title: Decipher Genomic Classifier Measured on Prostate Biopsy Predicts Metastasis Risk.
abstract: OBJECTIVE
  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 radical prostatectomy in a previously reported Decipher validation study at Cleveland Clinic. A Cox multivariable 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 prostate cancer. The Decipher plus National Comprehensive Cancer Network (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 multivariable analysis, Decipher was the only significant predictor of metastasis when adjusting for age, preoperative prostate-specific antigen and biopsy Gleason score (Decipher hazard ratio per 10% increase 1.72, 95% CI 1.07-2.81, P = .02).
  
  
  CONCLUSIONS
  Biopsy Decipher predicted the risk of metastasis at 10 years post radical prostatectomy. While further validation is required on larger cohorts, preoperative knowledge of Decipher risk derived from biopsy could indicate the need for multimodality therapy and help set patient expectations of therapeutic burden.
authors.affiliation: Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH. Electronic address: kleine@ccf.org.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Klein
authors.affiliation: GenomeDx Biosciences Inc, Vancouver, BC, Canada.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Haddad
authors.affiliation: GenomeDx Biosciences Inc, Vancouver, BC, Canada.
authors.forename: Kasra
authors.initials: K
authors.lastname: Yousefi
authors.affiliation: GenomeDx Biosciences Inc, Vancouver, BC, Canada.
authors.forename: Lucia L C
authors.initials: LL
authors.lastname: Lam
authors.affiliation: GenomeDx Biosciences Inc, Vancouver, BC, Canada.
authors.forename: Qiqi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: GenomeDx Biosciences Inc, Vancouver, BC, Canada.
authors.forename: Voleak
authors.initials: V
authors.lastname: Choeurng
authors.affiliation: GenomeDx Biosciences Inc, Vancouver, BC, Canada.
authors.forename: Beatrix
authors.initials: B
authors.lastname: Palmer-Aronsten
authors.affiliation: GenomeDx Biosciences Inc, Vancouver, BC, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Buerki
authors.affiliation: GenomeDx Biosciences Inc, Vancouver, BC, Canada.
authors.forename: Elai
authors.initials: E
authors.lastname: Davicioni
authors.affiliation: Cleveland Clinic, Quantitative Health Sciences, Cleveland, OH.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Li
authors.affiliation: Cleveland Clinic, Quantitative Health Sciences, Cleveland, OH.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Kattan
authors.affiliation: Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Stephenson
authors.affiliation: Cleveland Clinic, Anatomic Pathology, Cleveland, OH.
authors.forename: Cristina
authors.initials: C
authors.lastname: Magi-Galluzzi
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor; D001707:Biopsy, Needle; D005500:Follow-Up Studies; D023281:Genomics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D018570:Risk Assessment; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor