Genomics of Tumor Biology
Decipher Prostate is a genomic classifier (GC) test to screen patients
for prostate cancer and provides an independent prediction of early
clinical metastasis and Prostate Cancer-Specific Mortality following
biopsy or radical prostatectomy (RP)38, 39, 40, 41.
Decipher was created by compiling the genes of 192 metastatic patients
with increasing PSA levels over 5 years and comparing them with 271
patients from a retrospective, nested case-control study, culminating in
a 22 gene marker signature, known as the Decipher
GC42. Decipher GC includes the expression profiles of
coding and non-coding RNA (ncRNA) which is important because genes
involved in metastatic disease progression are significantly affected by
ncRNAs. Other PCa screeners that do not establish ncRNA may lose the
sensitivity to report prognostic information present in
GC14. Patient RNA can be extracted from primary
prostate cancer specimens that are fixed with formalin and paraffin.
After analysis, a Decipher score between 0 and 1 is generated, with low
scores of 0.0-0.44, average scores of 0.45-0.59, and high scores of
0.60-1.0. Higher scores indicate an increased likelihood of adverse
pathological outcomes41 43. In
particular, patients with lower GC scores tend to have lower incidence
of metastasis while higher GC scores give a prognosis of increased
metastasis39. The clinical utility of Decipher has
been verified specifically in intermediate and advanced PCa
patients44. Further validation is needed to verify the
disparity between PCa screening of AAM and EAM using Decipher GC.