Use of the genomic prostate score (GPS) on prostate cancer biopsy tissue resulted in a lower rate of selection of active surveillance among African American men with very low–risk to low intermediate–risk prostate cancer, according to the results of a randomized controlled trial published in the Journal of Clinical Oncology.

GPS can predict adverse outcomes in men with prostate cancer and may be used to select patients for active surveillance rather than active treatment. “However, its impact on treatment choice in high-risk populations of African Americans is largely unknown,” the authors stated.

The trial ( Identifier: NCT02668276) randomly assigned 200 patients with very low–risk to low intermediate–risk prostate cancer to undergo standard counseling or counseling with the 12-gene GPS assay results. The primary endpoint was treatment choice at the second visit after diagnosis.

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At baseline, the median age was 64 years; 70% of the patients were African American, 16.5% were European American, 12.5% were Hispanic or Latino, and 1.0% were Asian. The patients (40%) who had some college were the largest subgroup followed by high school (27.5%), less than high school (17.0%), and a bachelor’s degree or higher (15.5%). The median health literacy was 8.6, and a score lower than 9 was considered low literacy.

Active surveillance was selected by fewer patients (77%) who received GPS results compared with 88% of the patients who underwent standard counseling, although this result was not statistically significant (P =.067).

Lower health literacy was associated with lower rates of active surveillance selection among the patients who received GPS counseling compared with those who underwent standard counseling (P =.022). However, there was no difference among the men with higher health literacy.

The authors concluded that “Population characteristics should be accounted for when predicting the effects of a complex biomarker such as GPS.”

Disclosures: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Murphy AB, Abern MR, Wang H, et al. Impact of a genomic test on treatment decision in a predominantly African American population with favorable-risk prostate cancer: a randomized trial. J Clin Oncol. Published online April 9, 2021. doi:10.1200/JCO.20.02997