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 journalArticle

17 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)
JournalUrology
DOIs
StateAccepted/In press - 2017
Externally publishedYes

ASJC Scopus subject areas

  • Urology

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    Eure, G., Germany, R., Given, R., Lu, R., Shindel, A. W., Rothney, M., Glowacki, R., Henderson, J., Richardson, T., Goldfischer, E., Febbo, P. G., & Denes, B. S. (Accepted/In press). Use of a 17-Gene Prognostic Assay in Contemporary Urologic Practice: Results of an Interim Analysis in an Observational Cohort. Urology. https://doi.org/10.1016/j.urology.2017.02.052