Stratification of risk for patients with prostate cancer at biopsy using CCP score.

Genitourinary Cancer
Session Type and Session Title: 
General Poster Session A: Prostate Cancer
Abstract Number: 
J Clin Oncol 31, 2013 (suppl 6; abstr 127)
Neal D. Shore, Brian Abbott, Raoul S. Concepcion, Daniel Saltzstein, Rajesh R. Kaldate, Kelsey Moyes, Arletta van Breda, Christopher Clark, Jennifer Saam, Michael K. Brawer; Carolina Urologic Research Center, Myrtle Beach, SC; Myriad Genetic and Laboratories, Inc., Salt Lake City, UT; Urology Associates, Nashville, TN; Urology San Antonio, San Antonio, TX; The CSSP Group, LLC, Annandale, VA

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).

Abstract Disclosures


Background: In the US, most prostate cancers are treated with surgery or radiation, despite many having low malignant potential. If low cancer progression risk can be established, some men can be spared treatment. PSA, Gleason score and clinical stage work well for population risk assessment but lack precision for individuals. Molecular analysis can refine risk assessment as demonstrated by a cell cycle progression score (CCP) predictive of prostate cancer aggressiveness in 4 separate cohorts. In these studies, CCP typically ranged from −2 to +3 with each 1−unit increase corresponding to approximately a doubling of risk. We characterized the CCP distribution using recent samples from a typical US urology multi−centered clinical setting and determined the analytic success rate of the assay. Methods: Formalin fixed, prostate biopsy tissue from 300 patients diagnosed with adenocarcinoma within the last 12 months was analyzed. CCP is calculated by measuring the relative RNA expression of 31 cell cycle progression genes. Patients were recruited from 15 geographically diverse community urology practices. Results: CCP could be measured for 98% of samples (294/300). This study showed a normal distribution for the CCP ranging from −2 to 3.2 (median = −0.3, SD=0.92). There was little correlation of CCP with PSA, age, or body mass index. Correlation with Gleason score was similar to those in prior studies (r=0.494). A relative classification of cancer aggressiveness based on CCP of ~ 1200 patients from multiple cohorts has been developed. The 294 evaluable patients were cross−classified by AUA risk and cancer aggressiveness (see table). CCP further stratified patients within each AUA risk classification. Conclusions: CCP is a novel assay that can facilitate risk stratification for men with prostate adenocarcinoma.

Cancer aggressiveness based on CCP scores.
AUA risk
Consistent More
Low 3 (6.1%) 27 (55.1%) 18 (36.7%) 1 (2.1%) 0 (0.0%) 49
Intermediate 1 (1.0%) 36 (35.3%) 46 (45.1%) 16 (15.7%) 3 (2.9%) 102
High 9(6.3%) 33 (23.1%) 52 (36.3%) 34 (23.8%) 15 (10.5%) 143
Row totals 13 96 116 51 18 294