The impact of SPOP gene alterations in men with metastatic prostate cancer: Results from the Prostate Cancer Precision Medicine Multi-Institutional Collaborative Effort (PROMISE) consortium.

Authors

null

Kyra Lee Yamamoto

Moores Cancer Center at UC San Diego Health, La Jolla, CA

Kyra Lee Yamamoto , Nicholas Henderson , Clara Hwang , Pedro C. Barata , Mehmet Asim Bilen , Deepak Kilari , Laura Graham , Rohan Garje , Shoshana Rothstein , Vadim S Koshkin , Abhishek Tripathi , Frank Cameron Cackowski , Jones T. Nauseef , Michael Thomas Schweizer , Andrew J. Armstrong , Tanya B. Dorff , Ajjai Shivaram Alva , Rana R. McKay

Organizations

Moores Cancer Center at UC San Diego Health, La Jolla, CA, Department of Biostatistics, University of Michigan, Ann Arbor, MI, Division of Hematology/Oncology, Department of Internal Medicine, Henry Ford Cancer, Detroit, MI, University Hospitals Seidman Cancer Center, Cleveland, OH, Winship Cancer Institute of Emory University, Atlanta, GA, Department of Medicine, Medical College of Wisconsin Cancer Center, Medical College of Wisconsin, Milwaukee, WI, University of Colorado Cancer Center Anschutz Medical Campus, Aurora, CO, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, Karmanos Cancer Institute, Wayne State University, Detroit, MI, Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, Helen Diller Family Cancer Center, San Francisco, CA, University of Oklahoma, Norman, OK, Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, Division of Hematology & Medical Oncology, Weill Cornell Medicine; Sandra and Edward Meyer Cancer Center, New York, NY, University of Washington/Fred Hutchinson Cancer Center, Seattle, WA, Division of Medical Oncology, Duke University Medical Center, Duke Cancer Institute Center, Durham, NC, Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI

Research Funding

No funding sources reported

Background: Inactivating mutations in the SPOP gene, encoding speckled-type poxvirus and zinc-finger protein, are common among men with localized and metastatic prostate cancer, occurring at a frequency of 6-15%. Previous studies have suggested the presence of an inactivating mutation in SPOP results in increased sensitivity to androgen deprivation therapy (ADT). In this multi-institutional clinical-genomic database, we evaluated the impact of SPOP alterations on survival outcomes in men with metastatic prostate cancer. Methods: Retrospective data from the PROMISE Consortium were utilized for this analysis. Eligible patients had metastatic prostate cancer and had undergone standard of care next-generation sequencing (NGS). Patients with inactivating mutations in SPOP were defined as SPOP mutated, where. as those lacking such alterations were defined as SPOP wild-type. The primary endpoint was overall survival defined as the time from diagnosis of metastatic prostate cancer to death from any cause, censored at the date of last follow-up. Secondary endpoints included time from metastatic disease to castration resistance and time from castration resistance to death. Results: Of the 2097 patients with available NGS testing, 5.5% (n=115) had SPOP alterations. The median age at diagnosis was 63 years, 427 were Black, and 83 were Hispanic. At last assessment, 66% had bone metastases, 7% lung metastases, and 5% liver metastases. The most frequent co-occurring alterations in the SPOP-mutated group were: TP53 (30.4%), APC (25.2%), and AR (21.7%). 1832 patients were included in the survival analysis [n=96 (5.2%) with and n=1736 (94.8%) without SPOP alterations]. Median overall survival was numerically longer, though not statistically significant, in the SPOP-mutated compared SPOP-wild-type group (75.9 versus 59.5 months, p=0.12). In patients with metastatic disease, median time to castration resistance was 14.6 months in the SPOP-mutated group versus 12.2 months in the SPOP-wild-type group (p=0.30). Median time from metastatic castration resistant to death was 45.0 months in the SPOP-mutated group and 40.2 months in the SPOP-wild type group. Conclusions: Our hypothesis generating data support that SPOP-mutated prostate cancer likely represents a unique molecular subtype of prostate cancer that may confer prolonged survival. Future studies of novel androgen-receptor targeting treatments should be tested in this molecular population.

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Abstract Details

Meeting

2024 ASCO Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Other

Citation

J Clin Oncol 42, 2024 (suppl 4; abstr 225)

DOI

10.1200/JCO.2024.42.4_suppl.225

Abstract #

225

Poster Bd #

K13

Abstract Disclosures

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