Decipher Genomic Classifier Prognostic for Metastasis, PCa-specific Mortality

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The Decipher genomic classifier obtained from biopsy samples was prognostic for distant metastases and prostate cancer-specific mortality.
The Decipher genomic classifier obtained from biopsy samples was prognostic for distant metastases and prostate cancer-specific mortality.

ORLANDO, FL The Decipher genomic classifier obtained from biopsy samples was prognostic for distant metastases and prostate cancer-specific mortality after surgery or radiotherapy plus androgen deprivation therapy (ADT), according to a study presented at 2017 Genitourinary Cancers Symposium.1

"Decipher is a 22 gene RNA-based signature developed to predict risk of metastasis after radical prostatectomy," said Paul L. Nguyen, MD, vice chair for clinical research, department of radiation oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts. "It detects cell cycle proliferation markers, adhesion and motility markers, immune modulation markers, and androgen signaling markers."

Dr Nguyen and colleagues evaluated the Decipher genomic classifier's ability to predict metastasis and prostate cancer-specific mortality using samples from 175 patients treated with either first-line radical prostatectomy or radiation treatment plus ADT.

Of those, 13.1%, 50.9%, and 33.7% had NCCN low, intermediate, and high risk disease, respectively. Forty-three percent of patients received upfront treatment with radical prostatectomy while the rest had radiation plus ADT. Thirty-two patients developed metastases, including 11 who died from the disease, during a median follow-up of 6 years.

The Decipher classifier was a significant predictor of metastasis at 5 years post biopsy and of prostate cancer-specific mortality.

"The 20% of patients with genomic high risk had a very high 23.4% rate of metastasis and a 9.4% rate of prostate cancer-specific mortality at 5 years," said Dr Nguyen.

Those with an intermediate Decipher score had a 5-year metastasis rate of 9.3% and a 0% 5-year prostate cancer-specific mortality rate.

RELATED: Immunotherapy and the Future of Prostate Cancer Treatment

"This study demonstrates the prognostic value of the Decipher test in this cohort," Dr Nguyen explained. "Demonstrated predictive value ideally involves testing in randomized trials comparing treatment approaches."

Further validation is ongoing in larger cohorts. The investigators are planning to evaluate the test in completed randomized trials to determine predictive value.

Reference

  1. Nguyen PL, Haddad Z, Lam LL, et al. Evaluation of the Decipher prostate cancer classifier to predict metastasis and disease-specific mortality from genomic analysis of diagnostic prostate needle biopsy specimens. Paper presented at: 2017 Genitourinary Cancers Symposium; February 16-18, 2017; Orlando, FL.

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