Evidence map›Paper›PMID 41649471›Full record

ArticleThe oncologist2026

Tumor suppressor genes, treatments, and survival in US veterans with prostate cancer.

Krishny Karunanandaa, Eric Marshall Knoche, Robert Bruce Montgomery, Carley Pickett, Jason Doherty, Joshua Gruber, Ruben Raychaudhuri, Daniel Eaton, Isla P Garraway, Matthew B Rettig and 2 more

Abstract read
In one paragraph

Article in The oncologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Krishny KarunanandaaDepartment of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, United States.ORCID 0000-0001-9990-0356
Eric Marshall KnocheResearch Service, Veterans Affairs Saint Louis Medical Center, St. Louis, MO, St. Louis, MO 63110, United States.
Robert Bruce MontgomeryFred Hutch Cancer Center, Seattle, WA 98109, United States.
Carley PickettDepartment of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, United States.
Jason DohertyResearch Service, Veterans Affairs Saint Louis Medical Center, St. Louis, MO, St. Louis, MO 63110, United States.
Joshua GruberResearch Service, Veterans Affairs Saint Louis Medical Center, St. Louis, MO, St. Louis, MO 63110, United States.
Ruben RaychaudhuriFred Hutch Cancer Center, Seattle, WA 98109, United States.
Daniel EatonResearch Service, Veterans Affairs Saint Louis Medical Center, St. Louis, MO, St. Louis, MO 63110, United States.
Isla P GarrawayResearch Service, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, United States.ORCID 0000-0002-1129-4636
Matthew B RettigResearch Service, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, United States.
Kara N MaxwellMedical Oncology Service, Corporal Michael Crescenz VA Medical Center, Philadelphia, PA 19104, United States.ORCID 0000-0001-8192-4202
Martin W SchoenDepartment of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, United States.ORCID 0000-0001-6388-5553

Funding

CSRD VA I01 CX002946Department of Defense W81XWH-22-1-0602Prostate Cancer Foundation Igor Tulchinsky
6 · The paper itself

Abstract

backgroundTumor suppressor gene (TSG) alterations prognosticate inferior survival in metastatic hormone-sensitive prostate cancer (mHSPC) and may affect response to therapy. We evaluated the association of TSG alterations with overall survival (OS) in mHSPC, stratified by initial treatment.

methodsWe identified veterans with de novo mHSPC diagnosed from 2017 to 2023 within the Veterans Health Administration. TSG alterations included loss-of-function alterations in RB1, TP53, and PTEN identified by somatic sequencing through the National Precision Oncology Program. Treatments within 4 months of diagnosis included androgen deprivation therapy (ADT), docetaxel, and androgen receptor pathway inhibitors (ARPIs). Kaplan-Meier and Cox models evaluated relationships between TSG alterations, clinical factors, and OS.

resultsAmong 1842 veterans who met criteria, 865 had sequencing within 6 months. TSG alterations were found in 935 veterans, with the most common alterations being TP53 (36.7%), PTEN (23.4%), and RB1 (4.5%). In veterans sequenced within 6 months, RB1, TP53, and PTEN alterations were associated with mortality with a hazard ratio (95% CI) of 2.86 (1.94-4.21) (P < .001), 1.64 (1.30-2.05) (P < .001), and 1.52 (1.20-1.91) (P < .001), respectively. In the same cohort, median OS (95% CI) was 40.7 months (37.5-NR) with no alterations, 34.1 months (30.3-37.3) with 1, and 19.7 months (16.5-25.5) with ≥2 TSG alterations. In veterans with ≥1 alteration and sequencing within 6 months, combination therapy with ARPIs was associated with decreased mortality, aHR (95% CI) of 0.65 (0.48-0.88, P = .005).

conclusionTSG alterations were associated with inferior OS in veterans with mHSPC. In this real-world observational study, ARPI-based combination therapy in veterans with TSG alterations was associated with the longest survival.

Indexed as

Genes, Tumor SuppressorProstatic NeoplasmsAgedAndrogen AntagonistsHumansMaleMiddle AgedPrognosisUnited StatesVeteransAndrogen Antagonistsantineoplastic combined chemotherapy protocolsgenomicsprostatic neoplasmstumor suppressor genes

Identifiers

PMID41649471
PMCPMC12989102

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.