A Systematic Review of the Evidence for the Decipher Genomic Classifier in Prostate Cancer

Jairath, Neil; Pra, Alan Dal; Vince, Randy; Dess, Robert T.; Jackson, W. Clay; Tosoian, Jeffrey J.; McBride, Sean; Zhao, Shuang G.; Berlín, Alejandro; Mahal, Brandon A.; Kishan, Amar U.; Den, Robert B.; Freedland, Stephen J.; Salami, Simpa S.; Kaffenberger, Samuel D.; Pollack, Alan; Tran, Phuoc T.; Mehra, Rohit; Morgan, Todd M.; Weiner, Adam B.; Mohamad, Osama; Carroll, Peter R.; Cooperberg, Matthew R.; Karnes, R. Jeffrey; Nguyen, Paul L.; Michalski, Jeff M.; Tward, Jonathan D.; Feng, Felix Y.; Schaeffer, Edward M.; Spratt, Daniel E.

doi:10.1016/j.eururo.2020.11.021

Cited by 130 publications

(94 citation statements)

References 25 publications

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“…The algorithm is based on the expression of 22 RNA biomarkers important in cell proliferation and differentiation, androgen receptor signaling, cell motility, and immune response [90]. A recent systematic review examining the available evidence for its use in men with prostate cancer evaluated data from 30,407 patients, across 42 studies involving men with localized prostate cancer, post-prostatectomy, non-metastatic castrateresistant cancer, and in the metastatic hormone-sensitive setting [91]. The study found that the Decipher genomic classification was prognostic for adverse pathology, biochemical failure, metastasis, cancer-specific survival, and overall survival.…”

Section: Personalization Of Therapymentioning

confidence: 99%

A Review on the Current Treatment Paradigm in High-Risk Prostate Cancer

Burgess

Roy

Morgan

et al. 2021

Cancers

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High-risk prostate cancer is traditionally treated with a combination of radiotherapy (RT) and androgen deprivation therapy (ADT). However, recent advancements in systemic treatment and radiotherapy have widened the spectrum of treatment for this patient population. Use of image guidance and intensity modulation, as well as the incorporation of brachytherapy, has led to safe radiotherapy dose escalation with reduced risk of recurrence. Clinical trials have helped define the role of pelvic nodal radiotherapy, the role of stereotactic ablative radiotherapy, and the optimal duration and sequencing of ADT in combination with radiotherapy. Emerging evidence has redefined the role of surgery in this cohort. Contemporary clinical trials have identified new systemic therapy options in high-risk prostate cancer. Finally, new imaging modalities including multi-parametric MRI and molecular imaging and genomic classifiers have ushered a new era in patient selection, risk stratification, and treatment tailoring.

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Section: Personalization Of Therapymentioning

confidence: 99%

A Review on the Current Treatment Paradigm in High-Risk Prostate Cancer

Burgess

Roy

Morgan

et al. 2021

Cancers

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“…The authors were able to show that almost 95% of the transcriptomic information extracted from RP specimens could also be derived from biopsy tissue with high correlation (r = 0.96) (39). Several subsequent studies demonstrated the clinical efficacy of the Decipher Biopsy test (40)(41)(42). For example, Klein et al found that Decipher score from prostate biopsy specimens was a significant predictor of metastasis within 10 years after RP with an AUC of 0.8 (43).…”

Section: Deciphermentioning

confidence: 99%

“…Finally, the role of Decipher has been evaluated as a guide for androgen deprivation therapy after adjuvant or salvage radiotherapy post-prostatectomy (48). In this setting, a low Decipher score predicts a more favorable prognosis and may change treatment intensification strategies (40). Recently, Jairath et al performed a systematic review on the available evidence on Decipher and its role on PCa management (40).…”

Section: Deciphermentioning

confidence: 99%

“…In this setting, a low Decipher score predicts a more favorable prognosis and may change treatment intensification strategies (40). Recently, Jairath et al performed a systematic review on the available evidence on Decipher and its role on PCa management (40). The authors concluded that in multiple studies Decipher was an independent prognostic factor for adverse pathology, biochemical failure, metastasis, and cancer-specific and overall survival.…”

Section: Deciphermentioning

confidence: 99%

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Tissue-Based Biomarkers for the Risk Stratification of Men With Clinically Localized Prostate Cancer

et al. 2021

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Risk stratification of men with clinically localized prostate cancer has historically relied on basic clinicopathologic parameters such as prostate specific antigen level, grade group, and clinical stage. However, prostate cancer often behaves in ways that cannot be accurately predicted by these parameters. Thus, recent efforts have focused on developing tissue-based genomic tests that provide greater insights into the risk of a given patient’s disease. Multiple tests are now commercially available and provide additional prognostic information at various stages of the care pathway for prostate cancer. Indeed, early evidence suggests that these assays may have a significant impact on patient and physician decision-making. However, the impact of these tests on oncologic outcomes remains less clear. In this review, we highlight recent advances in the use of tissue-based biomarkers in the treatment of prostate cancer and identify the existing evidence supporting their clinical use.

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“…The ability of the Decipher test to alter clinical decisions regarding the use of adjuvant treatments has been reported [ 291 , 292 ]. Altogether, data from several studies has demonstrated the clinical usefulness of the Decipher test, exhibiting its potential to significantly improve the personalisation of PC treatment [ 293 ].…”

Section: Biomarkers That Can Predict Pc Aggressivenessmentioning

confidence: 99%

Tissue- and Liquid-Based Biomarkers in Prostate Cancer Precision Medicine

Meehan

Gray

Martínez-Pérez

et al. 2021

JPM

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Worldwide, prostate cancer (PC) is the second-most-frequently diagnosed male cancer and the fifth-most-common cause of all cancer-related deaths. Suspicion of PC in a patient is largely based upon clinical signs and the use of prostate-specific antigen (PSA) levels. Although PSA levels have been criticised for a lack of specificity, leading to PC over-diagnosis, it is still the most commonly used biomarker in PC management. Unfortunately, PC is extremely heterogeneous, and it can be difficult to stratify patients whose tumours are unlikely to progress from those that are aggressive and require treatment intensification. Although PC-specific biomarker research has previously focused on disease diagnosis, there is an unmet clinical need for novel prognostic, predictive and treatment response biomarkers that can be used to provide a precision medicine approach to PC management. In particular, the identification of biomarkers at the time of screening/diagnosis that can provide an indication of disease aggressiveness is perhaps the greatest current unmet clinical need in PC management. Largely through advances in genomic and proteomic techniques, exciting pre-clinical and clinical research is continuing to identify potential tissue, blood and urine-based PC-specific biomarkers that may in the future supplement or replace current standard practices. In this review, we describe how PC-specific biomarker research is progressing, including the evolution of PSA-based tests and those novel assays that have gained clinical approval. We also describe alternative diagnostic biomarkers to PSA, in addition to biomarkers that can predict PC aggressiveness and biomarkers that can predict response to certain therapies. We believe that novel biomarker research has the potential to make significant improvements to the clinical management of this disease in the near future.

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A Systematic Review of the Evidence for the Decipher Genomic Classifier in Prostate Cancer

Cited by 130 publications

References 25 publications

A Review on the Current Treatment Paradigm in High-Risk Prostate Cancer

A Review on the Current Treatment Paradigm in High-Risk Prostate Cancer

Tissue-Based Biomarkers for the Risk Stratification of Men With Clinically Localized Prostate Cancer

Tissue- and Liquid-Based Biomarkers in Prostate Cancer Precision Medicine

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