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@ARTICLE{Farazi:299519,
author = {M. Farazi and X. Yang and C. J. Gehl and G. C. Barnett and
N. G. Burnet and J. Chang-Claude$^*$ and C. C. Parker and A.
M. Dunning and D. Azria and A. Choudhury and T. Rancati and
D. De Ruysscher and P. Seibold$^*$ and E. Sperk and C. J.
Talbot and L. Veldeman and A. J. Webb and R. Elliott and M.
E. Aguado-Barrera and A. M. Carballo and O. Fuentes-Ríos
and A. Gómez-Caamaño and P. Peleteiro and A. Vega and H.
Ostrer and B. S. Rosenstein and S. Saito and M. Parliament
and N. Usmani and B. Marples and Y. Chen and G. Morrow and
E. Messing and M. C. Janelsins and W. Hall and C. M. L. West
and P. L. Auer and S. Kerns},
title = {{A} {P}olygenic {R}isk {S}core for {L}ate {B}ladder
{T}oxicity {F}ollowing {R}adiotherapy for {N}on-{M}etastatic
{P}rostate {C}ancer.},
journal = {Cancer epidemiology, biomarkers $\&$ prevention},
volume = {34},
number = {5},
issn = {1055-9965},
address = {Philadelphia, Pa.},
publisher = {AACR},
reportid = {DKFZ-2025-00477},
pages = {795-804},
year = {2025},
note = {2025 May 2;34(5):795-804},
abstract = {Late bladder toxicity is a concern for patients receiving
prostate cancer radiotherapy and negatively impacts
survivors. Few risk factors are known beyond the radiation
dose and volume of bladder exposed. A polygenic risk score
(PRS) could identify susceptible patients.A PRS was built
using genome-wide association results from the Radiogenomics
Consortium (N=3,988), then tested in the prospective REQUITE
and URWCI studies (N=2,034). The primary outcome was
time-to-patient-reported gross (≥ grade 2, G2) hematuria
analyzed using Cox proportional hazards regression.
Secondary outcomes were ≥G2 urinary retention and
frequency. The PRS was externally validated for
clinically-diagnosed irradiation cystitis in the UK Biobank
(N=8,430). A gene-burden test evaluated rare coding
variants.A 115-variant PRS was associated with significantly
increased risk of ≥G2 hematuria (hazard ratio [HR] per
standard deviation [SD]=1.22, p=0.009) as well as urinary
retention (HR-per-SD=1.18, p=0.016) and frequency
(HR-per-SD=1.14, p=0.036). When binarized, men in the upper
decile (PRShigh) had >2-fold increased risk of hematuria
after adjusting for clinical risk factors (HR=2.12, p=0.002;
Harrel's c-index 0.71 $[95\%CI=0.65$ to 0.76]). A similar
effect size was seen in the UK Biobank for
clinically-diagnosed irradiation cystitis (OR=2.15,
p=0.026). The burden test identified BOD1L1 as a putative
novel radiosensitivity gene.This PRS identifies susceptible
patients and could guide selection of those needing
re-optimized treatment plans that spare the bladder beyond
currently recommended constraints.PRS-guided treatment
planning in radiation oncology could lower the incidence of
clinically relevant bladder toxicity and reduce the impact
of this outcome on prostate cancer survivors.},
cin = {C020 / C130},
ddc = {610},
cid = {I:(DE-He78)C020-20160331 / I:(DE-He78)C130-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40029246},
doi = {10.1158/1055-9965.EPI-24-1228},
url = {https://inrepo02.dkfz.de/record/299519},
}