PURPOSE: We determined the value of Decipher®, a genomic classifier, to predict prostate cancer outcomes among patients after prostatectomy in a community health care setting. MATERIALS AND METHODS: We examined the experience of 224 men treated with radical prostatectomy from 1997 to 2009 at Kaiser Permanente Northwest, a large prepaid health plan in Portland, Oregon. Study subjects had aggressive prostate cancer with at least 1 of several criteria such as preoperative prostate specific antigen 20 ng/ml or greater, pathological Gleason score 8 or greater, stage pT3 disease or positive surgical margins at prostatectomy. The primary end point was clinical recurrence or metastasis after surgery evaluated using a time dependent c-index. Secondary end points were biochemical recurrence and salvage treatment failure. We compared the performance of Decipher alone to the widely used CAPRA-S (Cancer of the Prostate Risk Assessment Post-Surgical) score, and assessed the independent contributions of Decipher, CAPRA-S and their combination for the prediction of recurrence and treatment failure. RESULTS: Of the 224 patients treated 12 experienced clinical recurrence, 68 had biochemical recurrence and 34 experienced salvage treatment failure. At 10 years after prostatectomy the recurrence rate was 2.6% among patients with low Decipher scores but 13.6% among those with high Decipher scores (p=0.02). When CAPRA-S and Decipher scores were considered together, the discrimination accuracy of the ROC curve was increased by 0.11 compared to the CAPRA-S score alone (combined c-index 0.84 at 10 years after radical prostatectomy) for clinical recurrence. CONCLUSIONS: Decipher improves our ability to predict clinical recurrence in prostate cancer and adds precision to conventional pathological prognostic measures.
PURPOSE: We determined the value of Decipher®, a genomic classifier, to predict prostate cancer outcomes among patients after prostatectomy in a community health care setting. MATERIALS AND METHODS: We examined the experience of 224 men treated with radical prostatectomy from 1997 to 2009 at Kaiser Permanente Northwest, a large prepaid health plan in Portland, Oregon. Study subjects had aggressive prostate cancer with at least 1 of several criteria such as preoperative prostate specific antigen 20 ng/ml or greater, pathological Gleason score 8 or greater, stage pT3 disease or positive surgical margins at prostatectomy. The primary end point was clinical recurrence or metastasis after surgery evaluated using a time dependent c-index. Secondary end points were biochemical recurrence and salvage treatment failure. We compared the performance of Decipher alone to the widely used CAPRA-S (Cancer of the Prostate Risk Assessment Post-Surgical) score, and assessed the independent contributions of Decipher, CAPRA-S and their combination for the prediction of recurrence and treatment failure. RESULTS: Of the 224 patients treated 12 experienced clinical recurrence, 68 had biochemical recurrence and 34 experienced salvage treatment failure. At 10 years after prostatectomy the recurrence rate was 2.6% among patients with low Decipher scores but 13.6% among those with high Decipher scores (p=0.02). When CAPRA-S and Decipher scores were considered together, the discrimination accuracy of the ROC curve was increased by 0.11 compared to the CAPRA-S score alone (combined c-index 0.84 at 10 years after radical prostatectomy) for clinical recurrence. CONCLUSIONS: Decipher improves our ability to predict clinical recurrence in prostate cancer and adds precision to conventional pathological prognostic measures.
Authors: Daniel E Spratt; Darlene L Y Dai; Robert B Den; Patricia Troncoso; Kasra Yousefi; Ashley E Ross; Edward M Schaeffer; Zaid Haddad; Elai Davicioni; Rohit Mehra; Todd M Morgan; Walter Rayford; Firas Abdollah; Edouard Trabulsi; Mary Achim; Elsa Li Ning Tapia; Mireya Guerrero; Robert Jeffrey Karnes; Adam P Dicker; Mark A Hurwitz; Paul L Nguyen; Felix F Y Feng; Stephen J Freedland; John W Davis Journal: Eur Urol Date: 2017-12-10 Impact factor: 20.096
Authors: David P Labbé; Christopher J Sweeney; Myles Brown; Phillip Galbo; Spencer Rosario; Kristine M Wadosky; Sheng-Yu Ku; Martin Sjöström; Mohammed Alshalalfa; Nicholas Erho; Elai Davicioni; R Jeffrey Karnes; Edward M Schaeffer; Robert B Jenkins; Robert B Den; Ashley E Ross; Michaela Bowden; Ying Huang; Kathryn P Gray; Felix Y Feng; Daniel E Spratt; David W Goodrich; Kevin H Eng; Leigh Ellis Journal: Clin Cancer Res Date: 2017-09-12 Impact factor: 12.531
Authors: Timothy N Clinton; Aditya Bagrodia; Yair Lotan; Vitaly Margulis; Ganesh V Raj; Solomon L Woldu Journal: Expert Rev Precis Med Drug Dev Date: 2017-09-05
Authors: Hak J Lee; Kasra Yousefi; Zaid Haddad; Firas Abdollah; Lucia Lc Lam; Heesun Shin; Mohammed Alshalalfa; Elana Godebu; Song Wang; Ahmed Shabaik; Elai Davicioni; Christopher J Kane Journal: Res Rep Urol Date: 2016-06-28
Authors: Harrison K Tsai; Jonathan Lehrer; Mohammed Alshalalfa; Nicholas Erho; Elai Davicioni; Tamara L Lotan Journal: BMC Cancer Date: 2017-11-13 Impact factor: 4.430
Authors: R B Den; M Santiago-Jimenez; J Alter; M Schliekelman; J R Wagner; J F Renzulli Ii; D I Lee; C G Brito; K Monahan; B Gburek; N Kella; G Vallabhan; F Abdollah; E J Trabulsi; C D Lallas; L G Gomella; T L Woodlief; Z Haddad; L L C Lam; S Deheshi; Q Wang; V Choeurng; M du Plessis; J Jordan; B Parks; H Shin; C Buerki; K Yousefi; E Davicioni; V R Patel; N L Shah Journal: Prostate Cancer Prostatic Dis Date: 2016-08-30 Impact factor: 5.554
Authors: Mohammed Alshalalfa; Gerald W Verhaegh; Ewan A Gibb; Maria Santiago-Jiménez; Nicholas Erho; Jennifer Jordan; Kasra Yousefi; Lucia L C Lam; Tyler Kolisnik; Jijumon Chelissery; Roland Seiler; Ashley E Ross; R Jeffrey Karnes; Edward M Schaeffer; Tamara T Lotan; Robert B Den; Stephen J Freedland; Elai Davicioni; Eric A Klein; Jack A Schalken Journal: Oncotarget Date: 2017-02-07