Data Published in "The Red Journal” Validate Clinical Utility of Veracyte’s Decipher Prostate Genomic Classifier To Help Guide Therapy in Men with Intermediate-Risk Prostate Cancer
Findings represent first validation of any gene expression biomarker for intermediate-risk patients using data from a randomized phase 3 clinical trial
“Physicians have historically relied on clinical and pathological variables such as the Gleason score to guide the use of radiation treatment and the addition of androgen deprivation therapy to radiotherapy for men with intermediate-risk prostate cancer. However, these tools have only modest ability to accurately discriminate individual patients’ prognosis, leading to a long-standing challenge of both under- and over-treatment of these men,” said Daniel Spratt, M.D., Vincent K. Smith chair of Radiation Oncology at University Hospitals Seidman Cancer Center and professor and chair of the Department of Radiation Oncology at Case Western Reserve University School of Medicine, and lead investigator for the study. “The findings from this study suggest that the Decipher Prostate test provides reliable and clinically meaningfully risk-stratification that may enhance personalized decision-making in the intermediate-risk setting.”
Prostate cancer deemed “intermediate risk” by the National Comprehensive Cancer Network (NCCN) Guidelines® for Prostate Cancer is the most heterogenous of all risk groups in prostate cancer, and there are a wide variety of treatment options available. The Decipher Prostate Genomic Classifier is a prognostic biomarker that provides additional information about the aggressiveness of individual patients’ cancer to help physicians more accurately categorize personal risk and select appropriate treatments. The study conducted by Dr. Spratt and colleagues confirms findings from prior studies and validates for the first time the test’s performance in men with intermediate-risk disease using a multi-center, Phase 3 randomized trial.
To assess the prognostic performance of the Decipher Prostate test in the intermediate-risk, post-biopsy setting, researchers utilized patient biopsy samples from the NRG/RTOG 0126 National Cancer Institute-sponsored clinical trial. This study enrolled patients with intermediate-risk prostate cancer, and then compared clinical outcomes following randomization to two different doses of radiation therapy (70.2 Gy vs 79.2 Gy) without any concurrent hormone therapy (aka, androgen deprivation therapy, or ADT). Researchers generated Decipher scores for 215 patients from their biopsy samples, then linked the data with clinical outcomes assessing multiple oncologic and survival endpoints. Patients were followed for a median of 12.8 years.
Results show that the Decipher Prostate test was independently prognostic for all clinical endpoints, including disease progression (sub-distribution hazard ratio [sHR] 1.12), biochemical failure (sHR 1.22), distant metastasis (sHR 1.28), and prostate cancer-specific mortality (sHR 1.45). Overall, men in the study with higher Decipher Prostate test scores had worse 10-year outcomes with radiotherapy (RT) alone compared to men with lower Decipher Prostate test scores. The 10-year rate of distant metastasis among men with lower Decipher Prostate test scores was
The published study also evaluated – within Decipher risk groups - the clinical impact of receiving lower- vs. higher-dose radiation. Among patients with lower Decipher risk scores, the difference in 10-year distant metastasis rates between those who received low-dose radiation therapy (70.2Gy) vs. high-dose radiation therapy (79.2Gy) was lower (-
“This study suggests that using the Decipher Prostate test to more precisely determine prognosis and risk for men with intermediate-risk prostate cancer – and thereby potentially optimizing individual treatment decision-making – could help resolve a long-standing challenge in prostate cancer care and have a meaningful clinical impact for these patients,” said Elai Davicioni, Ph.D., Veracyte’s medical director for Urology.
About Veracyte
Veracyte (Nasdaq: VCYT) is a global diagnostics company whose vision is to transform cancer care for patients all over the world. We empower clinicians with the high-value insights they need to guide and assure patients at pivotal moments in the race to diagnose and treat cancer. Our high-performing tests enable clinicians to make more confident diagnostic, prognostic, and treatment decisions for some of the most challenging diseases such as thyroid, prostate, breast, bladder and lung cancers, as well as interstitial lung diseases. We help patients avoid unnecessary procedures and speed time to diagnosis and appropriate treatment. In addition to making our tests available in the
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Veracyte delivers the Decipher Prostate Genomic Classifier from its CLIA laboratories. Those tests are not CE-IVD marked and have not been cleared or approved by the FDA; their performance characteristics were determined by Veracyte and they might be considered for Research Use Only in some markets. Please contact Veracyte for confirmation.
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