OBJECTIVES: To evaluate the ability of the Decipher genomic classifier in predicting metastasis from analysis of prostate needle biopsy diagnostic tumor tissue specimens. MATERIALS AND METHODS: Fifty-seven patients with available biopsy specimens were identified from a cohort of 169 men treated with radical prostatectomy in a previously reported Decipher validation study at Cleveland Clinic. A Cox multivariable proportional hazards model and survival C-index were used to evaluate the performance of Decipher. RESULTS: With a median follow up of 8 years, 8 patients metastasized and 3 died of prostate cancer. The Decipher plus National Comprehensive Cancer Network (NCCN) model had an improved C-index of 0.88 (95% confidence interval [CI] 0.77-0.96) compared to NCCN alone (C-index 0.75, 95% CI 0.64-0.87). On multivariable analysis, Decipher was the only significant predictor of metastasis when adjusting for age, preoperative prostate-specific antigen and biopsy Gleason score (Decipher hazard ratio per 10% increase 1.72, 95% CI 1.07-2.81, P = .02). CONCLUSION: Biopsy Decipher predicted the risk of metastasis at 10 years post radical prostatectomy. While further validation is required on larger cohorts, preoperative knowledge of Decipher risk derived from biopsy could indicate the need for multimodality therapy and help set patient expectations of therapeutic burden.
OBJECTIVES: To evaluate the ability of the Decipher genomic classifier in predicting metastasis from analysis of prostate needle biopsy diagnostic tumor tissue specimens. MATERIALS AND METHODS: Fifty-seven patients with available biopsy specimens were identified from a cohort of 169 men treated with radical prostatectomy in a previously reported Decipher validation study at Cleveland Clinic. A Cox multivariable proportional hazards model and survival C-index were used to evaluate the performance of Decipher. RESULTS: With a median follow up of 8 years, 8 patients metastasized and 3 died of prostate cancer. The Decipher plus National Comprehensive Cancer Network (NCCN) model had an improved C-index of 0.88 (95% confidence interval [CI] 0.77-0.96) compared to NCCN alone (C-index 0.75, 95% CI 0.64-0.87). On multivariable analysis, Decipher was the only significant predictor of metastasis when adjusting for age, preoperative prostate-specific antigen and biopsy Gleason score (Decipher hazard ratio per 10% increase 1.72, 95% CI 1.07-2.81, P = .02). CONCLUSION: Biopsy Decipher predicted the risk of metastasis at 10 years post radical prostatectomy. While further validation is required on larger cohorts, preoperative knowledge of Decipher risk derived from biopsy could indicate the need for multimodality therapy and help set patient expectations of therapeutic burden.
Authors: R Jeffrey Karnes; Voleak Choeurng; Ashley E Ross; Edward M Schaeffer; Eric A Klein; Stephen J Freedland; Nicholas Erho; Kasra Yousefi; Mandeep Takhar; Elai Davicioni; Matthew R Cooperberg; Bruce J Trock Journal: Eur Urol Date: 2017-04-08 Impact factor: 20.096
Authors: Jeffrey J Tosoian; Stacy Loeb; Jonathan I Epstein; Baris Turkbey; Peter L Choyke; Edward M Schaeffer Journal: Am Soc Clin Oncol Educ Book Date: 2016
Authors: Charles R Rogers; Michael J Rovito; Musse Hussein; Ogechi Jessica Obidike; Rebekah Pratt; Mark Alexander; Jerica M Berge; Marc Dall'Era; Jeffrey W Nix; Christopher Warlick Journal: Am J Prev Med Date: 2018-11 Impact factor: 5.043
Authors: Izak Faiena; Stuart Holden; Mathew R Cooperberg; Stuart Holden; Howard R Soule; Jonathan W Simons; Todd M Morgan; David F Penson; Alicia K Morgans; Maha Hussain Journal: J Clin Oncol Date: 2018-02-05 Impact factor: 44.544