Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens

Paul L. Nguyen, Zaid Haddad, Ashley E. Ross, Neil E. Martin, Samineh Deheshi, Lucia L.C. Lam, Jijumon Chelliserry, Jeffrey J. Tosoian, Tamara L. Lotan, Daniel E. Spratt, Radka S. Stoyanova, Sanoj Punnen, Kaye Ong, Christine Buerki, Maria Aranes, Tyler Kolisnik, Jennifer Margrave, Kasra Yousefi, Voleak Choeurng, Elai Davicioni & 6 others Bruce J. Trock, Christopher J. Kane, Alan Pollack, John W. Davis, Felix Y. Feng, Eric A. Klein

Research output: Contribution to journalArticle

Abstract

Background: Decipher is a validated genomic classifier developed to determine the biological potential for metastasis after radical prostatectomy (RP). Objective: To evaluate the ability of biopsy Decipher to predict metastasis and Prostate cancer-specific mortality (PCSM) in primarily intermediate- to high-risk patients treated with RP or radiation therapy (RT). Design, setting, and participants: Two hundred and thirty-five patients treated with either RP (n = 105) or RT. ±. androgen deprivation therapy (n = 130) with available genomic expression profiles generated from diagnostic biopsy specimens from seven tertiary referral centers. The highest-grade core was sampled and Decipher was calculated based on a locked random forest model. Outcome measurements and statistical analysis: Metastasis and PCSM were the primary and secondary outcomes of the study, respectively. Cox analysis and c-index were used to evaluate the performance of Decipher. Results and limitations: With a median follow-up of 6 yr among censored patients, 34 patients developed metastases and 11 died of prostate cancer. On multivariable analysis, biopsy Decipher remained a significant predictor of metastasis (hazard ratio: 1.37 per 10% increase in score, 95% confidence interval [CI]: 1.06-1.78, p = 0.018) after adjusting for clinical variables. For predicting metastasis 5-yr post-biopsy, Cancer of the Prostate Risk Assessment score had a c-index of 0.60 (95% CI: 0.50-0.69), while Cancer of the Prostate Risk Assessment plus biopsy Decipher had a c-index of 0.71 (95% CI: 0.60-0.82). National Comprehensive Cancer Network risk group had a c-index of 0.66 (95% CI: 0.53-0.77), while National Comprehensive Cancer Network plus biopsy Decipher had a c-index of 0.74 (95% CI: 0.66-0.82). Biopsy Decipher was a significant predictor of PCSM (hazard ratio: 1.57 per 10% increase in score, 95% CI: 1.03-2.48, p = 0.037), with a 5-yr PCSM rate of 0%, 0%, and 9.4% for Decipher low, intermediate, and high, respectively. Conclusions: Biopsy Decipher predicted metastasis and PCSM from diagnostic biopsy specimens of primarily intermediate- and high-risk men treated with first-line RT or RP. Patient summary: Biopsy Decipher predicted metastasis and prostate cancer-specific mortality risk from diagnostic biopsy specimens. Biopsy Decipher was able to predict metastasis and prostate cancer-specific mortality from diagnostic biopsy specimens in a cohort of primarily intermediate- and high-risk men regardless of type of first-line treatment.

LanguageEnglish (US)
JournalEuropean Urology
DOIs
StateAccepted/In press - 2017

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Needle Biopsy
Prostatic Neoplasms
Radiation
Neoplasm Metastasis
Biopsy
Mortality
Confidence Intervals
Prostatectomy
Radiotherapy
Tertiary Care Centers
Androgens
Neoplasms
Outcome Assessment (Health Care)

Keywords

  • Biopsy
  • Genomics
  • Metastasis
  • Prostate cancer-specific mortality

ASJC Scopus subject areas

  • Urology

Cite this

Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens. / Nguyen, Paul L.; Haddad, Zaid; Ross, Ashley E.; Martin, Neil E.; Deheshi, Samineh; Lam, Lucia L.C.; Chelliserry, Jijumon; Tosoian, Jeffrey J.; Lotan, Tamara L.; Spratt, Daniel E.; Stoyanova, Radka S.; Punnen, Sanoj; Ong, Kaye; Buerki, Christine; Aranes, Maria; Kolisnik, Tyler; Margrave, Jennifer; Yousefi, Kasra; Choeurng, Voleak; Davicioni, Elai; Trock, Bruce J.; Kane, Christopher J.; Pollack, Alan; Davis, John W.; Feng, Felix Y.; Klein, Eric A.

In: European Urology, 2017.

Research output: Contribution to journalArticle

Nguyen, PL, Haddad, Z, Ross, AE, Martin, NE, Deheshi, S, Lam, LLC, Chelliserry, J, Tosoian, JJ, Lotan, TL, Spratt, DE, Stoyanova, RS, Punnen, S, Ong, K, Buerki, C, Aranes, M, Kolisnik, T, Margrave, J, Yousefi, K, Choeurng, V, Davicioni, E, Trock, BJ, Kane, CJ, Pollack, A, Davis, JW, Feng, FY & Klein, EA 2017, 'Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens' European Urology. DOI: 10.1016/j.eururo.2017.05.009
Nguyen, Paul L. ; Haddad, Zaid ; Ross, Ashley E. ; Martin, Neil E. ; Deheshi, Samineh ; Lam, Lucia L.C. ; Chelliserry, Jijumon ; Tosoian, Jeffrey J. ; Lotan, Tamara L. ; Spratt, Daniel E. ; Stoyanova, Radka S. ; Punnen, Sanoj ; Ong, Kaye ; Buerki, Christine ; Aranes, Maria ; Kolisnik, Tyler ; Margrave, Jennifer ; Yousefi, Kasra ; Choeurng, Voleak ; Davicioni, Elai ; Trock, Bruce J. ; Kane, Christopher J. ; Pollack, Alan ; Davis, John W. ; Feng, Felix Y. ; Klein, Eric A./ Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens. In: European Urology. 2017
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title = "Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens",
abstract = "Background: Decipher is a validated genomic classifier developed to determine the biological potential for metastasis after radical prostatectomy (RP). Objective: To evaluate the ability of biopsy Decipher to predict metastasis and Prostate cancer-specific mortality (PCSM) in primarily intermediate- to high-risk patients treated with RP or radiation therapy (RT). Design, setting, and participants: Two hundred and thirty-five patients treated with either RP (n = 105) or RT. ±. androgen deprivation therapy (n = 130) with available genomic expression profiles generated from diagnostic biopsy specimens from seven tertiary referral centers. The highest-grade core was sampled and Decipher was calculated based on a locked random forest model. Outcome measurements and statistical analysis: Metastasis and PCSM were the primary and secondary outcomes of the study, respectively. Cox analysis and c-index were used to evaluate the performance of Decipher. Results and limitations: With a median follow-up of 6 yr among censored patients, 34 patients developed metastases and 11 died of prostate cancer. On multivariable analysis, biopsy Decipher remained a significant predictor of metastasis (hazard ratio: 1.37 per 10{\%} increase in score, 95{\%} confidence interval [CI]: 1.06-1.78, p = 0.018) after adjusting for clinical variables. For predicting metastasis 5-yr post-biopsy, Cancer of the Prostate Risk Assessment score had a c-index of 0.60 (95{\%} CI: 0.50-0.69), while Cancer of the Prostate Risk Assessment plus biopsy Decipher had a c-index of 0.71 (95{\%} CI: 0.60-0.82). National Comprehensive Cancer Network risk group had a c-index of 0.66 (95{\%} CI: 0.53-0.77), while National Comprehensive Cancer Network plus biopsy Decipher had a c-index of 0.74 (95{\%} CI: 0.66-0.82). Biopsy Decipher was a significant predictor of PCSM (hazard ratio: 1.57 per 10{\%} increase in score, 95{\%} CI: 1.03-2.48, p = 0.037), with a 5-yr PCSM rate of 0{\%}, 0{\%}, and 9.4{\%} for Decipher low, intermediate, and high, respectively. Conclusions: Biopsy Decipher predicted metastasis and PCSM from diagnostic biopsy specimens of primarily intermediate- and high-risk men treated with first-line RT or RP. Patient summary: Biopsy Decipher predicted metastasis and prostate cancer-specific mortality risk from diagnostic biopsy specimens. Biopsy Decipher was able to predict metastasis and prostate cancer-specific mortality from diagnostic biopsy specimens in a cohort of primarily intermediate- and high-risk men regardless of type of first-line treatment.",
keywords = "Biopsy, Genomics, Metastasis, Prostate cancer-specific mortality",
author = "Nguyen, {Paul L.} and Zaid Haddad and Ross, {Ashley E.} and Martin, {Neil E.} and Samineh Deheshi and Lam, {Lucia L.C.} and Jijumon Chelliserry and Tosoian, {Jeffrey J.} and Lotan, {Tamara L.} and Spratt, {Daniel E.} and Stoyanova, {Radka S.} and Sanoj Punnen and Kaye Ong and Christine Buerki and Maria Aranes and Tyler Kolisnik and Jennifer Margrave and Kasra Yousefi and Voleak Choeurng and Elai Davicioni and Trock, {Bruce J.} and Kane, {Christopher J.} and Alan Pollack and Davis, {John W.} and Feng, {Felix Y.} and Klein, {Eric A.}",
year = "2017",
doi = "10.1016/j.eururo.2017.05.009",
language = "English (US)",
journal = "European Urology",
issn = "0302-2838",
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TY - JOUR

T1 - Ability of a Genomic Classifier to Predict Metastasis and Prostate Cancer-specific Mortality after Radiation or Surgery based on Needle Biopsy Specimens

AU - Nguyen,Paul L.

AU - Haddad,Zaid

AU - Ross,Ashley E.

AU - Martin,Neil E.

AU - Deheshi,Samineh

AU - Lam,Lucia L.C.

AU - Chelliserry,Jijumon

AU - Tosoian,Jeffrey J.

AU - Lotan,Tamara L.

AU - Spratt,Daniel E.

AU - Stoyanova,Radka S.

AU - Punnen,Sanoj

AU - Ong,Kaye

AU - Buerki,Christine

AU - Aranes,Maria

AU - Kolisnik,Tyler

AU - Margrave,Jennifer

AU - Yousefi,Kasra

AU - Choeurng,Voleak

AU - Davicioni,Elai

AU - Trock,Bruce J.

AU - Kane,Christopher J.

AU - Pollack,Alan

AU - Davis,John W.

AU - Feng,Felix Y.

AU - Klein,Eric A.

PY - 2017

Y1 - 2017

N2 - Background: Decipher is a validated genomic classifier developed to determine the biological potential for metastasis after radical prostatectomy (RP). Objective: To evaluate the ability of biopsy Decipher to predict metastasis and Prostate cancer-specific mortality (PCSM) in primarily intermediate- to high-risk patients treated with RP or radiation therapy (RT). Design, setting, and participants: Two hundred and thirty-five patients treated with either RP (n = 105) or RT. ±. androgen deprivation therapy (n = 130) with available genomic expression profiles generated from diagnostic biopsy specimens from seven tertiary referral centers. The highest-grade core was sampled and Decipher was calculated based on a locked random forest model. Outcome measurements and statistical analysis: Metastasis and PCSM were the primary and secondary outcomes of the study, respectively. Cox analysis and c-index were used to evaluate the performance of Decipher. Results and limitations: With a median follow-up of 6 yr among censored patients, 34 patients developed metastases and 11 died of prostate cancer. On multivariable analysis, biopsy Decipher remained a significant predictor of metastasis (hazard ratio: 1.37 per 10% increase in score, 95% confidence interval [CI]: 1.06-1.78, p = 0.018) after adjusting for clinical variables. For predicting metastasis 5-yr post-biopsy, Cancer of the Prostate Risk Assessment score had a c-index of 0.60 (95% CI: 0.50-0.69), while Cancer of the Prostate Risk Assessment plus biopsy Decipher had a c-index of 0.71 (95% CI: 0.60-0.82). National Comprehensive Cancer Network risk group had a c-index of 0.66 (95% CI: 0.53-0.77), while National Comprehensive Cancer Network plus biopsy Decipher had a c-index of 0.74 (95% CI: 0.66-0.82). Biopsy Decipher was a significant predictor of PCSM (hazard ratio: 1.57 per 10% increase in score, 95% CI: 1.03-2.48, p = 0.037), with a 5-yr PCSM rate of 0%, 0%, and 9.4% for Decipher low, intermediate, and high, respectively. Conclusions: Biopsy Decipher predicted metastasis and PCSM from diagnostic biopsy specimens of primarily intermediate- and high-risk men treated with first-line RT or RP. Patient summary: Biopsy Decipher predicted metastasis and prostate cancer-specific mortality risk from diagnostic biopsy specimens. Biopsy Decipher was able to predict metastasis and prostate cancer-specific mortality from diagnostic biopsy specimens in a cohort of primarily intermediate- and high-risk men regardless of type of first-line treatment.

AB - Background: Decipher is a validated genomic classifier developed to determine the biological potential for metastasis after radical prostatectomy (RP). Objective: To evaluate the ability of biopsy Decipher to predict metastasis and Prostate cancer-specific mortality (PCSM) in primarily intermediate- to high-risk patients treated with RP or radiation therapy (RT). Design, setting, and participants: Two hundred and thirty-five patients treated with either RP (n = 105) or RT. ±. androgen deprivation therapy (n = 130) with available genomic expression profiles generated from diagnostic biopsy specimens from seven tertiary referral centers. The highest-grade core was sampled and Decipher was calculated based on a locked random forest model. Outcome measurements and statistical analysis: Metastasis and PCSM were the primary and secondary outcomes of the study, respectively. Cox analysis and c-index were used to evaluate the performance of Decipher. Results and limitations: With a median follow-up of 6 yr among censored patients, 34 patients developed metastases and 11 died of prostate cancer. On multivariable analysis, biopsy Decipher remained a significant predictor of metastasis (hazard ratio: 1.37 per 10% increase in score, 95% confidence interval [CI]: 1.06-1.78, p = 0.018) after adjusting for clinical variables. For predicting metastasis 5-yr post-biopsy, Cancer of the Prostate Risk Assessment score had a c-index of 0.60 (95% CI: 0.50-0.69), while Cancer of the Prostate Risk Assessment plus biopsy Decipher had a c-index of 0.71 (95% CI: 0.60-0.82). National Comprehensive Cancer Network risk group had a c-index of 0.66 (95% CI: 0.53-0.77), while National Comprehensive Cancer Network plus biopsy Decipher had a c-index of 0.74 (95% CI: 0.66-0.82). Biopsy Decipher was a significant predictor of PCSM (hazard ratio: 1.57 per 10% increase in score, 95% CI: 1.03-2.48, p = 0.037), with a 5-yr PCSM rate of 0%, 0%, and 9.4% for Decipher low, intermediate, and high, respectively. Conclusions: Biopsy Decipher predicted metastasis and PCSM from diagnostic biopsy specimens of primarily intermediate- and high-risk men treated with first-line RT or RP. Patient summary: Biopsy Decipher predicted metastasis and prostate cancer-specific mortality risk from diagnostic biopsy specimens. Biopsy Decipher was able to predict metastasis and prostate cancer-specific mortality from diagnostic biopsy specimens in a cohort of primarily intermediate- and high-risk men regardless of type of first-line treatment.

KW - Biopsy

KW - Genomics

KW - Metastasis

KW - Prostate cancer-specific mortality

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U2 - 10.1016/j.eururo.2017.05.009

DO - 10.1016/j.eururo.2017.05.009

M3 - Article

JO - European Urology

T2 - European Urology

JF - European Urology

SN - 0302-2838

ER -