Genomic Testing Can Improve Confidence in Prostate Cancer Treatment Strategy Interview with:

Dr. John L. Gore, MD Associate Professor Adjunct Associate Professor-Surgery Department of Urology University of Washington

Dr. John Gore

Dr. John L. Gore, MD
Associate Professor
Adjunct Associate Professor-Surgery
Department of Urology
University of Washington What is the background for this study? What are the main findings?

Response: The rationale for our study derives from the uncertainty that both patients and clinicians confront when trying to make decisions about adjuvant therapy for prostate cancers found to have aggressive pathologic features at the time of radical prostatectomy. There is level 1 evidence in support of adjuvant radiation therapy in this setting, but several factors restrain providers from recommending adjuvant radiation. We found that interjecting a genomic test that predicts the risk of clinical metastases 5 years after surgery impacts the treatment recommended and helps men and clinicians feel more confident in the decision they are making or recommending. What should readers take away from your report?

Response: Decisions for adjuvant therapy are complex and integrate clinical information as well as the state patients are in with their quality of life recovery from surgery. A genomic test can help men either have more confidence in a more conservative observation strategy or have more evidence for the need for a more aggressive approach. What recommendations do you have for future research as a result of this study?

Response: The immediate next step is understanding how these decisions actually play out in terms of the actual treatments received. We have just finished collecting that data and will know more about how the recommendation impacts actual management strategy. The big unknown is whether the decisions that are made as a result of viewing the genomic test impact long-term health outcomes compared with clinical and pathologic information alone. So, if a patient who was going to be observed switches to receive adjuvant radiation therapy, was that associated with improved cancer-specific and patient-centered outcomes compared with a similar patient who would have been observed. And vice versa, what is the comparative effectiveness for a patient recommended to receive intervention with adjuvant radiation therapy who switches to a conservative strategy. Is there anything else you would like to add?

Response: Is there anything else you would like to add? Any disclosures? Thank you for your contribution to the community.


Effect of Decipher Test on Adjuvant Treatment Decision-Making Among Men with High-Risk Pathology at Radical Prostatectomy: Results from a Multicenter Prospective PRO-IMPACT Study ASCO Meeting:
2017 Genitourinary Cancers Symposium February 2017
Session Type and Session Title:
Poster Session A: Prostate Cancer Abstract Number: 24
Poster Session A Board #B11
J Clin Oncol 35, 2017 (suppl 6S; abstract 24)

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Last Updated on February 17, 2017 by Marie Benz MD FAAD