Representation of Low-Grade Prostate Cancer in Metastatic Prostate Cancer Trials

Prostate cancer is the most common non-skin cancer in men affecting roughly 1 in 7 men in the US over the course of their lifetime. As a disease, prostate cancer demonstrates a wide range of aggressiveness and outcomes. Currently, there is debate whether low-grade/low-risk (i.e., Gleason score 6) prostate cancers can spread in the body and be fatal. In 1994, researchers from Johns Hopkins University identified a group of clinically ‘insignificant’ prostate cancers characterized by very small and low-grade tumors that did not spread or cause death in men treated with surgery. The classification of these low-risk cancers is the basis of modern day active surveillance, which is the primary mode of managing low-risk cancers. In fact, some clinicians and researchers are advocating for removing the title of cancer from these low risk tumors.

In this study, we aim to characterize the baseline aggressiveness of men who were treated in large clinical trials for advanced (i.e., metastatic or stage IV) prostate cancer. We hypothesize that an insignificant proportion of men in these trials were diagnosed with low-grade/low-risk cancers. We will aggregate data from multiple trials to report the proportions of low-, intermediate- and high- risk cancer from the various clinical trials over the last last 4 decades.