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    Prostate Ca test influences decision-making post RP

    The genomic Decipher test, which predicts metastasis risk after radical prostatectomy, influences providers' decision-making for post-surgery adjuvant and salvage treatment, according to research presented at the AUA annual meeting.  

    “The Decipher test is unique in that it applies a genomic signature to the prediction of clinical metastases at 5 years post-prostatectomy,” said presenting author John L. Gore, MD MSHS, of the University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, Seattle. “It is not the first genomic test, but most of the available tests are being applied in the pre-treatment space, to either reassure patients about active surveillance or support decisions to undergo definitive treatment. This test, in our study, is being applied to the clinical situations where patients and their providers are trying to navigate complex decisions regarding adjuvant and salvage therapy after prostatectomy.”

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    Dr. Gore and colleagues studied 150 patients considering adjuvant radiation therapy and 115 patients considering salvage radiation therapy. Providers caring for these patients submitted their recommendations for management before processing the Decipher test and again after receiving the test’s results. The patients submitted validated surveys on prostate cancer-specific quality of life, decision quality, and prostate cancer-related anxiety, according to the study’s abstract.

    Researchers found that the test influences providers’ management recommendations. Low-risk patients, based on the Decipher test, are more likely to receive observation recommendations. High-risk patients are more likely to receive recommendations to undergo adjuvant or salvage treatments, usually with radiation therapy, according to Dr. Gore.

    More specifically, prior to the Decipher test, providers recommended observation for 89% of adjuvant patients and 58% of salvage patients. Post Decipher, 18% of treatment recommendations changed in the adjuvant group, including 31% of high-risk Decipher patients, and 32% of providers’ recommendations changed in the salvage group, including 56% of high-risk Decipher patients, the study found.

    Next: Higher perceived decision quality observed

    Lisette Hilton
    Lisette Hilton is a writer in Boca Raton, Fla., who heads up her company, Words Come Alive.

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