Abstract
Background: Decipher is a validated genomic classifier developed to determine the biological potential for metastasis after radical prostatectomy (RP). Objective: To evaluate the ability of biopsy Decipher to predict metastasis and Prostate cancer-specific mortality (PCSM) in primarily intermediate- to high-risk patients treated with RP or radiation therapy (RT). Design, setting, and participants: Two hundred and thirty-five patients treated with either RP (n = 105) or RT. ±. androgen deprivation therapy (n = 130) with available genomic expression profiles generated from diagnostic biopsy specimens from seven tertiary referral centers. The highest-grade core was sampled and Decipher was calculated based on a locked random forest model. Outcome measurements and statistical analysis: Metastasis and PCSM were the primary and secondary outcomes of the study, respectively. Cox analysis and c-index were used to evaluate the performance of Decipher. Results and limitations: With a median follow-up of 6 yr among censored patients, 34 patients developed metastases and 11 died of prostate cancer. On multivariable analysis, biopsy Decipher remained a significant predictor of metastasis (hazard ratio: 1.37 per 10% increase in score, 95% confidence interval [CI]: 1.06-1.78, p = 0.018) after adjusting for clinical variables. For predicting metastasis 5-yr post-biopsy, Cancer of the Prostate Risk Assessment score had a c-index of 0.60 (95% CI: 0.50-0.69), while Cancer of the Prostate Risk Assessment plus biopsy Decipher had a c-index of 0.71 (95% CI: 0.60-0.82). National Comprehensive Cancer Network risk group had a c-index of 0.66 (95% CI: 0.53-0.77), while National Comprehensive Cancer Network plus biopsy Decipher had a c-index of 0.74 (95% CI: 0.66-0.82). Biopsy Decipher was a significant predictor of PCSM (hazard ratio: 1.57 per 10% increase in score, 95% CI: 1.03-2.48, p = 0.037), with a 5-yr PCSM rate of 0%, 0%, and 9.4% for Decipher low, intermediate, and high, respectively. Conclusions: Biopsy Decipher predicted metastasis and PCSM from diagnostic biopsy specimens of primarily intermediate- and high-risk men treated with first-line RT or RP. Patient summary: Biopsy Decipher predicted metastasis and prostate cancer-specific mortality risk from diagnostic biopsy specimens. Biopsy Decipher was able to predict metastasis and prostate cancer-specific mortality from diagnostic biopsy specimens in a cohort of primarily intermediate- and high-risk men regardless of type of first-line treatment.
| Original language | English (US) |
|---|---|
| Journal | European Urology |
| DOIs | |
| State | Accepted/In press - 2017 |
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Keywords
- Biopsy
- Genomics
- Metastasis
- Prostate cancer-specific mortality
ASJC Scopus subject areas
- Urology
Cite this
Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens. / Nguyen, Paul L.; Haddad, Zaid; Ross, Ashley E.; Martin, Neil E.; Deheshi, Samineh; Lam, Lucia L.C.; Chelliserry, Jijumon; Tosoian, Jeffrey J.; Lotan, Tamara L.; Spratt, Daniel E.; Stoyanova, Radka; Punnen, Sanoj; Ong, Kaye; Buerki, Christine; Aranes, Maria; Kolisnik, Tyler; Margrave, Jennifer; Yousefi, Kasra; Choeurng, Voleak; Davicioni, Elai; Trock, Bruce J.; Kane, Christopher J.; Pollack, Alan; Davis, John W.; Feng, Felix Y.; Klein, Eric A.
In: European Urology, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens
AU - Nguyen, Paul L.
AU - Haddad, Zaid
AU - Ross, Ashley E.
AU - Martin, Neil E.
AU - Deheshi, Samineh
AU - Lam, Lucia L.C.
AU - Chelliserry, Jijumon
AU - Tosoian, Jeffrey J.
AU - Lotan, Tamara L.
AU - Spratt, Daniel E.
AU - Stoyanova, Radka
AU - Punnen, Sanoj
AU - Ong, Kaye
AU - Buerki, Christine
AU - Aranes, Maria
AU - Kolisnik, Tyler
AU - Margrave, Jennifer
AU - Yousefi, Kasra
AU - Choeurng, Voleak
AU - Davicioni, Elai
AU - Trock, Bruce J.
AU - Kane, Christopher J.
AU - Pollack, Alan
AU - Davis, John W.
AU - Feng, Felix Y.
AU - Klein, Eric A.
PY - 2017
Y1 - 2017
N2 - Background: Decipher is a validated genomic classifier developed to determine the biological potential for metastasis after radical prostatectomy (RP). Objective: To evaluate the ability of biopsy Decipher to predict metastasis and Prostate cancer-specific mortality (PCSM) in primarily intermediate- to high-risk patients treated with RP or radiation therapy (RT). Design, setting, and participants: Two hundred and thirty-five patients treated with either RP (n = 105) or RT. ±. androgen deprivation therapy (n = 130) with available genomic expression profiles generated from diagnostic biopsy specimens from seven tertiary referral centers. The highest-grade core was sampled and Decipher was calculated based on a locked random forest model. Outcome measurements and statistical analysis: Metastasis and PCSM were the primary and secondary outcomes of the study, respectively. Cox analysis and c-index were used to evaluate the performance of Decipher. Results and limitations: With a median follow-up of 6 yr among censored patients, 34 patients developed metastases and 11 died of prostate cancer. On multivariable analysis, biopsy Decipher remained a significant predictor of metastasis (hazard ratio: 1.37 per 10% increase in score, 95% confidence interval [CI]: 1.06-1.78, p = 0.018) after adjusting for clinical variables. For predicting metastasis 5-yr post-biopsy, Cancer of the Prostate Risk Assessment score had a c-index of 0.60 (95% CI: 0.50-0.69), while Cancer of the Prostate Risk Assessment plus biopsy Decipher had a c-index of 0.71 (95% CI: 0.60-0.82). National Comprehensive Cancer Network risk group had a c-index of 0.66 (95% CI: 0.53-0.77), while National Comprehensive Cancer Network plus biopsy Decipher had a c-index of 0.74 (95% CI: 0.66-0.82). Biopsy Decipher was a significant predictor of PCSM (hazard ratio: 1.57 per 10% increase in score, 95% CI: 1.03-2.48, p = 0.037), with a 5-yr PCSM rate of 0%, 0%, and 9.4% for Decipher low, intermediate, and high, respectively. Conclusions: Biopsy Decipher predicted metastasis and PCSM from diagnostic biopsy specimens of primarily intermediate- and high-risk men treated with first-line RT or RP. Patient summary: Biopsy Decipher predicted metastasis and prostate cancer-specific mortality risk from diagnostic biopsy specimens. Biopsy Decipher was able to predict metastasis and prostate cancer-specific mortality from diagnostic biopsy specimens in a cohort of primarily intermediate- and high-risk men regardless of type of first-line treatment.
AB - Background: Decipher is a validated genomic classifier developed to determine the biological potential for metastasis after radical prostatectomy (RP). Objective: To evaluate the ability of biopsy Decipher to predict metastasis and Prostate cancer-specific mortality (PCSM) in primarily intermediate- to high-risk patients treated with RP or radiation therapy (RT). Design, setting, and participants: Two hundred and thirty-five patients treated with either RP (n = 105) or RT. ±. androgen deprivation therapy (n = 130) with available genomic expression profiles generated from diagnostic biopsy specimens from seven tertiary referral centers. The highest-grade core was sampled and Decipher was calculated based on a locked random forest model. Outcome measurements and statistical analysis: Metastasis and PCSM were the primary and secondary outcomes of the study, respectively. Cox analysis and c-index were used to evaluate the performance of Decipher. Results and limitations: With a median follow-up of 6 yr among censored patients, 34 patients developed metastases and 11 died of prostate cancer. On multivariable analysis, biopsy Decipher remained a significant predictor of metastasis (hazard ratio: 1.37 per 10% increase in score, 95% confidence interval [CI]: 1.06-1.78, p = 0.018) after adjusting for clinical variables. For predicting metastasis 5-yr post-biopsy, Cancer of the Prostate Risk Assessment score had a c-index of 0.60 (95% CI: 0.50-0.69), while Cancer of the Prostate Risk Assessment plus biopsy Decipher had a c-index of 0.71 (95% CI: 0.60-0.82). National Comprehensive Cancer Network risk group had a c-index of 0.66 (95% CI: 0.53-0.77), while National Comprehensive Cancer Network plus biopsy Decipher had a c-index of 0.74 (95% CI: 0.66-0.82). Biopsy Decipher was a significant predictor of PCSM (hazard ratio: 1.57 per 10% increase in score, 95% CI: 1.03-2.48, p = 0.037), with a 5-yr PCSM rate of 0%, 0%, and 9.4% for Decipher low, intermediate, and high, respectively. Conclusions: Biopsy Decipher predicted metastasis and PCSM from diagnostic biopsy specimens of primarily intermediate- and high-risk men treated with first-line RT or RP. Patient summary: Biopsy Decipher predicted metastasis and prostate cancer-specific mortality risk from diagnostic biopsy specimens. Biopsy Decipher was able to predict metastasis and prostate cancer-specific mortality from diagnostic biopsy specimens in a cohort of primarily intermediate- and high-risk men regardless of type of first-line treatment.
KW - Biopsy
KW - Genomics
KW - Metastasis
KW - Prostate cancer-specific mortality
UR - http://www.scopus.com/inward/record.url?scp=85019884784&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019884784&partnerID=8YFLogxK
U2 - 10.1016/j.eururo.2017.05.009
DO - 10.1016/j.eururo.2017.05.009
M3 - Article
C2 - 28528811
AN - SCOPUS:85019884784
JO - European Urology
JF - European Urology
SN - 0302-2838
ER -