학술논문

Clinical Outcomes in Cyclin-dependent Kinase 12 Mutant Advanced Prostate Cancer
Document Type
article
Source
European Urology. 77(3)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Oncology and Carcinogenesis
Aging
Prostate Cancer
Urologic Diseases
Clinical Research
Genetics
Cancer
Detection
screening and diagnosis
2.1 Biological and endogenous factors
4.1 Discovery and preclinical testing of markers and technologies
Aetiology
Aged
Cyclin-Dependent Kinases
Humans
Male
Middle Aged
Mutation
Neoplasm Staging
Prostatic Neoplasms
Retrospective Studies
Treatment Outcome
Genomics
Next-generation sequencing
Prostate cancer
Cyclin-dependent kinase 12
Urology & Nephrology
Clinical sciences
Language
Abstract
BackgroundCyclin-dependent kinase 12 (CDK12) loss occurs in 3-7% of metastatic prostate cancer patients and is characterized by a genomic instability signature, but the clinical implications of CDK12 loss are not well established.ObjectiveTo determine the clinical course of patients with CDK12 mutant advanced prostate cancer compared with other genomic subtypes.Design, setting, and participantsA retrospective analysis of data from three academic medical centers, including 317 patients with advanced prostate cancer and prior next-generation sequencing from tumor tissue (n = 172) or circulating tumor DNA (n = 145), was performed. Forty-six patients had CDK12 mutations; 34 had biallelic CDK12 loss (79%).Outcome measurements and statistical analysisPatients were stratified by mutation status (CDK12, homologous recombination deficiency [HRD; BRCA1/2 and ATM], TP53, and other cohort). The Kaplan-Meier method was used to evaluate time to event outcomes: time to development of metastatic disease, time to development of castration resistance, and time to prostate-specific antigen (PSA) progression after first-line androgen receptor pathway inhibitor (ARPI) therapy in a patient subset.Results and limitationsThe median follow-up was 66.6 mo. Patients with CDK12 mutant prostate cancer exhibited shorter time to metastasis (median = 34.9 mo, p =  0.004) and development of castration-resistant disease (median = 32.7 mo, p