OBJECTIVES - To evaluate the ability of the Decipher genomic classifier in predicting metastasis from analysis of prostate needle biopsy diagnostic tumor tissue specimens.
METHODS - Fifty-seven patients with available biopsy specimens were identified from a cohort of 169 men treated with RP in a previously reported Decipher validation study at Cleveland Clinic.
Cox multivariable (MVA) proportional hazards model and survival c-index were used to evaluate the performance of Decipher.
RESULTS - With a median follow up of 8 years, 8 patients metastasized and 3 died of PCa. Decipher plus NCCN model had an improved c-index of 0. 88 (95% confidence interval [CI] 0. 77-0. 96) compared to NCCN alone (c-index 0. 75; 95% CI 0. 64-0. 87). On MVA, Decipher was the only significant predictor of metastasis when adjusting for age, preoperative PSA and biopsy Gleason score (Decipher hazard ratio per 10% increase 1. 72; 95% CI 1. 07-2. 81; P = 0. 02).
CONCLUSIONS - Biopsy-based Decipher predicted the risk of metastasis at 10 years post-RP. While further validation is required on larger cohorts, pre-operative knowledge of Decipher risk derived from biopsy could indicate the need for multimodality therapy and help set patient expectations of therapeutic burden.
Urology. 2016 Jan 22 [Epub ahead of print]
Eric A Klein, Zaid Haddad, Kasra Yousefi, Lucia L Lam, Qiqi Wang, Voleak Choeurng, Beatrix Palmer-Aronsten, Christine Buerki, Elai Davicioni, Jianbo Li, Michael W Kattan, Andrew J Stephenson, Cristina Magi-Galluzzi
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. GenomeDx Biosciences Inc, Vancouver, BC, Canada. , GenomeDx Biosciences Inc, Vancouver, BC, Canada. , GenomeDx Biosciences Inc, Vancouver, BC, Canada. , GenomeDx Biosciences Inc, Vancouver, BC, Canada. , GenomeDx Biosciences Inc, Vancouver, BC, Canada. , GenomeDx Biosciences Inc, Vancouver, BC, Canada. , GenomeDx Biosciences Inc, Vancouver, BC, Canada. , GenomeDx Biosciences Inc, Vancouver, BC, Canada. , Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA. , Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA. , Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. , Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA.