When compared with standard risk factors, only Decipher Prostate Genomic Classifier scores were independently associated with metastasis-free survival and distant metastasis.
Results from 2 studies shared during the 2023 ASTRO Annual Meeting showed that the Decipher Prostate Genomic Classifier—a 22-gene, whole-transcriptome profiling platform—facilitates treatment decisions for patients with prostate cancer.1
Researchers for the first study evaluated the Decipher genomic assay in a population of patients with clinically high-risk localized prostate cancer who had participated in the phase 3 NRG RTOG 051 trial. Patients in the phase 3 study had been treated with radiation along with 2 years of androgen deprivation therapy alone or combined with docetaxel chemotherapy. The investigators obtained biopsies and generated Decipher Prostate test scores from 183 of these patients, who had been followed for a median of 9.9 years.
The prognostic value of the Decipher assay was assessed, along with standard risk factors, such as PSA level, Gleason score, and T-stage. Compared with these standard markers, the researchers found that only Decipher Prostate Genomic Classifier scores were independently associated with both metastasis-free survival (hazard ratio [HR], 1.12) and distant metastasis (sHR, 1.22).
Compared to patients with low-risk scores on the Decipher assay, those with higher-risk scores had worse distant metastasis (sHR, 2.82). Additionally, after nearly a decade of follow-up, cumulative distant metastasis was 27% vs 9% for patients with higher- vs low-risk Decipher scores, respectively.
“This study reinforces the ability of the [Decipher Prostate Genomic Classifier] to improve risk stratification in high-risk prostate cancer, and thereby support more informed, personalized treatment decisions for these patients,” Phuoc T. Tran, MD, PhD professor and vice chair for research of radiation oncology at the University of Maryland School of Medicine, and co-senior investigator for the study, stated in a news release.1
The second study presented at ASTRO examined risk-score correlation among the Decipher test and 2 other commercially available gene expression signatures to determine whether the tests produced similar enough results to be used interchangeably. Using biopsy samples from more than 50,000 patients with localized prostate cancer, the investigators determined that the correlation level between scores on the 3 assays was minimal to moderate.
“The poor correlation we observed between the three risk scores suggests that these tests may not be used interchangeably, and clinicians should base utilization on the levels of evidence supporting them,” Daniel Spratt, MD, Vincent K. Smith chair of Radiation Oncology at University Hospitals Seidman Cancer Center and professor and chair of the Department of Radiation Oncology at Case Western Reserve University School of Medicine, and lead investigator for the study, stated in the news release.1
Commenting on the 2 studies in the news release, Elai Davicioni, PhD, medical director of urology at Veracyte, Decipher’s manufacturer, stated, “The findings presented at ASTRO 2023 add to the large body of evidence, which now includes 12 phase 3 randomized trials, demonstrating the Decipher Prostate classifier’s performance as a tool to help guide therapeutic decisions in prostate cancer. Furthermore, they reinforce that the substantial level of evidence supporting the Decipher Prostate test can help guide its selection and utilization for patients with prostate cancer.”1
1. New data from phase 3 trial further validate prognostic value of Veracyte’s Decipher Prostate genomic classifier. Press release. October 4, 2023. Accessed October 6, 2023. https://tinyurl.com/4esrchc8