Decipher correlation patterns post prostatectomy: initial experience from 2 342 prospective patients.

Area of Science:

• Genomic medicine
• Oncology
• Biomarker discovery

Background:

• Multiple RNA-based biomarkers are available for prostate cancer, but uncertainty exists regarding optimal patient selection for genomic testing.
• The Decipher assay is a commercially available genomic classifier used in prostate cancer management.

Purpose of the Study:

• To examine the correlation patterns of the Decipher assay with patient tumor characteristics.
• To understand the relationship between Decipher scores and clinicopathologic variables in radical prostatectomy patients.

Main Methods:

• Analysis of de-identified Decipher test results and clinicopathologic data from 2,342 radical prostatectomy patients.
• Correlation analysis using Spearman's rank correlation to assess relationships between Decipher scores and variables like Gleason score, T-stage, and CAPRA-S.
• Mixed-effect linear models were used to investigate the association of practice type with Decipher scores.

Main Results:

• Decipher scores showed positive correlations with pathologic Gleason score (PGS), pathologic T-stage, CAPRA-S, and patient age.
• The Decipher assay reclassified a significant proportion of patients across different CAPRA-S risk groups.
• High-risk disease was identified in 28% of pT2 patients, and low risk in 7% of pT3b/pT4, PGS 8-10 patients by Decipher.

Conclusions:

• The Decipher assay correlates with established tumor characteristics but significantly reclassifies tumor aggressiveness compared to clinical parameters alone.
• Genomic classifier utilization, such as Decipher, can impact postoperative risk assessment and influence physician-patient decision-making.
• This study highlights the potential of genomic testing to refine patient management in prostate cancer.