Using Genomic Testing to Select Patients for Post-Operative Radiation

Decipher is a genomic test that looks for specific genes in a patient’s tumor that are known to be involved in prostate cancer’s development and progression. A recent study aimed to identify a Decipher test score that would help identify patients who would benefit from having adjuvant radiation therapy after having prostate cancer surgery.

The researchers looked at data from 512 prostate cancer patients who had pT3a or greater disease, positive surgical margins, and/or lymph node invasion. They found that 10 years after surgery, the cancer recurrence rate was 4.9% in patients who had adjuvant radiation therapy, compared to 17.4% of patients who did not undergo postoperative radiation. Along with other pathological features already used in a clinical setting, a Decipher score of >0.6 was associated with a greater risk of cancer recurrence. The researchers hope that their risk stratification model, which incorporates Decipher scores, could reduce the risk of cancer recurrence in patients with aggressive disease that their data showed would benefit from adjuvant radiation therapy.