Presentation Authors: Darryl Martin, Kamyar Ghabili*, Angelique Levi, Peter Humphrey, Peter Schulam, Preston Sprenkle, New Haven, CT
Introduction: The utility of the Decipher biopsy test in magnetic resonance imaging (MRI)-targeted biopsies from men with favorable-risk prostate cancer has not been evaluated. We sought to assess the association between Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) score, the Decipher score and histologic grade of carcinoma in biopsy tissue among low- to intermediate-risk prostate cancer patients.
Methods: MRI-ultrasound targeted biopsy of regions of interest and concurrent 12-core systematic biopsy was performed on 291 men with Gleason grade group (GG) 1 and 2. We compared Decipher score with PI-RADS scores and biopsy Gleason GG. Subgroup analyses were performed to evaluate patients who underwent radical prostatectomy, and men with Decipher testing from a targeted biopsy core.
Results: One hundred three patients with GG1 and GG2 had biopsy Decipher testing. There was no significant difference in the median Decipher scores among the three mpMRI categories. Patients with GG2 vs. GG1 in the setting of PI-RADS 4 and 5 had higher genomic scores (p = 0.01), but no significant difference was noted in patients with PI-RADS â‰¤3. The rate of genomic higher-risk disease on a targeted biopsy from PI-RADS 5 was higher in GG2 (75%) vs. GG1 (11.1%; p = 0.01) (Figure 1). Among 14 patients who underwent radical prostatectomy, no downgrading was detected.
Conclusions: High-risk genomic classification can be seen across all combinations of PI-RADS categories and Gleason GG1 and GG2, confirming a potential utility for Decipher testing in men with low- to favorable intermediate-risk prostate cancer. The Decipher biopsy genomic test related to Gleason GG independent of PI-RADSv2 score, which may be beneficial when incorporating this genomic marker into a nomogram or a clinical decision-making model.