(UroToday.com) The 2023 SUO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Archan Khandekar discussing grade and volume progression and its association with the Decipher genomic classifier using patients enrolled in a prospective active surveillance protocol.
The progression of prostate cancer through serial biopsies in patients on active surveillance is a multifaceted process, with grade and volume progression offering unique perspectives on disease advancement. The Decipher genomic classifier has been recognized as a valuable tool for predicting disease progression across several studies. As such, this study presented at the SUO 2023 annual meeting examined the relationship between the Decipher score, and other GRID signatures and pathways, and grade and volume progression in prostate cancer patients, utilizing data collected prospectively from the Miami Active Surveillance Trial (MAST).
This study included 224 baseline samples from 124 unique patients in the MAST database. Progression was categorized into grade progression, volume progression, and no progression. For patients with multiple samples, the sample with the highest Decipher score was selected. Dr. Khandekar and colleagues also evaluate the association between 11 prognostic signatures, including the Decipher score and an average genomic risk score combining the 11 signatures and 20 pathways available from the Decipher GRID.
Among the baseline samples, 60 demonstrated grade progression, 51 volume progression, and 113 showed no progression. Dr. Khandekar found that the Decipher genomic classifier was not associated with the trial definition of progression, but that combined grade and volume progression led to a statistically significant difference in Decipher scores from patients who experience grade progression (p = 0.0005) as compared to volume progression (p = 0.92) when comparing them to patients with no progression:
A heat map evaluating prognostic signatures and pathways available on the Decipher grid found that the majority of prognostic signatures including the Decipher score and the average risk model were more associated with grade progression compared to volume or no progression:
Dr. Khandekar concluded this presentation discussing grade and volume progression and its association with the Decipher genomic classifier using patients enrolled in a prospective active surveillance protocol with the following take-home points:
- These findings suggest that the Decipher score has a stronger correlation with grade progression than volume progression in prostate cancer patients on active surveillance
- This highlights the potential of genomic classifiers like Decipher to enhance our understanding of disease progression and in tailoring personalized treatment strategies
- Further prospective studies are required to validate these findings
Presented by: Archan Khandekar, MD, University of Miami, Miami, FL
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2023 Society of Urologic Oncology (SUO) Annual Meeting, Washington, D.C., Tues, Nov 28 – Fri, Dec 1, 2023.