MP45-10: Does Perioperative Testosterone predict Post-Prostatectomy Genomic Risk Score?

mohammed Shahait*, Amman, Jordan, Joseph G. Cheaib, Baltimore, MD, Elai Davicioni, Yang Liu, san Francisco , CA, Ibrahim Abu Ghaida, Abu Dhabi, United Arab Emirates, Ryan Dobbs, Chicago, IL, Priti Lal, Daniel Lee, philadelphia, PA, PA, David Lee, Irvine, CA

Introduction: The association between low serum testosterone and high-grade disease, advanced pathologic stage, and biochemical recurrence (BCR) following radical prostatectomy (RP), was observed in several cohorts. The effect of T on the tumor genome is not explored yet. To explore the correlation between perioperative T level on genomic risk score (GRS) in a cohort of men who underwent RP.

Methods: We included Pts who underwent RARP (2013-2018) & have(positive margin, and/or pT3a or higher).The outcome of interest was the GRS: low( <0.45), intermediate(0.45-0.6), & high (>0.6). Pts were categorized into: low ( <230), intermediate (230-350), & normal (>350). The associations between serum T level and 188 gene expression-based signatures retrieved from the Decipher GRID database were  examined. Secondary outcomes of interest included BCR & receipt of secondary treatment.

Results: The median GRS score was lower in the low T group compared to the intermediate & normal T groups (0.38 Vs. 0.52 Vs. 0.53, respectively; p=0.049).However, when Pts were stratified into low-, intermediate-, and high-risk GRS groups, no differences of the categorical GRS groups was observed .A total of 63 (18.6%) Pts developed BCR. There was no difference in BCR-free survival between the three T groups (p=0.9) .Pts with low T level had significantly higher odds of receiving secondary treatment (OR: 2.27; 95% CI: 1.14-4.50; p=0.02) as compared to Pts with a normal T level .A total of 43 (of 188) gene expression signatures were associated with T level (p < 0.05). 33 signatures were positively associated with serum T levels including 12 signatures involved in DNA repair pathways.

Conclusions: This is the first study to assess the correlation of pre-operative T level on the tumor transcriptome and showed that no  clinical correlation between pre-defined GRS groups and T group. Having said that, this study adds to the notion of the limited role of endogenous T on the development of de novo localized Pca.

Source of Funding: None