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Gore JL , du Plessis M , Zhang J , Dai D , Thompson DJS , Karsh L , Lane B , Franks M , Chen DYT , Bianco FJ Jr , Brown G , Clark W , Kibel AS , Kim H , Lowrance W , Manoharan M , Maroni P , Perrapato S , Sieber P , Trabulsi EJ , Waterhouse R , Spratt DE , Davicioni E , Lotan Y , Lin DW
Clinical Utility of a Genomic Classifier in Men Undergoing Radical Prostatectomy: The PRO-IMPACT Trial
Pract Radiat Oncol. 2020 Mar - Apr;10(2) :e82-e90
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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.
1879-8519 Gore, John L du Plessis, Marguerite Zhang, Jingbin Dai, Darlene Thompson, Darby J S Karsh, Lawrence Lane, Brian Franks, Michael Chen, David Y T Bianco, Fernando J Jr Brown, Gordon Clark, William Kibel, Adam S Kim, Hyung Lowrance, William Manoharan, Murugesan Maroni, Paul Perrapato, Scott Sieber, Paul Trabulsi, Edouard J Waterhouse, Robert Spratt, Daniel E Davicioni, Elai Lotan, Yair Lin, Daniel W Journal Article United States Pract Radiat Oncol. 2019 Nov 20. pii: S1879-8500(19)30305-4. doi: 10.1016/j.prro.2019.09.016.