Recommendation for the Use of Genomic Classifiers in Determining Patient Eligibility for Adjuvant Radiation Therapy - Editorial

Biomarkers and more complex integration of panels in so-called molecular or genomic classifiers have reached the level of clinical implication after careful standardization (LDT) and clinical validation. Whether these molecular classifiers are actually used and alter treatment decisions is studied in this manuscript.

A genomic classifier (GC) with prognostic indication, Decipher (Decipher Biosciences), aids in the decision for adjuvant radiotherapy (ART). In this study, the authors show that whereas the decision would have been "observation" in 39% of pre-genomic testing cases, the recommendation changed. The authors conclude that the use of GC substantially altered treatment decision-making, with a number needed to test of only 3.

Implementing best practices to routinely recommend ART for genomic-high patients led to larger than expected improvements in early biochemical endpoints, without jeopardizing outcomes for genomic-low/intermediate-risk patients. Even though studies such as this one are largely observational, they give us an insight into the acceptance of the use of genomic classifiers which is still surprisingly low.

Written by: Jack A. Schalken, Ph.D., Professor of Experimental Urology, Director of Urological Research, Radboud University Medical Center, Nijmegen, The Netherlands

Read the Full-Text Article: Prospective Study to Define the Clinical Utility and Benefit of Decipher Testing in Men Following Prostatectomy - Full-Text Article
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