Clinical Utility of a Genomic Classifier in Men Undergoing Radical Prostatectomy: The PRO-IMPACT Trial.

Autor:	Gore JL; University of Washington, Seattle Cancer Care Alliance, Seattle, Washington. Electronic address: jlgore@uw.edu., du Plessis M; Decipher Biosciences, Vancouver, BC, Canada., Zhang J; Decipher Biosciences, Vancouver, BC, Canada., Dai D; Decipher Biosciences, Vancouver, BC, Canada., Thompson DJS; EMMES Canada, Burnaby, BC, Canada., Karsh L; The Urology Center of Colorado, Denver, Colorado., Lane B; Spectrum Health Medical Group, Grand Rapids, Michigan., Franks M; Virginia Urology, Richmond, Virginia., Chen DYT; Fox Chase Cancer Center, Philadelphia, Pennsylvania., Bianco FJ Jr; Urological Research Network, Nova Southeastern University, Miami, Florida., Brown G; Delaware Valley Urology, LLC, Voorhees, New Jersey., Clark W; Alaska Clinical Research Center, Anchorage, Alaska., Kibel AS; Brigham and Women's Hospital, Boston, Massachusetts., Kim H; Cedars-Sinai Medical Center, Los Angeles, California., Lowrance W; Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah., Manoharan M; Miller School of Medicine at University of Miami, Miami, Florida., Maroni P; University of Colorado, Anschutz Medical Campus, Aurora, Colorado., Perrapato S; University of Vermont Medical Center, Burlington, Vermont., Sieber P; Lancaster Urology, Lancaster, Pennsylvania., Trabulsi EJ; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania., Waterhouse R; Carolina Urology Partners, Gastonia, North Carolina., Spratt DE; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Davicioni E; Decipher Biosciences, Vancouver, BC, Canada., Lotan Y; UT Southwestern Medical Center, Dallas, Texas., Lin DW; University of Washington, Seattle Cancer Care Alliance, Seattle, Washington.
Jazyk:	angličtina
Zdroj:	Practical radiation oncology [Pract Radiat Oncol] 2020 Mar - Apr; Vol. 10 (2), pp. e82-e90. Date of Electronic Publication: 2019 Nov 21.
DOI:	10.1016/j.prro.2019.09.016
Abstrakt:	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. (Copyright © 2019 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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