Real-world utilization, patient characteristics, and treatment patterns among men with localized prostate cancer tested with the 17-gene genomic prostate score® (GPSTM) assay.

The Prostate Pub Date : 2024-04-26 DOI:10.1002/pros.24709
Amy M Nguyen, Gebra Cuyun Carter, Lesley-Ann Miller Wilson, Steven Canfield
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Abstract

OBJECTIVES Descriptive study focusing on real-world utilization and characteristics of men with prostate cancer tested with the 17-gene Genomic Prostate Score® (GPS™) assay by linking administrative claims and electronic health record (EHR) data with GPS results. METHODS This retrospective, observational cohort study (January 1, 2013 to December 31, 2020) included men aged 40-80 years with localized prostate cancer claims, continuous enrollment in Optum's Integrated Claims data set, ≥1 day of EHR clinical activity, and a GPS result. Men were classified as undergoing definitive therapy (DT) (prostatectomy, radiation, or focal therapy) or active surveillance (AS). AS and DT distribution were analyzed across GPS results, National Comprehensive Cancer Network® (NCCN®) risk, and race. Costs were assessed 6 months after the first GPS result (index); clinical outcomes and AS persistence were assessed during the variable follow-up. All variables were analyzed descriptively. RESULTS Of 834 men, 650 (77.9%) underwent AS and 184 (22.1%) DT. Most men had Quan-Charlson comorbidity scores of 1-2 and a tumor stage of T1c (index). The most common Gleason patterns were 3 + 3 (79.6%) (AS cohort) and 3 + 4 (55.9%) (DT cohort). The mean (standard deviation) GPS results at index were 23.2 (11.3) (AS) and 30.9 (12.9) (DT). AS decreased with increasing GPS result and NCCN risk. Differences between races were minimal. Total costs were substantially higher in the DT cohort. CONCLUSIONS Most men with GPS-tested localized prostate cancer underwent AS, indicating the GPS result can inform clinical management. Decreasing AS with increasing GPS result and NCCN risk suggests the GPS complements NCCN risk stratification.
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使用 17 基因前列腺基因组评分® (GPSTM) 检测局部前列腺癌男性患者的实际使用情况、患者特征和治疗模式。
目的通过将行政索赔和电子病历 (EHR) 数据与 GPS 结果联系起来,对使用 17 基因前列腺基因组评分® (GPS™) 检测前列腺癌男性患者的实际使用情况和特征进行描述性研究。方法这项回顾性、观察性队列研究(2013 年 1 月 1 日至 2020 年 12 月 31 日)纳入了年龄在 40-80 岁、有局部前列腺癌索赔、连续加入 Optum 综合索赔数据集、电子病历临床活动≥1 天且有 GPS 结果的男性。男性被分为接受确定性治疗 (DT)(前列腺切除术、放射治疗或病灶治疗)或积极监护 (AS)。根据 GPS 结果、国家综合癌症网络® (NCCN®) 风险和种族对 AS 和 DT 的分布情况进行了分析。在首次 GPS 结果(指数)出来 6 个月后对成本进行评估;在可变随访期间对临床结果和 AS 持续性进行评估。结果 在 834 名男性中,650 人(77.9%)接受了 AS 治疗,184 人(22.1%)接受了 DT 治疗。大多数男性的Quan-Charlson合并症评分为1-2分,肿瘤分期为T1c(指数)。最常见的格里森模式为 3 + 3(79.6%)(AS 队列)和 3 + 4(55.9%)(DT 队列)。索引时的 GPS 结果平均值(标准差)为 23.2(11.3)(AS)和 30.9(12.9)(DT)。AS随着GPS结果和NCCN风险的增加而降低。不同种族之间的差异很小。结论大多数通过 GPS 检测的局部前列腺癌患者都接受了 AS,这表明 GPS 结果可以为临床管理提供参考。随着GPS结果和NCCN风险的增加,AS的减少表明GPS是对NCCN风险分层的补充。
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