To study the impact of genomic testing in shared decision making for men with clinically low risk prostate cancer (PCa).
Patients with clinically low-risk PCa were enrolled in a prospective, multi-institutional study of a validated 17-gene tissue-based RT-PCR assay (Genomic Prostate Score™; GPS). In this manuscript 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 endpoints were shared decision on initial management and persistence on active surveillance (AS) at one year post-diagnosis. AS utilization and persistence were compared to similar endpoints in a group of patients who did not have genomic testing (baseline cohort). Secondary endpoints included perceived utility of the assay and patient decisional conflict before and after testing.
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 one 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.
Patients who received GPS testing were more likely to select and persist on AS for initial management compared to a matched baseline group. These data indicate that GPS help guide shared decisions in clinically low-risk PCa.
Urology. 2017 Apr 25 [Epub ahead of print]
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 Denes
Urology of Virginia, Virginia Beach, VA., Regional Urology LLC, Shreveport, LA., Genomic Health Inc., Redwood City, CA., The Iowa Clinic, West Des Moines, IA., Wichita Urology, Wichita, KS., Premier Medical Group, Poughkeepsie, NY., Genomic Health Inc., Redwood City, CA. Electronic address: .