The Decipher Prostate genomic classifier — a genomic test performed on biopsy samples to gauge the expression of 22 genes involved in prostate cancer progression — was associated with Gleason upgrading among men on active surveillance for low- or favorable-intermediate-risk prostate cancer.
Integration of the Decipher score improved the predictive power of baseline clinical features, although only modestly.
Why This Matters
There is an unmet need to better identify patients with prostate cancer who will progress on active surveillance.
Incorporating Decipher testing into standard clinical predictors might help guide decision-making surrounding active surveillance as well as the intensity of monitoring.
Decipher has been validated as a predictor of PCa recurrence, metastasis, and mortality, but there has been little evidence until now for its value in active surveillance.
The study was a review of 133 men with prostate cancer under active surveillance. Decipher testing was performed on their baseline biopsy samples.
The goal was to examine the association between the baseline Decipher score and Gleason upgrading on subsequent biopsies.
Forty-three patients (32%) had a biopsy upgrade.
Decipher scores were significantly associated with biopsy upgrade (OR, 1.37 per 0.10 unit increase; P = .02).
Decipher scores above a cutoff of 0.475 increased the odds of biopsy upgrade nearly fourfold (OR, 3.71; P = 0.01).
Scores were associated with upgrade for Grade Group 1 disease (OR, 1.29 per 0.10 unit; P = .047) but not Grade Group 2 disease (P = .41).
The discriminative ability of clinical predictors of progression increased with the integration of Decipher scores.
Patients at higher risk of progression may have been more likely to be tested.
Sample size and follow-up were insufficient to assess long-term outcomes.
Funding source and investigator disclosures were not reported.
This is a summary of a preprint research report led by Benjamin Press of Yale University in New Haven, Conn., provided to you by Medscape. The study has not yet been peer-reviewed. The full text can be found at medrxiv.org.
M. Alexander Otto is a physician assistant with a master’s degree in medical science, and an award-winning medical journalist who has worked for several major news outlets before joining Medscape. He is an MIT Knight Science Journalism fellow. Email: email@example.com
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Cite this: Genetic Test Helps Predict PCa Progression on Active Surveillance - Medscape - Dec 03, 2021.