Use of a 17-Gene Prognostic Assay in Contemporary Urologic Practice: Results of an Interim Analysis in an Observational Cohort

Gregg Eure, Raymond Germany, Robert Given, Ruixiao Lu, Alan W. Shindel, Megan Rothney, Richard Glowacki, Jonathan Henderson, Tim Richardson, Evan Goldfischer, Phillip G. Febbo, Bela S. Denes

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Objective To study the impact of genomic testing in shared decision making for men with clinically low-risk prostate cancer (PCa). Materials and Methods Patients with clinically low-risk PCa were enrolled in a prospective, multi-institutional study of a validated 17-gene tissue-based reverse transcription polymerase chain reaction assay (Genomic Prostate Score [GPS]). In this paper we report on outcomes in the first 297 patients enrolled in the study with valid 17-gene assay results and decision-change data. The primary end points were shared decision on initial management and persistence on active surveillance (AS) at 1 year post diagnosis. AS utilization and persistence were compared with similar end points in a group of patients who did not have genomic testing (baseline cohort). Secondary end points included perceived utility of the assay and patient decisional conflict before and after testing. Results One-year results were available on 258 patients. Shift between initial recommendation and shared decision occurred in 23% of patients. Utilization of AS was higher in the GPS-tested cohort than in the untested baseline cohort (62% vs 40%). The proportion of men who selected and persisted on AS at 1 year was 55% and 34% in the GPS and baseline cohorts, respectively. Physicians reported that GPS was useful in 90% of cases. Mean decisional conflict scores declined in patients after GPS testing. Conclusion Patients who received GPS testing were more likely to select and persist on AS for initial management compared with a matched baseline group. These data indicate that GPS help guide shared decisions in clinically low-risk PCa.

Original languageEnglish (US)
Pages (from-to)67-75
Number of pages9
JournalUrology
Volume107
DOIs
StatePublished - Sep 2017

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