennifer B. GordetskyPam SteeleShilajit D. KunduJazmine StockdaleMonique J. RoobolLionne D.F. VenderbosMartin G. SandaRebecca ArnoldDattatraya PatilChristopher P. EvansMarc A. Dall’EraAnjali VijAnthony J. CostelloKen ChowNiall M. CorcoranSoroush Rais-BahramiCourtney PharesDouglas S. ScherrThomas FlynnR. Jeffrey KarnesMichael KochCourtney Rose DhondtJoel B. NelsonDawn McBrideMichael S. CooksonKelly L. StrattonStephen FarriesterErin HemkenWalter M. StadlerTuula PeraDeimante BanionyteFernando J. Bianco, Jr.Isabel H. LopezStacy LoebSamir S. TanejaNataliya ByrneChristopher L. AmlingAnn MartinezLuc BoileauFranklin D. GaylisJacqueline PetkewiczNicholas KirwenBrian T. HelfandJianfeng XuDenise M. ScholtensWilliam J. CatalonaJohn S. Witte
Source
HGG Advances, Vol 3, Iss 1, Pp 100070- (2022)
Subject
prostatic neoplasms
prostate
genome-wide association study
genetics
Genetics
QH426-470
Language
English
ISSN
2666-2477
Abstract
Summary: Men diagnosed with low-risk prostate cancer (PC) are increasingly electing active surveillance (AS) as their initial management strategy. While this may reduce the side effects of treatment for PC, many men on AS eventually convert to active treatment. PC is one of the most heritable cancers, and genetic factors that predispose to aggressive tumors may help distinguish men who are more likely to discontinue AS. To investigate this, we undertook a multi-institutional genome-wide association study (GWAS) of 5,222 PC patients and 1,139 other patients from replication cohorts, all of whom initially elected AS and were followed over time for the potential outcome of conversion from AS to active treatment. In the GWAS we detected 18 variants associated with conversion, 15 of which were not previously associated with PC risk. With a transcriptome-wide association study (TWAS), we found two genes associated with conversion (MAST3, p = 6.9 × 10−7 and GAB2, p = 2.0 × 10−6). Moreover, increasing values of a previously validated 269-variant genetic risk score (GRS) for PC was positively associated with conversion (e.g., comparing the highest to the two middle deciles gave a hazard ratio [HR] = 1.13; 95% confidence interval [CI] = 0.94–1.36); whereas decreasing values of a 36-variant GRS for prostate-specific antigen (PSA) levels were positively associated with conversion (e.g., comparing the lowest to the two middle deciles gave a HR = 1.25; 95% CI, 1.04–1.50). These results suggest that germline genetics may help inform and individualize the decision of AS—or the intensity of monitoring on AS—versus treatment for the initial management of patients with low-risk PC.