TY - JOUR
T1 - Clinical Utility of a Genomic Classifier in Men Undergoing Radical Prostatectomy
T2 - The PRO-IMPACT Trial
AU - Gore, John L.
AU - du Plessis, Marguerite
AU - Zhang, Jingbin
AU - Dai, Darlene
AU - Thompson, Darby J.S.
AU - Karsh, Lawrence
AU - Lane, Brian
AU - Franks, Michael
AU - Chen, David Y.T.
AU - Bianco, Fernando J.
AU - Brown, Gordon
AU - Clark, William
AU - Kibel, Adam S.
AU - Kim, Hyung
AU - Lowrance, William
AU - Manoharan, Murugesan
AU - Maroni, Paul
AU - Perrapato, Scott
AU - Sieber, Paul
AU - Trabulsi, Edouard J.
AU - Waterhouse, Robert
AU - Spratt, Daniel E.
AU - Davicioni, Elai
AU - Lotan, Yair
AU - Lin, Daniel W.
N1 - Funding Information:
Disclosures: Marguerite du Plessis, Jingbin Zhang, Darlene Dai, and Elai Davicioni were employees of GenomeDx Inc. Dr Lotan reported grants from GenomeDx, during the conduct of the study, granted from GenomeDx, outside the submitted work. Dr Karsh reported other from GenomeDX, outside the submitted work. Dr Kim reports grants from GenomeDx, outside the submitted work. Dr Thompson reports other from GenomeDx, during the conduct of the study. No other authors endorse conflicts of interest related to the publication of this manuscript.
Publisher Copyright:
© 2019 American Society for Radiation Oncology
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Purpose: The optimal management of men with prostate cancer at high risk of recurrence postradical prostatectomy is controversial. The clinical utility of the Decipher test was evaluated prospectively on postoperative treatment decisions and patient-reported outcomes. Methods and Materials: In the study, 246 eligible men across 19 centers were enrolled. Patients were dichotomized into those considering adjuvant or salvage radiation therapy (ART or SRT). Participating providers submitted a management recommendation before and after receiving the Decipher test results. Treatment received within 12 months and a validated survey on prostate cancer–related anxiety were collected longitudinally. Results: Pre-Decipher, treatment was recommended for 12% and 40% for the ART and SRT arms, respectively. Post-Decipher, 17% and 30% of treatment recommendations changed in the ART and SRT arms, respectively. Post-Decipher treatment recommendation was administered 78% and 76% of the time in the ART and SRT arms, respectively. Multivariable analysis confirmed that the Decipher score was an independent predictor for change in management for both adjuvant and salvage patients. The number needed to test to change management for one patient was 4. Cancer-specific anxiety decreased among Decipher risk categories in both arms. Conclusions: Use of Decipher postradical prostatectomy test was associated with postoperative treatment decisions. Overall, high Decipher risk was associated with an increase in treatment intensity whereas low risk scores were associated with a decrease in therapy administered independent of clinical and pathologic risk factors.
AB - Purpose: The optimal management of men with prostate cancer at high risk of recurrence postradical prostatectomy is controversial. The clinical utility of the Decipher test was evaluated prospectively on postoperative treatment decisions and patient-reported outcomes. Methods and Materials: In the study, 246 eligible men across 19 centers were enrolled. Patients were dichotomized into those considering adjuvant or salvage radiation therapy (ART or SRT). Participating providers submitted a management recommendation before and after receiving the Decipher test results. Treatment received within 12 months and a validated survey on prostate cancer–related anxiety were collected longitudinally. Results: Pre-Decipher, treatment was recommended for 12% and 40% for the ART and SRT arms, respectively. Post-Decipher, 17% and 30% of treatment recommendations changed in the ART and SRT arms, respectively. Post-Decipher treatment recommendation was administered 78% and 76% of the time in the ART and SRT arms, respectively. Multivariable analysis confirmed that the Decipher score was an independent predictor for change in management for both adjuvant and salvage patients. The number needed to test to change management for one patient was 4. Cancer-specific anxiety decreased among Decipher risk categories in both arms. Conclusions: Use of Decipher postradical prostatectomy test was associated with postoperative treatment decisions. Overall, high Decipher risk was associated with an increase in treatment intensity whereas low risk scores were associated with a decrease in therapy administered independent of clinical and pathologic risk factors.
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U2 - 10.1016/j.prro.2019.09.016
DO - 10.1016/j.prro.2019.09.016
M3 - Article
C2 - 31761540
AN - SCOPUS:85077660086
SN - 1879-8500
VL - 10
SP - e82-e90
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
IS - 2
ER -