Photo Credit: Nobi Prizue

The following is a summary of “Association Between the Decipher Genomic Classifier and Prostate Cancer Outcome in the Real-world Setting,” published in the August 2024 issue of Urology by Leapman et al.

The prognostic value of the decipher prostate cancer genomic classifier (GC) has been well-documented primarily through analyses of archival tissue samples; however, its association with clinical outcomes in contemporary real-world practice settings remains less understood. This study aimed to investigate the relationship between Decipher GC results and the risks of metastasis and biochemical recurrence (BCR) following prostate biopsy and radical prostatectomy (RP) in a real-world cohort.

Researchers conducted a retrospective cohort study using a novel longitudinal linkage of transcriptomic data from the Decipher GC and real-world clinical data (RWD), which were sourced from insurance claims, pharmacy records, and electronic health records across various payors and healthcare settings. Kaplan-Meier survival analysis and Cox proportional hazards regression were employed to evaluate the associations between the GC scores and study outcomes, adjusting for relevant clinical and pathological factors.

The study analyzed data from 58,935 participants who underwent Decipher testing, including 33,379 patients with biopsy specimens and 25,556 with RP specimens. The median age of patients was 67 years (interquartile range [IQR] 62–72) at the time of biopsy and 65 years (IQR 59–69) at the time of RP. The median GC score was 0.43 (IQR 0.27–0.66) for patients who were biopsy-tested and 0.54 (IQR 0.32–0.79) for patients who were RP-tested. The Decipher GC score was found to be independently associated with the risk of metastasis in both biopsy-tested (hazard ratio [HR] per 0.1 unit increase in GC 1.21 [95% CI 1.16–1.27], p < 0.001) and patients who were RP-tested (HR 1.20 [95% CI 1.17–1.24], p < 0.001) after adjusting for baseline clinical and pathological risk factors. Additionally, in patients who were RP-tested, the GC score was significantly associated with the risk of BCR (HR 1.12 [95% CI 1.10–1.14], p < 0.001) when adjusted for age and Cancer of the Prostate Risk Assessment postsurgical score.

This large-scale real-world study supports the external prognostic validity of the Decipher GC, demonstrating its relevance in predicting metastasis and BCR in contemporary clinical practice. These findings underscore the utility of the Decipher GC in refining risk assessments and guiding treatment decisions for patients with prostate cancer.

Source: sciencedirect.com/science/article/pii/S2588931124001834