Japanese journal of clinical oncology · 2026
Real-world insights from comprehensive genomic profiling in patients with metastatic castration-resistant prostate cancer.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Yasuda Yosuke, Yoshida Soichiro, Ikeda Sadakatsu, Yonese Ichiro, Sano Yuta, Urasaki Tetsuya, Nakamura Yuki, Tanaka Hajime, Ito Masaya, Miura Yuji, Numao Noboru, Matsuoka Yoh, Koga Fumitaka, Yonese Junji, Fujii Yasuhisa
Аннотация
INTRODUCTION: Comprehensive genomic profiling (CGP) has expanded treatment options for metastatic castration-resistant prostate cancer (mCRPC); however, real-world data on its clinical utility in Japanese patients remain limited. To address this gap, we conducted a multicenter real-world analysis to evaluate the implementation and clinical relevance of CGP in Japanese patients with mCRPC.
METHODS: We retrospectively analyzed 128 patients with mCRPC who underwent CGP at four Japanese institutions using FoundationOne® CDx, FoundationOne® Liquid CDx, or OncoGuide™ NCC Oncopanel. We assessed the prevalence of druggable genomic signatures, including BRCA pathogenic variants (PVs), microsatellite instability-high (MSI-high), and tumor mutational burden-high (TMB-high), and described subsequent use of genomically matched therapies.
RESULTS: The median age at CGP testing was 73 years, and patients had received a median of three prior systemic treatment lines. BRCA PVs were identified in 18 patients (14%), MSI-high in 4 (3%), and TMB-high in 11 (9%); all MSI-high cases were also TMB-high. Overall, 26 patients (20%) harbored either BRCA PVs or TMB-high status. Among these, 14 patients (54%) received matched targeted therapies, including poly(ADP-ribose) polymerase inhibitors or pembrolizumab. BRCA PVs were detected in 17% of tissue-based (F1 CDx) assays and 9% of liquid-based assays, without a statistically significant difference.
CONCLUSIONS: CGP identified BRCA PVs, MSI-high, or TMB-high in 20% of patients with metastatic CRPC, supporting its value in guiding precision oncology. However, only some patients received matched therapy, supporting earlier CGP testing. Routine integration of CGP may facilitate precision oncology-guided treatment decision-making in this population.
METHODS: We retrospectively analyzed 128 patients with mCRPC who underwent CGP at four Japanese institutions using FoundationOne® CDx, FoundationOne® Liquid CDx, or OncoGuide™ NCC Oncopanel. We assessed the prevalence of druggable genomic signatures, including BRCA pathogenic variants (PVs), microsatellite instability-high (MSI-high), and tumor mutational burden-high (TMB-high), and described subsequent use of genomically matched therapies.
RESULTS: The median age at CGP testing was 73 years, and patients had received a median of three prior systemic treatment lines. BRCA PVs were identified in 18 patients (14%), MSI-high in 4 (3%), and TMB-high in 11 (9%); all MSI-high cases were also TMB-high. Overall, 26 patients (20%) harbored either BRCA PVs or TMB-high status. Among these, 14 patients (54%) received matched targeted therapies, including poly(ADP-ribose) polymerase inhibitors or pembrolizumab. BRCA PVs were detected in 17% of tissue-based (F1 CDx) assays and 9% of liquid-based assays, without a statistically significant difference.
CONCLUSIONS: CGP identified BRCA PVs, MSI-high, or TMB-high in 20% of patients with metastatic CRPC, supporting its value in guiding precision oncology. However, only some patients received matched therapy, supporting earlier CGP testing. Routine integration of CGP may facilitate precision oncology-guided treatment decision-making in this population.