Retrospective multi-institutional analysis of clinical and molecular features in 99 IDH1-mutated and 12 IDH2-mutated prostate cancer cases versus a matched IDH1/2 wild-type control cohort, evaluating survival outcomes, co-occurring genomic alterations, and transcriptional changes.
IDH1 mutations were associated with significantly better overall survival (HR 0.16, 95% CI 0.04–0.68), metastasis-free survival (HR 0.22, 95% CI 0.09–0.58), and progression-free survival on hormonal therapy (HR 0.35, 95% CI 0.16–0.76) vs. matched controls — despite high tumor stage (42% T3) and grade (54% grade group 5) at presentation.
Retrospective design with cases drawn from genomics databases introduces selection bias. IDH2-mutated cohort is small (n=12), limiting conclusions for that subgroup. Full-text was not accessible for review of statistical methods or covariate adjustment details.
When IDH1 mutations are identified on tumor genomic profiling in prostate cancer, clinicians should recognize this as a likely favorable-prognosis subtype — even when grade and stage appear high. Routine reporting of IDH1 mutation status may aid prognostic counseling.
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