PD27-12 CORRELATION OF POST-PROSTATECTOMY DECIPHER GENOMIC CLASSIFICATION TO CLINICAL OUTCOMES IN PROSTATE CANCER OVER 8 YEAR FOLLOW-UP

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD27-12 CORRELATION OF POST-PROSTATECTOMY DECIPHER GENOMIC CLASSIFICATION TO CLINICAL OUTCOMES IN PROSTATE CANCER OVER 8 YEAR FOLLOW-UP Benjamin Behers, Spencer Kortum, Genesis Dolgetta, Karim Ghazli, Tonya King, Victoria Bird, and Robert Carey Benjamin BehersBenjamin Behers More articles by this author , Spencer KortumSpencer Kortum More articles by this author , Genesis DolgettaGenesis Dolgetta More articles by this author , Karim GhazliKarim Ghazli More articles by this author , Tonya KingTonya King More articles by this author , Victoria BirdVictoria Bird More articles by this author , and Robert CareyRobert Carey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003305.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Decipher genomic classification (DGC) has been developed to predict disease severity in prostate cancer. This study seeks to evaluate how well Decipher scores predicted actual clinical outcome in 192 patients that underwent robotic prostatectomy (RALRP) with 8-year follow-up of survival outcomes. METHODS: Data is collected from an IRB-approved, prospectively-maintained database of 192 patients who underwent RALRP with DGC testing of the post prostatectomy specimens with mean 8 year follow-up outcomes. The Decipher prediction signatures were Metastasis Risk, Androgen Deprivation Therapy (ADT) Response, Post-Operative Radiation Response, Docetaxel Sensitivity, Seminal Vesicle Invasion, Genomic Gleason Score of Primary 4 or 5, Genomic CAPRA-S Score of High (>5), Pathology Stage T3 (pT3 Disease), Tumor Cell Proliferation, and Androgen Receptor (AR) Signaling Activity. A logistic regression analysis test evaluated these signatures with the actual clinical outcomes of metastatic castration-resistant prostate cancer (mCRPC), metastasis, ADT use, overall mortality (OM), and disease-specific mortality (DSM). RESULTS: Higher Decipher scores for pT3 Disease was the most significant predictor of requiring ADT. The odds of ADT were 1.8 times greater for every 25-unit increase in pT3 Disease (95% CI 1.84-4.96, p<0.001). A negative relationship was seen between the Decipher prediction of Genomic Gleason Score of Primary 4 or 5 and no disease progression. The odds of no progression was 0.6 times lower for every 25-unit increase in Genomic Gleason Score of Primary 4 or 5 (95% CI 0.41-0.82, p=0.002). Higher Decipher scores for Post-Operative Radiation Response had a positive relationship with overall mortality. For every 25-unit increase in Post-Operative Radiation Response, OM was 1.9 times greater (95% CI 1.32-2.87, p<0.001). Finally, AR Signaling Activity had a negative relationship with disease-specific mortality. DSM was 0.21 times lower for every 25-unit increase in AR Signaling Activity (95% CI 0.05-0.85, p=0.028). CONCLUSIONS: This paper finds correlation between Decipher genomic predictions with actual clinical outcomes at 8 year post prostatectomy follow-up. Decipher scores for pT3 Disease and Genomic Gleason Score of Primary 4 or 5 signature were the best predictors of requiring ADT treatment and of no disease progression, respectively. AR Signaling Activity signature was the best predictor of disease-specific mortality, whereas Post-Operative Radiation Response was the best predictor of overall mortality. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e746 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Behers More articles by this author Spencer Kortum More articles by this author Genesis Dolgetta More articles by this author Karim Ghazli More articles by this author Tonya King More articles by this author Victoria Bird More articles by this author Robert Carey More articles by this author Expand All Advertisement PDF downloadLoading ...