Decipher Test ScoresĪfter accounting for differences in participants’ ages, races, ethnicities, cancer treatments, and other factors, the researchers found that prostate cancer was more likely to have spread in people with higher Decipher scores than in people with lower scores.
DECIPHER TEXT TRIAL
The participants’ medical outcomes had been tracked for about 13 years.Īssessing the Decipher test in the context of this previous trial allowed the researchers to determine whether the test could predict outcomes in patients who hadn’t yet been treated and whether it could predict how well that treatment would work, Dr. The trial participants-who all had rising PSA levels after surgery-had been randomly assigned to receive radiation alone or in combination with bicalutamide (Casodex), a type of hormone therapy. They applied the Decipher test to tumor tissue that was removed during surgery from 352 patients who participated in an earlier clinical trial. Feng and his colleagues set out to see how well the test worked in the context of a clinical trial that had followed participants forward in time. The test looks at the activity of 22 genes in prostate tumors and calculates a score from 0 to 1.įor the new study, Dr. The Decipher test was developed to address the need for a reliable biomarker, and retrospective studies that looked back in time have shown that it does indeed outperform standard markers like PSA level. “A patient could have a rising PSA and die of something else” rather than prostate cancer down the road, explained Adam Sowalsky, Ph.D., head of NCI’s Prostate Cancer Genetics Section, who was not involved in the study. But studies have shown that these characteristics aren’t very good at identifying people who truly need the combination treatment. The Need for a Better Biomarkerĭoctors currently use certain criteria-like the tumor grade and PSA level-to recommend whether patients with recurrent prostate cancer should get hormone therapy in addition to radiation. The results, published February 11 in JAMA Oncology, also showed that hormone therapy helped people with higher scores live longer but was far less helpful for those with lower scores.Īlthough the Decipher test was developed nearly a decade ago, the new findings are important because previously there wasn’t enough evidence to recommend its routine use in patient care, explained Sean McGuire, M.D., Ph.D., in an accompanying editorial. Using data from an NCI-sponsored clinical trial, researchers found that people with higher Decipher scores were more likely to have cancer that spread years later and to die from the cancer. The new study found that the genetic biomarker test, called Decipher, may have the ability to do just that. But it’s currently challenging to determine which patients have aggressive cancer that may require the addition of hormone therapy. Most people with recurrent prostate cancer “don’t want hormone therapy unless they absolutely have to receive it,” he added. The standard treatment for prostate cancer that has come back after prostatectomy is radiation therapy, either alone or with the addition of hormone therapy.īecause hormone therapy can cause distressing side effects-including hot flashes, loss of energy, and loss of sexual desire-the treatment is typically reserved for patients with aggressive cancer that is more likely to spread, explained the study’s lead investigator, Felix Feng, M.D., of the University of California, San Francisco. If a person’s PSA level starts to rise after surgery to remove the entire prostate ( radical prostatectomy), that generally means the cancer has come back. The test could help people with prostate cancer and their doctors choose the most appropriate treatment, the researchers concluded. A large study has confirmed that a genetic test can correctly predict how likely it is for recurrent prostate cancer to spread (metastasize) to other parts of the body.
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