Prospective prostate cancer screening in germline pathogenic variant carriers: The PATROL study.

作者：D C Lee, Caitlin Orr, Evelyn Milavsky, Andrew E. Amini, Christopher L. Amling, Kristin M. Follmer, Grace Jun, Chenee Holcomb, Maxwell Poole, Linda H. Rodgers, Hiten Dilip Patel, Matthew R. Cooperberg, Joanne Jeter, Alexandra O. Sokolova, Keyan Salari, Kara N. Maxwell, Heather H. Cheng, Daniel Wei Lin · 发表于：Journal of Clinical Oncology · 年份：2026 · DOI：10.1200/jco.2026.44.16_suppl.10505 · 研究领域：Prostate Cancer Diagnosis and Treatment、Prostate Cancer Treatment and Research、BRCA gene mutations in cancer

10505 Background: Germline pathogenic variants (gPV) in prostate cancer (PCa) risk genes are associated with aggressive disease, but optimal screening thresholds for this population are unclear. We report early results from the Prostate Cancer Screening for People at Genetic Risk for Aggressive Disease (PATROL) study. Methods: PATROL is a multicenter, prospective study enrolling participants ≥40 years with a gPV in at least one of 13 PCa risk genes. Biopsy is recommended using age-specific prostate-specific antigen (PSA) thresholds: > 1.0 ng/mL (< 50y), > 1.5 (50–59y), > 2.0 (≥60y). Prostate multiparametric MRI is encouraged at baseline and within 1 year of biopsy. Clinically significant PCa (csPCa) was defined as Grade Group (GG) ≥2 (NCT04472338). Results: As of 12/1/2025, 436 participants were enrolled; 69% carried BRCA1/2 gPVs ( BRCA2 46%, BRCA1 22%), 12% carried mismatch repair gene variants, and gPVs in other genes were each ≤7%. Overall, 106 participants underwent 119 on-study biopsies (median age 61 [IQR 53–68]) with a median PSA 2.3 ng/mL [IQR 1.3–3.9]). GG1 disease was detected in 21/119 (18%) biopsies and csPCa in 21/119 (18%) biopsies. Among csPCa, the median PSA was 3.2 ng/mL (IQR 2.2-4.1), and 76% (16/21) had a PIRADS 4-5 lesion. Fifteen (71%) and 14 (67%) of GG1 and csPCa, respectively, were identified in participants with BRCA1/2 gPVs. In multivariable logistic regression adjusting for age, PSA, and genetic status, PI-RADS 4-5 was associated with csPCa (OR 12.2...