by Lauren Dubinsky
, Senior Reporter | July 30, 2014
A genomic test is able to determine what patients would benefit the most from radiation therapy after prostate cancer surgery, according to a recent study conducted by Thomas Jefferson University.
Surgery is intended to cure prostate cancer but in some cases, it's not possible to totally cure the cancer. Physicians have created high risk criteria based on clinical factors in order to determine the likelihood of recurrence but it's not always the most effective approach because only 50 percent of high risk patients ever develop metastases.
"The clinicopathological prognostic and predictive factors have enabled us to select patients for various therapies. However, we know that different patients respond differently," Dr. Robert Den, assistant professor of radiation oncology and cancer biology at the university, wrote to DOTmed News. "The use of genomics provides us with further insight into the cancer and allows us to personalize therapy."
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The genomic test is called Decipher and it's created by the genome diagnostics company, GenomeDx. It produces a gene signature from a patient's cancer tissue sample and then classifies them into high, intermediate and low risk for cancer recurrence and metastases.
For the study, the researchers tested the genomes from the tumor samples of 139 patients who had radiation therapy after prostate surgery at Thomas Jefferson University Hospital. They then used the patients' medical records to categorize them based on the treatments they received after surgery and matched that with the results of the genomic test.
They found that the genomic test was able to accurately predict outcomes. The patients who had high Decipher scores were more likely to develop metastases than the patients with low scores.
Additionally, the patients with a high Decipher score who received radiation therapy sooner survived longer than the patients who didn't get the therapy right after surgery.
Since it gives physicians and patients more information to make informed decisions regarding treatment and it can also reduce over-treatment, Den thinks that it will become widely used in clinical practice within the next six to 12 months.
The researchers are currently validating their findings with a bigger patient population across multiple institutions.