Researchers studied prostate cancer samples from 352 participants in the NRG/RTOG 9601 clinical trial, which compared radiation therapy alone with radiation therapy combined with hormone therapy. The investigators found that the Decipher test, which measures the activity of 22 genes among seven known cancer pathways, independently estimated the participants' risk of metastasis, death from prostate cancer and overall survival. Researchers say it also guided treatment recommendations for recurrence of prostate cancer after surgery, helping identify patients most likely to benefit from hormone therapy.

The test uses "genomic classifier scores" determined from the genomic characteristics of the tumour to stratify patients into three groups. Lower scores correlate with a more favourable prognosis. Of the participants, 148 patients (42%) had low genomic classifier scores, below .45; 132 (38%) had intermediate genomic classifier scores, between 45 and 60; and 72 (20%) had high genomic classifier scores, above 60.

 These genomic classifiers helped predict the risk of distant metastases, prostate cancer-specific death and overall survival, even after adjusting for participants' age, race/ethnicity, Gleason score, T stage of T1 to T4 to classify the extent of tumour spread, margin status, prostate-specific antigen level and whether they were receiving hormone therapy. It also was able to determine the benefit of patients receiving hormones or no hormones.

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John
Editorial Assistant
Immunogenetics Open Access