Key PointsQuestionDoes inheritance of the adrenal-permissive HSD3B1(1245C) allele indicate probable worse clinical outcomes in men treated with androgen deprivation therapy with or without docetaxel for metastatic castration-sensitive prostate cancer? FindingsIn this study including 475 genotyped white men with metastatic prostate cancer treated in the E3805 Chemohormonal Therapy vs Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer trial, the adrenal-permissive genotype (ie, inheritance of ≥1 HSD3B1[1245C] allele) was associated with significantly shorter time to castration-resistant disease and significantly lower overall survival in men with low-volume disease. There was no association between genotype and outcomes in men with high-volume disease. MeaningThe adrenal-permissive genotype is associated with inferior outcomes in low-volume metastatic prostate cancer and may help identify patients who could benefit from escalated therapy.
JAMA Oncology – American Medical Association
Published: Apr 13, 2020
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