Predicting Adverse Prostate Cancer Pathology With Genetic Assay
Posted: Wednesday, May 1, 2019
In the face of a new prostate cancer diagnosis, both physicians and patients can second-guess the wisdom of their treatment decisions. Their confidence may prove to be markedly boosted with the utilization of the 17-gene Oncotype DX Genomic Prostate Score (GPS), according to study results published in Urology. The GPS appears to be a useful predictor of disease aggressiveness beyond clinical factors, and thus the information derived from it may enhance decision-making discussions between physicians and patients with prostate cancer, particularly those with low-risk or favorable intermediate-risk disease.
Scott Eggener, MD, of the University of Chicago, and colleagues focused on 114 of 1,200 newly diagnosed men with prostate cancer, representing 19 different study sites, who underwent genetic testing. They then chose to undergo radical prostatectomy, rather than active surveillance or any other treatment option. Biopsies taken after surgery indicated adverse pathology in 40 of the men’s cancers (35%), which, by univariable analysis, was strongly correlated (P = .008) with the presurgical GPS results.
The correlation remained significant after adjustment for biopsy Gleason score, clinical tumor stage, and log prostate-specific antigen (P = .04) or for National Comprehensive Cancer Network® risk group (P = .02). “GPS testing provides prognostic information that substantially and consistently improves on the diagnostic accuracy of clinical parameters alone,” concluded Dr. Eggener and his team. And, as demonstrated by the patients’ Decisional Conflict Scale scores before and after GPS testing, “genomic testing…gave patients greater certainty about their chosen management strategy and empowered them to make effective choices regarding their care.”
Disclosure: The study authors’ disclosure information may be found at goldjournal.net.