Adjuvant vs. salvage Radiation Therapy after Radical Prostatectomy: Role of Decipher® in the Era of Personalized Medicine
1 January 2020
Prostate Cancer (PCa) is the most prevalent cancer in men. Radical Prostatectomy (RP) as a primary definitive treatment may be followed by adjuvant or salvage radiotherapy. However, there are some uncertainties about receiving immediate adjuvant radiation after RP in men with adverse pathological features versus early salvage radiation therapy. Decipher is a novel genomic classifier and almost all studies have confirmed Decipher as a reliable predictor of metastasis, recurrence and mortality. With the aid of Decipher, clinicians are able to determine the need for adjuvant versus salvage radiotherapy. Decipher has the potential to reduce decisional conflicts in clinical recommendations, and is cost-effective. However, further investigations are required to prove Decipher’s role in clinical outcome improvement in patients receiving Decipher-based course of treatment compared with those receiving usual care.
- Prostatic Neoplasms
- Genomic Test
How to Cite
2. Penson, D.F., J.M. Chan, and P. Urologic Diseases in America, Prostate cancer. J Urol, 2007. 177(6): p. 2020-9.
3. Freedland, S.J., et al., Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA, 2005. 294(4): p. 433-9.
4. Klein, E.A., et al., A genomic classifier improves prediction of metastatic disease within 5 years after surgery in node-negative high-risk prostate cancer patients managed by radical prostatectomy without adjuvant therapy. Eur Urol, 2015. 67(4): p. 778-86.
5. Gore, J.L., et al., Decipher test impacts decision making among patients considering adjuvant and salvage treatment after radical prostatectomy: Interim results from the Multicenter Prospective PRO-IMPACT study. Cancer, 2017. 123(15): p. 2850-2859.
6. Marrone, M., et al., A 22 Gene-expression Assay, Decipher(R) (GenomeDx Biosciences) to Predict Five-year Risk of Metastatic Prostate Cancer in Men Treated with Radical Prostatectomy. PLoS Curr, 2015. 7.
7. Glass, A.G., et al., Validation of a Genomic Classifier for Predicting Post-Prostatectomy Recurrence in a Community Based Health Care Setting. J Urol, 2016. 195(6): p. 1748-53.
8. Van den Broeck, T., et al., Validation of the Decipher Test for Predicting Distant Metastatic Recurrence in Men with High-risk Nonmetastatic Prostate Cancer 10 Years After Surgery. Eur Urol Oncol, 2019. 2(5): p. 589-596.
9. Nguyen, P.L., et al., Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens. Eur Urol, 2017. 72(5): p. 845-852.
10. Spratt, D.E., et al., Individual Patient-Level Meta-Analysis of the Performance of the Decipher Genomic Classifier in High-Risk Men After Prostatectomy to Predict Development of Metastatic Disease. J Clin Oncol, 2017. 35(18): p. 1991-1998.
11. Masic, S., et al., Effects of Initial Gleason Grade on Outcomes during Active Surveillance for Prostate Cancer. Eur Urol Oncol, 2018. 1(5): p. 386-394.
12. Raldow, A.C., et al., Risk Group and Death From Prostate Cancer: Implications for Active Surveillance in Men With Favorable Intermediate-Risk Prostate Cancer. JAMA Oncol, 2015. 1(3): p. 334-40.
13. Aghazadeh, M.A., et al., National Comprehensive Cancer Network(R) Favorable Intermediate Risk Prostate Cancer-Is Active Surveillance Appropriate? J Urol, 2018. 199(5): p. 1196-1201.
14. Herlemann, A., et al., Decipher identifies men with otherwise clinically favorable-intermediate risk disease who may not be good candidates for active surveillance. Prostate Cancer Prostatic Dis, 2019.
15. Den, R.B., et al., Genomic classifier identifies men with adverse pathology after radical prostatectomy who benefit from adjuvant radiation therapy. J Clin Oncol, 2015. 33(8): p. 944-51.
16. Dalela, D., et al., Genomic Classifier Augments the Role of Pathological Features in Identifying Optimal Candidates for Adjuvant Radiation Therapy in Patients With Prostate Cancer: Development and Internal Validation of a Multivariable Prognostic Model. J Clin Oncol, 2017. 35(18): p. 1982-1990.
17. Lobo, J.M., et al., Cost-effectiveness of the Decipher Genomic Classifier to Guide Individualized Decisions for Early Radiation Therapy After Prostatectomy for Prostate Cancer. Clin Genitourin Cancer, 2017. 15(3): p. e299-e309.
- Abstract Viewed: 0 times
- Just Accepted/6526 Downloaded: 0 times