Abstract
BACKGROUND: Castration-resistant prostate cancer (CRPC) represents a significant difficulty in oncology, with limited treatment options and decreasing survival rates. The comprehensive genomic profiling (CGP) test has appeared as a promising tool for personalizing treatment according to the genetic characteristics of tumors. In Japan, the incidence of prostate cancer (PC) has sharply increased, making it crucial to investigate effective therapies informed by genomic data. METHODS: This study retrospectively analyzed data from 30 patients who underwent the CGP test at Kanazawa University from March 2020 to February 2024. Patient information, including age, clinical stage, and previous treatments, was collected. The CGP tests were conducted on the tumor and blood specimens using FoundationOne® CDx. Survival analysis was conducted using the Kaplan-Meier method, with a significance level set at a p-value of <0.05. RESULTS: Genomic mutations were detected in 27 patients (90%), predominantly TP53 (19 cases) and PTEN mutations (10 cases). Five patients received treatment based on the CGP results but with no significant difference in overall survival (OS) between the treated and untreated groups (p = 0.72). Notably, patients with CDK12 mutations demonstrated a significantly shorter OS (p = 0.032). Pembrolizumab in cases with high tumor mutation burden exhibited limited efficacy. CONCLUSIONS: The CGP test revealed critical genetic mutations in patients with CRPC and highlighted the poor prognosis associated with CDK12 mutations. The results underscore the necessity for novel therapies tailored to these genetic profiles, emphasizing the role of the CGP in improving treatment personalization.