Observational studyBritish journal of cancer2026
Molecular reflex testing in patients with early metastatic castration-resistant prostate cancer within the PROMPT-study.
Observational study in British journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04746300 (imPlementing ROutine Molecular Characterization in Patients With Metastatic Castration-resistant ProsTate Cancer by Next Generation DNA Sequencing), which is not on this map. Not yet cited in PubMed.
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imPlementing ROutine Molecular Characterization in Patients With Metastatic Castration-resistant ProsTate Cancer by Next Generation DNA Sequencing (PROMPT-study)
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Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrecision oncology using genotype-matched treatments (GMT) offers potential to improve survival in metastatic castration-resistant prostate cancer (mCRPC). PATIENT AND
methodsIn the PROMPT study (NCT04746300), reflex tumour testing through next-generation sequencing was performed in treatment-naïve or first-line mCRPC patients. All patients received a molecular tumour board (MTB) recommendation for GMT based on predefined druggable targets (DT). The main objective was to identify clinicopathological variables associated with DT.
resultsAnalysis included 340 tissue samples from 307 patients, 51% of samples were newly biopsied. Valid results were generated in 84% (76% new, 92% archived; P < 0.01). DT were identified in 39% of the patients, with PI3K-AKT (26%) and Homologous Recombination (HR; 21%) pathways most frequently affected. Metastatic tissue, especially from mCRPC setting (P < 0.01), yielded higher GMT recommendations than primary tissue (P = 0.03). HR-associated genes were linked with shorter ADT-to-CRPC time (OR 3.77, 95%CI 1.62-10.32, P < 0.01). PI3K-AKT alterations were associated with metachronous metastatic disease (OR 0.48, 95%CI 0.26-0.89, P = 0.021) and longer time to CRPC (OR 0.47, 95%CI 0.25-0.87, P = 0.017). No distinct variables predicted DT genotypes.
conclusionMolecular tumour testing should preferably be done on metastatic mCRPC tissue. No combination of features could robustly identify druggable genotypes; therefore, reflex molecular characterisation should be routine for every mCRPC patient.
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