title: Biopsy Based Proteomic Assay Predicts Risk of Biochemical Recurrence after Radical Prostatectomy.
abstract: Current clinicopathological parameters are insufficient to predict the likelihood of biochemical recurrence in patients with prostate cancer after radical prostatectomy. Such information may help identify patients who would likely benefit from adjuvant radiotherapy rather than active surveillance. A multiplex proteomic assay, previously tested on biopsies and found to be predictive of favorable or unfavorable pathology at radical prostatectomy, was assessed for its predictive value to identify patients at higher risk for biochemical relapse.
  
  
  
  Proteomic assays from core needle biopsies of 288 men who subsequently underwent radical prostatectomy at CHUM (Centre hospitalier de l'Université de Montréal) were evaluated for the prediction of subsequent biochemical recurrence.
  
  
  
  Of the 288 men, biochemical relapse was observed in 47 (16.3%) and metastases were found in 5 (1.7%). Median followup was 68.5 months. The proteomic assay clearly separated patients into 3 categories, including those at low, intermediate and high risk for biochemical relapse (p = 0.0007). Assay scores predicted biochemical relapse on univariate analysis (HR 1.724, p = 0.0002 per 20% change in score), significantly better than other preoperative prognostic parameters. Additionally, the assay score had a significantly higher p value when combined with clinical National Comprehensive Cancer Network® stage compared to stage alone (HR 1.579, p = 0.0017 per 20% change in score).
  
  
  
  A protein based assay score derived from diagnostic needle biopsy has strong predictive ability for biochemical relapse after surgery. These results suggest that this assay score can be used at the diagnostic stage to identify patients in whom prostate cancer is potentially more biologically aggressive and active treatment should be considered.
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Université de Montréal Endowed Chair in Prostate Cancer, Montreal, Quebec, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, Quebec, Canada; Department of Surgery, Université de Montréal, Montreal, Quebec, Canada. Electronic address: fred.saad@umontreal.ca.
authors.forename: Fred
authors.initials: F
authors.lastname: Saad
authors.affiliation: Université de Montréal Endowed Chair in Prostate Cancer, Montreal, Quebec, Canada; Department of Pathology and Cellular Biology, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Latour
authors.affiliation: Centre de recherche du Centre Hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, Quebec, Canada; Department of Surgery, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Lattouf
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Department of Surgery, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Hugues
authors.initials: H
authors.lastname: Widmer
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Department of Surgery, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Zorn
authors.affiliation: Centre de recherche du Centre Hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, Quebec, Canada; Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Mes-Masson
authors.affiliation: Centre de recherche du Centre Hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, Quebec, Canada.
authors.forename: Veronique
authors.initials: V
authors.lastname: Ouellet
authors.affiliation: Centre de recherche du Centre Hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, Quebec, Canada.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Saad
authors.affiliation: Metamark Genetics, Inc., Cambridge, Massachusetts.
authors.forename: Amol
authors.initials: A
authors.lastname: Prakash
authors.affiliation: Metamark Genetics, Inc., Cambridge, Massachusetts.
authors.forename: Sibgat
authors.initials: S
authors.lastname: Choudhury
authors.affiliation: Metamark Genetics, Inc., Cambridge, Massachusetts; Department of Epidemiology and Biostatistics, Texas A&M University, College Station, Texas.
authors.forename: Gang
authors.initials: G
authors.lastname: Han
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Karakiewicz
authors.affiliation: Metamark Genetics, Inc., Cambridge, Massachusetts.
authors.forename: Jerome P
authors.initials: JP
authors.lastname: Richie
mesh_terms: D001706:Biopsy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D040901:Proteomics; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen
keywords: biomarkers; biopsy; cancer; local; neoplasm recurrence; prostatic neoplasms; watchful waiting