Eur Urol Open Sci: Lower blood LRG1 levels predict patients at high risk of progression to castration-resistant prostate cancer

After radical prostatectomy (RP), up to 40% of prostate cancer (PCa) patients will experience biochemical failure (BF).

Despite salvage therapy, approximately one-third of these patients require permanent hormone therapy (pHT) and are at risk
of progressing to castration-resistant PCa (CRPC).
Prognostic markers predict the need for neoadjuvant, adjuvant, or multimodal therapy
.

Recently, researchers from Norway published an article in Eur Urol Open Sci to evaluate the added value of blood LRG1 in predicting treatment failure in patients undergoing radical prostatectomy (RP).

The researchers presented a survey of data from Martini-Klinik (Martini; n=423), the Danish CuPCa queue (CuPCa; n=182) and Oslo University Hospital (OUH; n=145) patients were analyzed to quantify LRG1 levels
in serum or plasma collected prior to their radical prostatectomy.
The endpoints of the study were BF, pHT and CRPC
.
The relationship
between LRG1 and survival outcomes was evaluated using Kaplan-Meier estimation and Cox proportional hazards models.
In the nested model, the additional predictive value
of LRG1 is estimated by the consistency index, the area under the time-dependent receiver operation characteristic curve, and the decision curve analysis.

In a multivariate Cox model using preoperative features, LRG1 was associated with
lower risk estimates of BF in the Martini cohort (adjusted hazard ratio [aHR] 0.
68, 95% confidence interval [CI] 0.
52-0.
90) and CuPCa cohort (aHR 0.
47, 95% CI 0.
30-0.
73).
。 Data using preoperative prognostic variables showed that LRG1 doubling was associated with a lower risk of pHT in the CuPCa cohort (aHR 0.
43, 95% CI 0.
20-0.
93) and with the development of CRPC in the OUH cohort (aHR 0.
32, 95% CI 0.
15-0.
69).

Similar aHR values
were observed using preoperative or postoperative variables in all endpoints.

Summary of preoperative and postoperative clinical models of multivariate Cox proportional risk

In summary, patients with PCa with high LRG1 levels have a lower
risk of BF, pHT, and progression to CRPC.
Therefore, LRG1 is prognostic and should be added to a new combination of prognostic factors in future studies
.

Original source:

Ingrid Jenny Guldvik， Peder Rustøen Braadland， Shivanthe Sivanesan et al.
Low Blood Levels of LRG1 Before Radical Prostatectomy Identify Patients with High Risk of Progression to Castration-resistant Prostate Cancer.
Eur Urol Open Sci.
Oct 2022.