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    Prostate cancer risk category changes often when CCP is assessed

    Bethesda, MD—Risk classification changed in more than half of prostate cancers following assessment of cell cycle progression (CCP) in tumors, researchers reported at the 2013 Society of Urologic Oncology meeting in Bethesda, MD.

    Almost 30% of men had more aggressive tumors by CCP score, and 27% had less aggressive tumors, as compared with the AUA risk category.

    “The CCP test allows for personalized risk stratification and identifies men who are good candidates for active surveillance or those who are likely to fail monotherapy and need more aggressive management,” E. David Crawford, MD, head of urologic oncology at the University of Colorado in Aurora, and colleagues concluded in a poster presentation.

    In a second study reported at the meeting, CCP scores showed that 55% of almost 300 prostate cancer patients had a higher or lower mortality risk than their physicians expected. Questionnaires completed by treating physicians suggested that the test results possibly or definitely would have changed treatment decisions in one-third of cases.

    Dr. Crawford reported findings from an evaluation of a commercial version of the CCP test (Prolaris, Myriad Genetics, Salt Lake City, UT), using prostate biopsy specimens obtained from 1,813 men with newly diagnosed prostate cancer. The test measures RNA expression by a panel of 31 cell-cycle genes, normalized to 15 housekeeping genes. Expression patterns translate into prostate cancer risk scores. Each one-unit increase in CCP score represents approximately a doubling in the risk of recurrence or prostate cancer death.

    From CCP scores of about 1,200 men from multiple cohorts, investigators developed a relative classification of cancer aggressiveness to compare CCP scores with men in the same AUA risk category. CCP scores had a normal distribution range of –2.9 to +3.1.

    CCP scores classify patients into five risk groups corresponding to the AUA risk category (low, intermediate, or high). Intervals between risk categories are one unit of CCP score apart, and the “consistent” interval is centered at the median CCP score. The five CCP score categories ranged from “Considerably Less Aggressive” than the AUA risk category to “Considerably More Aggressive.”

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