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    Study: PCa genomic test reduces decisional conflict

    Test ‘clearly impacts providers' recommendations’ regarding adjuvant therapy

    Chicago—For men with high-risk pathology at radical prostatectomy, exposure to results of a genomic test that classifies 5-year risk of metastasis reduces decisional conflict, according to findings of a prospective study presented at the American Society of Clinical Oncology annual meeting in Chicago.  

    Read: Low concordance with NCCN surveillance guide seen

    The research also demonstrated that information from the genomic test, Decipher, lowers provider uncertainty about treatment recommendations and alters treatment intensity recommendations.

    John L. Gore, MD, MSDr. Gore“There is a lot of uncertainty about proceeding with adjuvant therapy because while randomized controlled trials show that it decreases the risk of biochemical progression, we are still awaiting definitive evidence that it affects clinical metastasis or survival. Previous studies evaluating the impact of prostate cancer biomarker tests on treatment recommendations have looked at decision change. However, our study is novel in that we investigated an effect on decision quality using a validated instrument,” said first author John L. Gore, MD, MS.

    “The results indicate that knowledge from the genomic classifier test gives patients with high-risk features and their urologists greater confidence that they are making the right decision about adjuvant treatment,” added Dr. Gore, associate professor of urology, University of Washington, Seattle, and co-principal investigator with Daniel W. Lin, MD, professor and chief of urologic oncology at the University of Washington.

    The study included data for 141 men enrolled by 43 urologists practicing in community and academic settings. Eligible patients had extracapsular extension, seminal vesicle invasion, or positive surgical margins found at radical prostatectomy. According to the genomic classifier results, about half of the men had a low risk of disease progression within 5 years, 20% were classified as being intermediate risk, and the rest were at high risk.

    Also see: Adjuvant chemo well tolerated in high-risk PCa patients

    The study collected data about provider treatment recommendations before and after the urologists knew the genomic classifier results. In addition, both providers and patients completed a validated questionnaire for assessing decisional conflict (Decisional Conflict Scale) on patient enrollment and after seeing the genomic classifier results.

    Next: Conflict scores drop for patients, urologists

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