Point-Counterpoint: Oncotype Dx Genomic Prostate Score in Active Surveillance - Canary PASS Study

Grand Rounds in Urology presents a special three-part Point-Counterpoint on GPS in active surveillance.
Pro: Daniel W. Lin, MD, Pritt Family Endowed Chair for Prostate Cancer Research at the University of Washington School of Medicine, discusses recent results of Canary PASS (Prostate Active Surveillance Study), which looked at the ability of the Oncotype DX genomic prostate score (GPS) to predict adverse pathology (AP) in patients with low-risk prostate cancer treated with immediate surgery. The study demonstrated no significant link between GPS and adverse pathology in the cohort, specifically at surgery or during subsequent upgrading during biopsy when considered along with other clinical variables in the model.
Con: Eric A. Klein, MD, Andrew C. Novick Distinguished Chair of the Glickman Urological and Kidney Institute and Professor of Surgery in the Lerner College of Medicine of the Cleveland Clinic, provides a counterpoint to the results discussed by Dr. Lin on the Canary PASS study. He focuses on how the results of the study are at odds with a recent study that showed a higher Oncotype DX genomic prostate score (GPS) is associated with an increase in adverse pathology (AP), as well as biochemical recurrence following radical prostatectomy. Dr. Klein further examines differences between the studies, including how the pathology was read, relatively small event rate, as well as the effects of focusing on a mostly low-risk population. He also reviews unpublished data on the original OncotypeDX cohort that may suggest a stronger connection between GPS score and AP.
For the full point/counterpoint and Q&As, please view this post on our website: grandroundsinu...