Validation of the Decipher Test for Predicting Distant Metastatic Recurrence in Men with High-risk Nonmetastatic Prostate Cancer 10 Years After Surgery

Thomas Van den Broeck, Lisa Moris, Thomas Gevaert, Lorenzo Tosco, Elien Smeets, Nick Fishbane, Yang Liu, Christine Helsen, Jennifer Margrave, Christine Buerki, Elai Davicioni, Hendrik Van Poppel, Wouter Everaerts, Sheila Weinmann, Robert Den, John Davis, Edward Schaeffer, Robert Jeffrey Karnes, Frank Claessens, Steven Joniau

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Decipher is a genomic classifier designed to predict the development of distant metastases after surgical treatment of prostate cancer (PC). Its long-term prognostic role in a high-risk PC population has not been investigated previously. OBJECTIVE: To determine the prognostic role of the Decipher genomic classifier in two high-risk PC case-control studies. DESIGN, SETTING, AND PARTICIPANTS: Patients who developed distant metastases after surgery for high-risk, nonmetastatic PC in a European tertiary referral center from 1991 to 2011 were matched to patients not developing distant metastases (n=54). A validation study (n=298) was performed using a similar US case-control cohort. Formalin-fixed, paraffin-embedded tissue blocks from the index PC lesion were used for RNA extraction and gene expression analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The outcome investigated was the development of distant metastasis within 10-yr follow-up. Multivariable logistic regression analysis was performed, with statistical significance considered at p<0.05. RESULTS AND LIMITATIONS: In both the European and US case-control studies, the median Decipher scores were higher in the population that developed metastases. In the multivariable analysis, each 10% increase in Decipher score translated to an increase in the risk of distant metastases within 10-yr follow-up, with an odds ratio of 1.53 (95% confidence interval [CI] 1.06-2.22; p=0.025) and 1.58 (95% CI 1.31-1.92; p<0.001) for the European and US cohorts, respectively. Median follow-up for the European cohort was 12yr (interquartile range 8-12). The study limitation is the small size of the European cohort. CONCLUSIONS: Our study validates Decipher as a predictor for metastatic recurrence even in patients with high-risk, nonmetastatic PC within 10-yr follow-up. PATIENT SUMMARY: Decipher is a test based on gene expression profiles in primary tumors in prostate cancer. It has already been proven to predict cancer recurrence after surgery, but this has not yet been shown for patients with high-risk prostate cancer. This is the first study confirming that Decipher predicts a patient's risk of developing cancer recurrence after surgery for high-risk prostate cancer.

Original languageEnglish (US)
Pages (from-to)589-596
Number of pages8
JournalEuropean Urology Oncology
Volume2
Issue number5
DOIs
StatePublished - Sep 1 2019

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Prostatic Neoplasms
Recurrence
Neoplasm Metastasis
Case-Control Studies
Confidence Intervals
Neoplasms
Validation Studies
Transcriptome
Tertiary Care Centers
Paraffin
Formaldehyde
Population
Logistic Models
Odds Ratio
Regression Analysis
RNA
Gene Expression

Keywords

  • Decipher
  • Prognosis
  • Prostate cancer
  • Prostatectomy
  • Risk assessment

Cite this

Validation of the Decipher Test for Predicting Distant Metastatic Recurrence in Men with High-risk Nonmetastatic Prostate Cancer 10 Years After Surgery. / Van den Broeck, Thomas; Moris, Lisa; Gevaert, Thomas; Tosco, Lorenzo; Smeets, Elien; Fishbane, Nick; Liu, Yang; Helsen, Christine; Margrave, Jennifer; Buerki, Christine; Davicioni, Elai; Van Poppel, Hendrik; Everaerts, Wouter; Weinmann, Sheila; Den, Robert; Davis, John; Schaeffer, Edward; Karnes, Robert Jeffrey; Claessens, Frank; Joniau, Steven.

In: European Urology Oncology, Vol. 2, No. 5, 01.09.2019, p. 589-596.

Research output: Contribution to journalArticle

Van den Broeck, T, Moris, L, Gevaert, T, Tosco, L, Smeets, E, Fishbane, N, Liu, Y, Helsen, C, Margrave, J, Buerki, C, Davicioni, E, Van Poppel, H, Everaerts, W, Weinmann, S, Den, R, Davis, J, Schaeffer, E, Karnes, RJ, Claessens, F & Joniau, S 2019, 'Validation of the Decipher Test for Predicting Distant Metastatic Recurrence in Men with High-risk Nonmetastatic Prostate Cancer 10 Years After Surgery', European Urology Oncology, vol. 2, no. 5, pp. 589-596. https://doi.org/10.1016/j.euo.2018.12.007
Van den Broeck, Thomas ; Moris, Lisa ; Gevaert, Thomas ; Tosco, Lorenzo ; Smeets, Elien ; Fishbane, Nick ; Liu, Yang ; Helsen, Christine ; Margrave, Jennifer ; Buerki, Christine ; Davicioni, Elai ; Van Poppel, Hendrik ; Everaerts, Wouter ; Weinmann, Sheila ; Den, Robert ; Davis, John ; Schaeffer, Edward ; Karnes, Robert Jeffrey ; Claessens, Frank ; Joniau, Steven. / Validation of the Decipher Test for Predicting Distant Metastatic Recurrence in Men with High-risk Nonmetastatic Prostate Cancer 10 Years After Surgery. In: European Urology Oncology. 2019 ; Vol. 2, No. 5. pp. 589-596.
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abstract = "BACKGROUND: Decipher is a genomic classifier designed to predict the development of distant metastases after surgical treatment of prostate cancer (PC). Its long-term prognostic role in a high-risk PC population has not been investigated previously. OBJECTIVE: To determine the prognostic role of the Decipher genomic classifier in two high-risk PC case-control studies. DESIGN, SETTING, AND PARTICIPANTS: Patients who developed distant metastases after surgery for high-risk, nonmetastatic PC in a European tertiary referral center from 1991 to 2011 were matched to patients not developing distant metastases (n=54). A validation study (n=298) was performed using a similar US case-control cohort. Formalin-fixed, paraffin-embedded tissue blocks from the index PC lesion were used for RNA extraction and gene expression analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The outcome investigated was the development of distant metastasis within 10-yr follow-up. Multivariable logistic regression analysis was performed, with statistical significance considered at p<0.05. RESULTS AND LIMITATIONS: In both the European and US case-control studies, the median Decipher scores were higher in the population that developed metastases. In the multivariable analysis, each 10{\%} increase in Decipher score translated to an increase in the risk of distant metastases within 10-yr follow-up, with an odds ratio of 1.53 (95{\%} confidence interval [CI] 1.06-2.22; p=0.025) and 1.58 (95{\%} CI 1.31-1.92; p<0.001) for the European and US cohorts, respectively. Median follow-up for the European cohort was 12yr (interquartile range 8-12). The study limitation is the small size of the European cohort. CONCLUSIONS: Our study validates Decipher as a predictor for metastatic recurrence even in patients with high-risk, nonmetastatic PC within 10-yr follow-up. PATIENT SUMMARY: Decipher is a test based on gene expression profiles in primary tumors in prostate cancer. It has already been proven to predict cancer recurrence after surgery, but this has not yet been shown for patients with high-risk prostate cancer. This is the first study confirming that Decipher predicts a patient's risk of developing cancer recurrence after surgery for high-risk prostate cancer.",
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TY - JOUR

T1 - Validation of the Decipher Test for Predicting Distant Metastatic Recurrence in Men with High-risk Nonmetastatic Prostate Cancer 10 Years After Surgery

AU - Van den Broeck, Thomas

AU - Moris, Lisa

AU - Gevaert, Thomas

AU - Tosco, Lorenzo

AU - Smeets, Elien

AU - Fishbane, Nick

AU - Liu, Yang

AU - Helsen, Christine

AU - Margrave, Jennifer

AU - Buerki, Christine

AU - Davicioni, Elai

AU - Van Poppel, Hendrik

AU - Everaerts, Wouter

AU - Weinmann, Sheila

AU - Den, Robert

AU - Davis, John

AU - Schaeffer, Edward

AU - Karnes, Robert Jeffrey

AU - Claessens, Frank

AU - Joniau, Steven

PY - 2019/9/1

Y1 - 2019/9/1

N2 - BACKGROUND: Decipher is a genomic classifier designed to predict the development of distant metastases after surgical treatment of prostate cancer (PC). Its long-term prognostic role in a high-risk PC population has not been investigated previously. OBJECTIVE: To determine the prognostic role of the Decipher genomic classifier in two high-risk PC case-control studies. DESIGN, SETTING, AND PARTICIPANTS: Patients who developed distant metastases after surgery for high-risk, nonmetastatic PC in a European tertiary referral center from 1991 to 2011 were matched to patients not developing distant metastases (n=54). A validation study (n=298) was performed using a similar US case-control cohort. Formalin-fixed, paraffin-embedded tissue blocks from the index PC lesion were used for RNA extraction and gene expression analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The outcome investigated was the development of distant metastasis within 10-yr follow-up. Multivariable logistic regression analysis was performed, with statistical significance considered at p<0.05. RESULTS AND LIMITATIONS: In both the European and US case-control studies, the median Decipher scores were higher in the population that developed metastases. In the multivariable analysis, each 10% increase in Decipher score translated to an increase in the risk of distant metastases within 10-yr follow-up, with an odds ratio of 1.53 (95% confidence interval [CI] 1.06-2.22; p=0.025) and 1.58 (95% CI 1.31-1.92; p<0.001) for the European and US cohorts, respectively. Median follow-up for the European cohort was 12yr (interquartile range 8-12). The study limitation is the small size of the European cohort. CONCLUSIONS: Our study validates Decipher as a predictor for metastatic recurrence even in patients with high-risk, nonmetastatic PC within 10-yr follow-up. PATIENT SUMMARY: Decipher is a test based on gene expression profiles in primary tumors in prostate cancer. It has already been proven to predict cancer recurrence after surgery, but this has not yet been shown for patients with high-risk prostate cancer. This is the first study confirming that Decipher predicts a patient's risk of developing cancer recurrence after surgery for high-risk prostate cancer.

AB - BACKGROUND: Decipher is a genomic classifier designed to predict the development of distant metastases after surgical treatment of prostate cancer (PC). Its long-term prognostic role in a high-risk PC population has not been investigated previously. OBJECTIVE: To determine the prognostic role of the Decipher genomic classifier in two high-risk PC case-control studies. DESIGN, SETTING, AND PARTICIPANTS: Patients who developed distant metastases after surgery for high-risk, nonmetastatic PC in a European tertiary referral center from 1991 to 2011 were matched to patients not developing distant metastases (n=54). A validation study (n=298) was performed using a similar US case-control cohort. Formalin-fixed, paraffin-embedded tissue blocks from the index PC lesion were used for RNA extraction and gene expression analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The outcome investigated was the development of distant metastasis within 10-yr follow-up. Multivariable logistic regression analysis was performed, with statistical significance considered at p<0.05. RESULTS AND LIMITATIONS: In both the European and US case-control studies, the median Decipher scores were higher in the population that developed metastases. In the multivariable analysis, each 10% increase in Decipher score translated to an increase in the risk of distant metastases within 10-yr follow-up, with an odds ratio of 1.53 (95% confidence interval [CI] 1.06-2.22; p=0.025) and 1.58 (95% CI 1.31-1.92; p<0.001) for the European and US cohorts, respectively. Median follow-up for the European cohort was 12yr (interquartile range 8-12). The study limitation is the small size of the European cohort. CONCLUSIONS: Our study validates Decipher as a predictor for metastatic recurrence even in patients with high-risk, nonmetastatic PC within 10-yr follow-up. PATIENT SUMMARY: Decipher is a test based on gene expression profiles in primary tumors in prostate cancer. It has already been proven to predict cancer recurrence after surgery, but this has not yet been shown for patients with high-risk prostate cancer. This is the first study confirming that Decipher predicts a patient's risk of developing cancer recurrence after surgery for high-risk prostate cancer.

KW - Decipher

KW - Prognosis

KW - Prostate cancer

KW - Prostatectomy

KW - Risk assessment

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