title: Decipher correlation patterns post prostatectomy: initial experience from 2 342 prospective patients.
abstract: Currently, there are multiple commercially available RNA-based biomarkers that are Medicare approved and suggested for use by the National Comprehensive Cancer Network guidelines. There is uncertainty as to which patients benefit from genomic testing and for whom these tests should be ordered. Here, we examined the correlation patterns of Decipher assay to understand the relationship between the Decipher and patient tumor characteristics.
  
  
  
  De-identified Decipher test results (including Decipher risk scores and clinicopathologic data) from 2 342 consecutive radical prostatectomy (RP) patients tested between January and September 2015 were analyzed. For clinical testing, tumor specimen from the highest Gleason grade was sampled using a 1.5 mm tissue punch. Decipher scores were calculated based on a previously locked model. Correlations between Decipher score and clinicopathologic variables were computed using Spearman's rank correlation. Mixed-effect linear models were used to study the association of practice type and Decipher score. The significance level was 0.05 for all tests.
  
  
  
  Decipher score had a positive correlation with pathologic Gleason score (PGS; r=0.37, 95% confidence interval (CI) 0.34-0.41), pathologic T-stage (r=0.31, 95% CI 0.28-0.35), CAPRA-S (r=0.32, 95% CI 0.28-0.37) and patient age (r=0.09, 95% CI 0.05-0.13). Decipher reclassified 52%, 76% and 40% of patients in CAPRA-S low-, intermediate- and high-risk groups, respectively. We detected a 28% incidence of high-risk disease through the Decipher score in pT2 patients and 7% low risk in pT3b/pT4, PGS 8-10 patients. There was no significant difference in the Decipher score between patients from community centers and those from academic centers (P=0.82).
  
  
  
  Although Decipher correlated with baseline tumor characteristics for over 2 000 patients, there was significant reclassification of tumor aggressiveness as compared to clinical parameters alone. Utilization of the Decipher genomic classifier can have major implications in assessment of postoperative risk that may impact physician-patient decision making and ultimately patient management.
authors: Department of Radiation Oncology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors: R B
authors: RB
authors: Den
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: M
authors: M
authors: Santiago-Jimenez
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: J
authors: J
authors: Alter
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: M
authors: M
authors: Schliekelman
authors: Urologic Oncology and Minimally Invasive Surgery, Hartford Healthcare Medical Group, Hartford, CT, USA.
authors: J R
authors: JR
authors: Wagner
authors: Section of Minimally Invasive Urology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors: J F
authors: JF
authors: Renzulli Ii
authors: Division of Urology, Penn Presbyterian Medical Center, Philadelphia, PA, USA.
authors: D I
authors: DI
authors: Lee
authors: Arizona Urology Specialists, Scottsdale, AZ, USA.
authors: C G
authors: CG
authors: Brito
authors: Penn Urology, Philadelphia, PA, USA.
authors: K
authors: K
authors: Monahan
authors: Arizona Urology Specialists, Scottsdale, AZ, USA.
authors: B
authors: B
authors: Gburek
authors: The Urology and Prostate Institute, San Antonio, TX, USA.
authors: N
authors: N
authors: Kella
authors: Lubbock Urology, Lubbock, TX, USA.
authors: G
authors: G
authors: Vallabhan
authors: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
authors: F
authors: F
authors: Abdollah
authors: Department of Urology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors: E J
authors: EJ
authors: Trabulsi
authors: Department of Urology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors: C D
authors: CD
authors: Lallas
authors: Department of Urology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors: L G
authors: LG
authors: Gomella
authors: Global Robotics Institute, Celebration, FL, USA.
authors: T L
authors: TL
authors: Woodlief
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: Z
authors: Z
authors: Haddad
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: L L C
authors: LL
authors: Lam
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: S
authors: S
authors: Deheshi
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: Q
authors: 0000-0002-6373-7339
authors: Q
authors: Wang
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: V
authors: V
authors: Choeurng
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: M
authors: M
authors: du Plessis
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: J
authors: J
authors: Jordan
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: B
authors: B
authors: Parks
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: H
authors: H
authors: Shin
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: C
authors: C
authors: Buerki
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: K
authors: K
authors: Yousefi
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.
authors: E
authors: E
authors: Davicioni
authors: Global Robotics Institute, Celebration, FL, USA.
authors: V R
authors: VR
authors: Patel
authors: GenomeDx Biosciences Inc., Vancouver, BC, Canada.|Piedmont Health Care, Atlanta, GA, USA.
authors: N L
authors: NL
authors: Shah
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading / Q000379:methods; D011184:Postoperative Period; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D018570:Risk Assessment
chemical_list: D017430:Prostate-Specific Antigen