Deciphered.

We’ve known for a while that Decipher genomic testing aids in prognostication of prostate cancers, but that doesn’t mean insurance will cover it. A pooled analysis is here to provide “sufficient” evidence of its clinical utility. There were 42 studies with over 30,000 patients identified, and in 32 studies (n=12,600) Decipher was independently prognostic of every single endpoint including overall survival. More importantly, when assessed in 5 studies (n=4331), Decipher changed clinical management in at least 1 of 4 adjuvant settings and 1 of 9 active surveillance settings. Finally, using Simon and AUA criteria for biomarkers, evidence levels for Decipher were grade 1-2 and A-B (aka the best and next to best) across all diseases except high-risk. TBL: Incorporating Decipher genomic testing into the work-up for prostate cancer has a higher level of evidence than much of the other more standard testing. | Jairath, Euro Urol 2020