Prostate Cancer Genomic Classifier Appears Effective for Improved Patient Outcomes - Cancer Network

A study published in Prostate Cancer and Prostatic Diseases demonstrated the clinical utility of a prostate genomic classifier, created by Decipher, after radical prostatectomy in men with prostate cancer, suggesting that when treatment decisions were made and followed based on genomic test results, patient outcomes significantly improved.¹

A multidisciplinary tumor board at Thomas Jefferson University independently developed a guideline based on patient genomic risk, using Decipher as the determining factor for treatment recommendations in patients with prostate cancer following prostatectomy.

Following the tumor board’s guideline, patients with adverse pathological findings after radical prostatectomy received the genomic test. Patients who received high-risk scores were recommended for immediate adjuvant radiation therapy, and those with low- and intermediate-risk scores were recommended for observation. 

“Our findings show that use of Decipher Prostate (Radical Prostatectomy) allows us to appropriately treat the men with adverse pathology after surgery who are most likely to derive maximum benefit,” study author Robert Den, MD, Thomas Jefferson University, said in a press release.² “We can also identify the men who may be safely observed and avoid the incontinence and sexual dysfunction commonly associated with immediate radiation following radical prostatectomy.”

In this prospective cohort of 135 patients, participants were monitored for 2 years after receiving their recommendations according to the board. A 3% rate of disease progression was found in low- and intermediate-risk patients who followed guideline recommendations, with no significant benefit found for those who did not and instead opted for immediate treatment. High-risk patients who did not follow their guidelines experienced a 25% rate of disease progression, whereas only 3% of those who received the recommended adjuvant radiation therapy progressed.

“Taking into account the practice patterns observed with widespread use of the test, we believe that Decipher is already making a meaningful impact on the lives of prostate cancer patients in the United States,” Tina Nova, PhD, Decipher Biosciences’ president and chief executive officer, said in a press release.³

The study also examined the impact of Decipher genomic testing on treatment decisions in a diverse practice setting of 823 providers and 3,455 patients in the adjuvant setting nationwide. The researchers reported that the use of Decipher genomic testing resulted in a higher rate of observation for patients with low- and intermediate-risk scores, and increased utilization of immediate treatment for patients with high-risk scores.

Used to aid in treating patients with prostate cancer who have received a radical prostatectomy and are being considered for additional therapy, the Decipher Prostate RP score prognosticates a patient’s risk of metastasis within 5 years. The intention of the test is to improve clinical decision making by helping physicians identify patients who have high risk of metastasis and can reduce treatment intensity. 

Current clinicopathologic nomograms estimate that 30-95% of men with pathologically advanced prostate cancer may experience biochemical recurrence within the first 5 years of surgery, per the researchers.

According to the American Cancer Society, prostate cancer is the second leading cause of cancer death in American men, only behind lung cancer. In 2019 alone, 31,620 men are estimated to die from prostate cancer.

References:

1. Decipher Biosciences Announces Publication of a Prospective Clinical Study Demonstrating that the Use of Decipher Prostate RP Guides Post-Operative Management Decisions and Improves Patient Outcomes [news release]. San Diego, California. Published December 16, 2019. prnmedia.prnewswire.com/news-releases/decipher-biosciences-announces-publication-of-a-prospective-clinical-study-demonstrating-that-the-use-of-decipher-prostate-rp-guides-post-operative-management-decisions-and-improves-patient-outcomes-300975077.html. Accessed December 18, 2019. 

2. Marascio J, Spratt DE, Zhang J, et al. Prospective study to define the clinical utility and benefit of Decipher testing in men following prostatectomy. Prostate Cancer and Prostatic Diseases. nature.com/articles/s41391-019-0185-7. doi:10.1038/s41391-019-0185-7.

3. American Cancer Society. Key Statistics for Prostate Cancer. American Cancer Society website. Published August 1, 2019. cancer.org/cancer/prostate-cancer/about/key-statistics.html. Accessed December 18, 2019.