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Investigators examine nationwide variations in genomic expression profiles in prostate cancer


"We saw that Black men within this cohort had lower Decipher scores across all ages and Gleason scores different than what had been reported in other data sets, which was interesting," says Samuel L. Washington III, MD, MAS.

In this video, Samuel L. Washington III, MD, MAS, the 2024 American Urological Association Annual Meeting abstract “Variations in Genomic expression profiles by age, race, gleason grade group, and geography among men with prostate cancer.” Washington is an assistant professor of urology and holds the Goldberg-Benioff Endowed Professorship in Cancer Biology at the University of California, San Francisco.


Please provide an overview of this abstract and its notable data.

At UCSF, we do a lot of genomic testing. It helps us understand where men will lie on the risk spectrum. And it helps inform what we may do or how we may counsel patients, knowing that this is 1 more data point, but not a crystal ball that helps us understand where that person may need further work-up, further counseling, or help us understand what expectations we may need to set when we discuss treatment. So for this, we wanted to look at, well, we've been doing genomic expression profile Decipher testing at UCSF; what does that look like nationally? We've seen datasets and publications from other institutions and smaller groups. Now, we have access to over 165,000 men with Decipher testing, including biopsy specimens and radical prostatectomy or surgical specimens. And we looked to see, what are we seeing at a national level, and then how may that be changing depending on where people live, which state they're in? Thankfully, within this cohort, there was almost 10% of Black men who had data within this data set. We noticed pretty broad variation across states, even when we look at how many tests are being done. So we looked at both utilization by state and weighted scores based on the number of tests being done in each state, and noticed pretty interesting variations. We saw that Black men within this cohort had lower Decipher scores across all ages and Gleason scores different than what had been reported in other data sets, which was interesting. We're diving into that more to understand context, because now we really have geography, race, Gleason scores, but we don't understand where these people live, what is happening in these places to help us flesh out why we may be observing this. And then the grid data helped us flesh out expression profiles a little bit more. And this was more consistent with what we had seen in the literature, giving us a little bit of validation of our findings. But it's an interesting hypothesis-generating data set that we're now looking to explore further and layer on more clinical context to understand.

This transcription was edited for clarity.

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