A Prospective Validation of the Decipher Genomic Classifier in Men With Early Localized Prostate Cancer: The VANDAAM...

Area of Science:

• Genomic medicine
• Oncology
• Prostate cancer research

Background:

• Genomic precision oncology offers personalized prostate cancer (PCa) care.
• African American men (AAM) face higher PCa burden but are underrepresented in genomic studies.
• This study prospectively validates a genomic classifier (GC) for predicting early recurrence in AAM.

Purpose of the Study:

• To prospectively validate a genomic classifier (GC) for predicting rapid biochemical recurrence (BCR) in African American men (AAM) with prostate cancer.
• To assess the GC's performance in predicting 2-year BCR rates as a surrogate for disease aggressiveness.
• To evaluate the concordance of GC scores derived from biopsy and radical prostatectomy (RP) tissue.

Main Methods:

• A multicenter prospective validation study (2016-2021) involving 243 patients with low- or intermediate-risk PCa.
• Patients were recruited 1:1 (AAM:White) and matched by CAPRA score; active surveillance patients were excluded.
• Decipher GC testing was performed on tumor tissue; primary outcome was prediction of 2-year BCR.

Main Results:

• The cohort included 207 evaluable cases (104 AAM, 103 White).
• A high GC score significantly increased the odds of rapid 2-year BCR by 5.25-fold (OR, 5.25; P=.021).
• Biopsy- and RP-derived GC scores showed 77% concordance in risk reclassification.

Conclusions:

• This is the first prospective validation of GC performance for predicting early BCR in both AAM and White men.
• Findings support integrating the GC into clinical guidelines for improved risk stratification in early-stage PCa.
• The GC can enhance the management of AAM with early-stage prostate cancer.