Decipher Genomic Testing for Post-prostatectomy Prostate Cancer

“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.

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]