High Risk Prostate Cancer and Genomics - Paul Nguyen & Alan Pollack

November 18, 2021

Paul Nguyen and Alan Pollack join Alicia Morgans in a discussion on risk prognostication in high-risk prostate cancer.   Dr. Nguyen discusses the role of genomics to risk-stratify high-risk prostate cancer patients and the role of Decipher at the time of biopsy.  He reviews data from an oral presentation he delivered at the 2021 American Society for Radiation Oncology (ASTRO) annual meeting titled: Validation of a 22-Gene Genomic Classifier in the NRG Oncology/RTOG 9202, 9413, and 9902 Phase III Randomized trials: A Biopsy-Based Meta-Analysis in High-Risk Prostate Cancer".   The purpose of the study was to validate the performance of the Decipher 22-gene genomic classifier in pre-treatment biopsy samples collected in three randomized phase 3 high-risk definitive radiotherapy trials: NRG/RTOG 9202, 9413, and 9902. This is the first validation of any gene expression biomarker on the pretreatment biopsy samples from prospective randomized trials of high-risk prostate cancer.  This trial demonstrated an independent association of the Genomic Classifier score, which was a Decipher score and was prognostic for distant metastasis, prostate cancer mortality, and overall survival on univariate analysis. In looking at any of the trials, it was highly prognostic. Each of the endpoints was significant. High-risk prostate cancer is a heterogeneous disease to personalize shared decision-making for treatments.  They also discussed a currently enrolling clinical trial, NRG-GU009/PREDICT-RT (NCT 04513717) will further determine the optimal therapy based on the Genomic Classifier score.  


Paul Nguyen, MD, Radiation Oncologist, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts

Alan Pollack, MD, PhD, Radiation Oncologist, University of Miami, Miami, Florida

Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts

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