|The following article features coverage from the American Urological Association (AUA) 2019 meeting. Click here to read more of Renal & Urology News’ conference coverage.|
CHICAGO—In men on active surveillance (AS) for localized Gleason 3+3 or 3+4 prostate cancer, PSA kinetics (PSAk) correlate with reclassification at biopsy, investigators reported at the 2019 American Urological Association annual meeting.
Lisa Newcomb, PhD, and collaborators from the Fred Hutchinson Cancer Research Center in Seattle evaluated data from the multicenter Canary PASS (Prostate Active Surveillance Study) with protocol-directed biopsies at 6 to 12 months and 24 months after diagnosis, then every 2 years. PSA was measured every 3 months.
Compliance with the protocol-directed biopsy schedule was high. In 851 men with 1750 surveillance biopsies, 78% of biopsies were on time, 11% were early, and 11% were late. A total of 562 men had all surveillance biopsies on time, whereas the vast majority (805 men) had at least 1 surveillance biopsy on time. Overall, 34% of men had reclassification of their cancer at biopsy, including 38% of men with all on-time biopsies and 33% of men with at least 1 on-time biopsy.
PSAk associated with the odds of having an early or late biopsy. Yet in multivariable models restricted to the 562 men with all on-time biopsies, PSAk still significantly and independently associated with double the risk for biopsy reclassification. The investigators adjusted for clinical parameters such as prostate size, time since diagnosis, percentage of positive cores, and prior negative biopsies.
“Many factors, such as PSA and results from prior biopsies, can affect the timing of a biopsy during active surveillance,” Dr Newcomb told Renal & Urology News. “This can result in compromised decision making about continuing surveillance. In the absence of validated risk models, providers should biopsy active surveillance patients on a regular schedule.”
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Newcomb L, Zheng Y, Faino A, et al. Evaluation of Potential bias in risk factor assessment in the CANARY prostate active surveillance study (PASS). Presented at the 2019 American Urological Association annual meeting held May 3-6 in Chicago. Abstract MP48-15.