Veracyte, Inc. announced the publication of data reinforcing the clinical utility of the Decipher Prostate genomic classifier for helping to guide the timing and intensity of therapy in men experiencing prostate cancer recurrence following radical prostatectomy (RP). The findings, from an ancillary study of the prospective open-label, multicenter, randomized phase 3 SAKK 09/10 trial conducted at 28 centers in Belgium, Germany, and Switzerland, appear in Annals of Oncology. It is estimated that more than 40 percent of men with intermediate- or high-risk prostate cancer may experience a biochemical disease recurrence after RP, which is characterized by rising levels of serum prostate-specific antigen (PSA). For men who experience a rising PSA, determining the optimal timing to initiate salvage radiotherapy (SRT) and whether to add androgen deprivation therapy (ADT) to SRT is challenging. This decision is important in part because the side effects of ADT when given concurrently with SRT are often difficult for patients to manage and are associated with long-term cardiovascular impact of hormone therapy.
Researchers in the Swiss Group for Clinical Cancer Research (SAKK) and collaborating cancer centers assessed the clinical outcomes and Decipher Prostate genomic risk for 226 prostate cancer patients from the SAKK 09/10 trial, which randomized patients to standard vs. dose-escalated SRT. This study involved men experiencing a rise in PSA following RP, all of whom received SRT without the addition of ADT. Patients in the Decipher Prostate analysis were followed for a
median of 6.3 years. Findings suggest that Decipher Prostate can identify the patients who are at risk of cancer progression following RP and would benefit from earlier, more intensive treatment. Patients with a high Decipher score were more than twice as likely than those with a lower Decipher score to experience biochemical and clinical progression, and to receive long-term salvage hormone therapy. Additionally, patients with high Decipher scores had markedly improved outcomes when treated with SRT when the PSA burden was still low as compared to late SRT, when PSA levels have already.