The source of tissue for genomic profiling of metastatic castration-resistant prostate cancer (mCRPC) is often limited to osseous metastases. To guide patient management, metastatic site selection and the technique for targeted bone biopsies are critical for identifying deleterious gene mutations. Our objective was to identify key parameters associated with successful large-panel DNA sequencing.
We analyzed parameters for 243 men with progressing mCRPC who underwent 269 bone biopsies for genomic profiling between 2014 and 2018. Univariate and multivariate analyses were performed for clinical, imaging (bone scan; fluorodeoxyglucose [FDG] positron emission tomography [PET]; computed tomography [CT]; magnetic resonance imaging), and technical (biopsy site, number of samples, needle gauge) features associated with successful genomic profiling.
Overall, 159 of 269 biopsies (59%) generated sufficient tumor material for a genomic profile. Seventy (26%) of the failures were histopathologically negative for mCRPC and 40 (15%) had insufficient tumor for genomic profiling. Of 199 mCRPC samples submitted for molecular testing, 159 (80%) yielded a genomic profile. On univariate analysis, PSA, serum acid phosphatase, number of biopsy samples, FDG PET positivity, CT attenuation, and CT morphology were significantly associated with genomic profiling success. On multivariate analysis, higher FDG maximum standardized uptake value (odds ratio [OR] 7.51, 95% confidence interval [CI] 3.01-18.78; p < 0.001), higher number of biopsy samples (OR 4.73, 95% CI 1.49-15.02; p = 0.008), and lower mean CT attenuation (OR 0.4, 95% CI 0.18-0.89; p = 0.025) were significantly associated with sequencing success.
In patients with mCRPC, bone biopsies from sites with metabolic activity and lower CT attenuation are associated with higher success rates for genomic profiling via a large-panel DNA sequencing platform.
We identified factors associated with successful genetic testing of bone tissue for patients with metastatic prostate cancer. Our findings may help in guiding the right scan technique and biopsy site for personalized treatment planning.
European urology oncology. 2024 Aug 01 [Epub ahead of print]
Fourat Ridouani, H Alberto Vargas, Daniel J Holzwanger, Heiko Schöder, Emily Waters, Elena N Petre, Axel Martin, Jaya Satagopan, Mithat Gonen, Karen A Autio, Yu Chen, Susan F Slovin, Daniel C Danila, Michael J Morris, Howard I Scher, Maria E Arcila, Stephen B Solomon, Jeremy C Durack
Department of Radiology, Interventional Radiology Division, Memorial Sloan Kettering Cancer, New York, NY, USA., Department of Radiology, Oncologic Imaging Division, NYU Langone, New York, NY, USA., Department of Radiology, Interventional Radiology Division, Weill Cornell Medicine, New York, NY, USA., Department of Radiology, Molecular Imaging and Therapy Division, Memorial Sloan Kettering Cancer, New York, NY, USA., Department of Medicine, Genitourinary Oncology Division, Memorial Sloan Kettering Cancer, New York, NY, USA., Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer, New York, NY, USA., Department of Biostatistics and Epidemiology, Rutgers School of Public Health, New Brunswick, NJ, USA., Department of Pathology, Memorial Sloan Kettering Cancer, New York, NY, USA., Department of Radiology, Interventional Radiology Division, Memorial Sloan Kettering Cancer, New York, NY, USA; Department of Radiology, Interventional Radiology Division, Veterans Administration Hospital, Palo Alto, CA, USA. Electronic address: .