Genomics Test Guides Treatment Decisions for Prostate Cancer
The Decipher genomics test, which measures activity of 22 genes among seven known cancer pathways, independently estimates patients’ risk of prostate cancer metastasis, death, and overall survival and helps identify patients most likely to benefit from hormone therapy, researchers reported in study findings published in JAMA Oncology.
Researchers ran genetic information from prostate cancer samples from 352 men who were randomized to receive radiation therapy either with or without hormone therapy through the Decipher test, which uses genomic classifier scores to categorize patients into three groups: 148 patients (42%) had low-risk scores, 132 (38%) intermediate risk, and 72 (20%) high risk. The scores factor the genomics findings with patients’ age, race and ethnicity, Gleason score, tumor stage, margin status, prostate-specific antigen level, and current hormone therapy to predict risk of distant metastases, prostate cancer-specific death, and overall survival.
Patients with intermediate and high scores had an 88% increased risk of distant metastases. But the addition of hormone therapy was associated with an 11.2% improvement in 12-year occurrence of distant metastasis and a 4.6% improvement in overall survival in those patients compared to ones with low Decipher scores.
“These results suggest that not all men with biochemically recurrent prostate cancer after surgery benefit equally from the addition of hormone therapy to radiotherapy,” the researchers wrote.
Learn more about the nursing considerations for patients who may not benefit and progress to metastatic castration-resistant prostate cancer on the Oncology Nursing Podcast Episode 149: Health Disparities and Barriers in Metastatic Castration-Sensitive Prostate Cancer.