“Decipher” genomic testing may improve clinical decision-making among patients with prostate cancer post-prostatectomy, according to an article published in Cancer.1

There is often insufficient evidence to recommend observation, adjuvant radiotherapy (ART), or salvage radiotherapy (SRT) when the disease displays evidence of aggressive pathology after radical prostatectomy.

Radiotherapy improves progression-free survival in this population, though this treatment may worsen quality of life, and whether there is an overall survival benefit is undetermined.

For the prospective PRO-IMPACT study (ClinicalTrials.gov Identifier: NCT02080689), researchers evaluated whether the Decipher test — a genomic classifier predictive of metastases within 5 years of prostatectomy — affects clinical decision-making in this patient population.

Two hundred and sixty-five patients were enrolled; 150 were considering ART and 115 were considering SRT. Clinical recommendations were given by care providers before and after Decipher testing.

Prior to Decipher testing, 89% of patients in the ART consideration group and 58% of patients in the SRT consideration group were recommended for observation. About a third of patients from both groups determined to be high risk had recommended treatment changes after Decipher testing.

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According to the authors, disease-related fear and anxiety were reduced among low-risk patients post–Decipher testing.

The authors concluded that the Decipher test improves treatment decision-making among patients considering ART or SRT for prostate cancer post-prostatectomy.

Reference

  1. Gore JL, du Plessis M, Santiago-Jimenez M, et al. Decipher test impacts decision making among patients considering adjuvant and salvage treatment after radical prostatectomy: interim results from the multicenter prospective PRO-IMPACT study. Cancer. 2017 Apr 19. doi: 10.1002/cncr.30665 [Epub ahead of print]