ArticleEuropean urology2026
IDH1 Mutations Are Associated with Favorable Outcomes in Prostate Cancer.
Article in European urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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26 authors.
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Abstract
Prostate cancer with isocitrate dehydrogenase 1 (IDH1) or isocitrate dehydrogenase 2 (IDH2) mutation appears to be a unique molecular subclass, but its associated clinical features have not been previously described. Here, we performed a retrospective analysis of clinical and molecular features of prostate cancer with IDH1 p.R132 or IDH2 p.R172 mutations. A series of 99 IDH1-mutated and 12 IDH2-mutated cases was identified using genomics databases at multiple institutions. An IDH1/2 wild-type control cohort was generated with matched clinical features at diagnosis. IDH-mutated cases frequently presented with localized disease (91%), but exhibited high tumor stage (42% T3) and grade (54% grade group 5). Compared with matched controls, patients with IDH1 mutations exhibited longer overall survival (hazard ratio [HR], 0.16; 95% confidence interval [CI], 0.04-0.68; p = 0.01), metastasis-free survival (HR, 0.22; 95% CI, 0.09-0.58; p = 0.002), and progression-free survival on hormonal therapy (HR, 0.35; 95% CI, 0.16-0.76; p = 0.036). IDH1-mutant cases were enriched for concurrent activating mutations of FOXA1 and CTNNB1 and tended to lack TMPRSS2-ERG fusions, SPOP mutations, and RB1 alterations. IDH1 mutations were associated with global transcriptional repression and evidence of metabolic and epigenetic reprogramming. These results depict IDH-mutant prostate cancer as a subtype that can present with high tumor stage and grade, but is associated with favorable outcomes.
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