Clinicians may soon be able to improve the risk stratification of men with prostate cancer with the help of a genomic classifier or a biopsy-based reverse transcription polymerase chain reaction (RT-PCR) assay, according to the results of two studies presented at the Genitourinary Cancers Symposium in Orlando, FL.
In the first study,presented by Paul L. Nguyen, MD, the genomic classifier Decipher was able to accurately predict metastasis and prostate-cancer specific mortality (PCSM) from a needle biopsy in men with intermediate- and high-risk prostate cancer.
“The Decipher classifier obtained from biopsy samples was associated with distant metastases and prostate-cancer specific mortality after radical prostatectomy or radiation therapy and a short course of hormone therapy. It provided significant prognostic information beyond clinical variables alone,” said Dr. Nguyen, associate professor of radiation oncology at Harvard Medical School, Boston.
Decipher is a 22-gene RNA-based signature developed to predict risk of metastasis after radical prostatectomy. Here, Dr. Nguyen and co-authors conducted a multi-institutional study of Decipher aimed at evaluating whether it could predict metastasis and prostate cancer-specific mortality earlier in the treatment process using needle biopsy tumor specimens.
The study included 175 patients who were treated with first-line radical prostatectomy (43%) or radiation therapy plus androgen deprivation therapy (57%). All patients had genomic expression profiles available.
The majority of the men in the study (85%) had intermediate- or high-risk disease. With a median follow-up of 6 years, 32 patients developed metastases and 11 patients died of prostate cancer.