Prognostic Value of Genomic Classifier Testing for Prostate Cancer: A Systematic Review

Matthew J. Boyer; David Carpenter; Jeffrey R. Gingrich; Sudha Raman; Deepika Sirohi; Amir Alishahi Tabriz; Alexis Rompre-Brodeur; Joseph Lunyera; Fahmin Basher; Rhonda L. Bitting; Andrzej Kosinski; Sarah Cantrell; Adelaide M. Gordon; Belinda Ear; Jennifer M. Gierisch; Morgan Jacobs; Karen M. Goldstein

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Prognostic Value of Genomic Classifier Testing for Prostate Cancer: A Systematic Review

Evidence Synthesis Program

Matthew J. Boyer, MD, PhD, Conceptualization, Methodology, Investigation, Formal analysis, Writing – original draft, Writing – review & editing, David Carpenter, MD, MHS, Conceptualization, Methodology, Investigation, Formal analysis, Writing – original draft, Writing – review & editing, Jeffrey R. Gingrich, MD, FACS, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Sudha Raman, PhD, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Deepika Sirohi, MD, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Amir Alishahi Tabriz, MD, PhD, MPH, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Alexis Rompre-Brodeur, MD, FRCSC, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Joseph Lunyera, MBChB, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Fahmin Basher, MD, PhD, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Rhonda L. Bitting, MD, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing, Andrzej Kosinski, PhD, Data curation, Methodology, Formal analysis, Visualization, Writing – review & editing, Sarah Cantrell, MLIS, AHIP, Conceptualization, Methodology, Writing – review & editing, Adelaide M. Gordon, MPH, Conceptualization, Data curation, Methodology, Investigation, Project administration, Formal analysis, Writing – original draft, Writing – review & editing, Belinda Ear, MPH, Conceptualization, Data curation, Methodology, Project administration, Writing – original draft, Jennifer M. Gierisch, PhD, Conceptualization, Methodology, Investigation, Writing – review & editing, Morgan Jacobs, MPH, Data curation, Project administration, Visualization, and Karen M. Goldstein, MD, MSPH, Conceptualization, Data curation, Methodology, Supervision, Investigation, Formal analysis, Visualization, Writing – original draft, Writing – review & editing.

Author Information and Affiliations

Authors

Matthew J. Boyer, MD, PhD, Conceptualization, Methodology, Investigation, Formal analysis, Writing – original draft, Writing – review & editing,¹ David Carpenter, MD, MHS, Conceptualization, Methodology, Investigation, Formal analysis, Writing – original draft, Writing – review & editing,² Jeffrey R. Gingrich, MD, FACS, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing,^3,4 Sudha Raman, PhD, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing,⁵ Deepika Sirohi, MD, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing,⁶ Amir Alishahi Tabriz, MD, PhD, MPH, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing,⁷ Alexis Rompre-Brodeur, MD, FRCSC, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing,⁸ Joseph Lunyera, MBChB, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing,⁹ Fahmin Basher, MD, PhD, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing,¹⁰ Rhonda L. Bitting, MD, Conceptualization, Methodology, Investigation, Writing – original draft, Writing – review & editing,^11,12 Andrzej Kosinski, PhD, Data curation, Methodology, Formal analysis, Visualization, Writing – review & editing,¹³ Sarah Cantrell, MLIS, AHIP, Conceptualization, Methodology, Writing – review & editing,¹⁴ Adelaide M. Gordon, MPH, Conceptualization, Data curation, Methodology, Investigation, Project administration, Formal analysis, Writing – original draft, Writing – review & editing,^15,16 Belinda Ear, MPH, Conceptualization, Data curation, Methodology, Project administration, Writing – original draft,^17,18 Jennifer M. Gierisch, PhD, Conceptualization, Methodology, Investigation, Writing – review & editing,^19,20,21 Morgan Jacobs, MPH, Data curation, Project administration, Visualization,²² and Karen M. Goldstein, MD, MSPH, Conceptualization, Data curation, Methodology, Supervision, Investigation, Formal analysis, Visualization, Writing – original draft, Writing – review & editing^23,24,25,26.

Affiliations

¹ Medical Instructor, Department of Radiation Oncology, Duke University School of Medicine Durham, NC

² Resident, Department of Radiation Oncology, Duke University School of Medicine Durham, NC

³ Staff Physician, Durham VA Medical Center

⁴ Professor of Surgery, Urology, Duke University Durham, NC

⁵ Assistant Professor, Department of Population Health Sciences at Duke University School of Medicine Durham, NC

⁶ Associate Professor, Department of Pathology, University of Utah and ARUP Laboratories Salt Lake City, UT

⁷ Assistant Member, Department of Health Outcomes and Behavior Moffitt Cancer Center Tampa, FL

⁸ Assistant Professor of Surgery, Division of Urology, McGill University Montreal, Canada

⁹ Medical Instructor, Department of Medicine, Duke University School of Medicine Durham, NC

¹⁰ Fellow, Hematology, Medical Oncology, Duke University Durham, NC

¹¹ Staff Physician, Genitourinary Medical Oncology, Durham VA Medical Center

¹² Associate Professor of Medicine, Duke University Durham, NC

¹³ Professor of Biostatistics & Bioinformatics, Duke University Durham, NC

¹⁴ Associate Director for Research & Education, Duke University Medical Center Library & Archives, Duke University School of Medicine Durham, NC

¹⁵ Project Coordinator, Durham Evidence Synthesis Program (ESP) Center

¹⁶ Research Health Science Specialist, Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System Durham, NC

¹⁷ Research Assistant, Durham ESP Center, Durham, NC

¹⁸ Research Health Science Specialist, Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System Durham, NC

¹⁹ Co-director, Durham ESP Center

²⁰ Core Investigator, Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System

²¹ Associate Professor, Department of Population Health Sciences, Duke University School of Medicine Durham, NC

²² Research Assistant, Durham ESP Center Durham, NC

²³ Co-director, Durham ESP Center

²⁴ Core Investigator, Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System

²⁵ Staff Physician, Durham VA Medical Center

²⁶ Associate Professor, Department of Medicine, Division of General Internal Medicine, Duke University Durham, NC

Washington (DC): Department of Veterans Affairs (US); 2023 Mar.

Prostate cancer is the most common malignancy in men, with an estimated 268,490 new cases in the United States in 2022, and 12,500 new diagnoses annually within the Veterans Health Administration (VHA). A major challenge for prostate cancer management is identifying patients who would benefit from treatment and tailoring the intensity of that treatment to personalized risk assessments. Risk stratification traditionally has been based on readily available clinical features; however, multiple options exist for treatment, and there is variability in patient outcomes not otherwise explained by currently recognized risk factors. Individualized prognosis beyond clinically based risk stratification schemas could inform patient-physician decisionmaking, reduce unnecessary overtreatment, and improve patient outcomes. A relatively recent advancement in prostate cancer risk stratification is the development of commercially available, tissue-based genomic classifiers. This systematic review addresses the impact of 3 commercial genomic classifier tests—Decipher, Oncotype DX GPS (now named Genomic Prostate Score but referred to in this report as Oncotype), and Prolaris—on risk classification, treatment choice and harms, and the prognostic ability of these tests beyond the clinical features of patients diagnosed with or treated for localized prostate cancer. (See Appendix A for guidelines for the 3 tests.)

Suggested citation:

Boyer MJ, Carpenter D, Gingrich JR, et al. Prognostic Value of Genomic Classifier Testing for Prostate Cancer: A Systematic Review. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-010; 2023.

This report was prepared by the Evidence Synthesis Program Center located at the Durham VA Medical Center, directed by Jennifer M. Gierisch, PhD, MPH, and Karen M. Goldstein, MD, MSPH, and funded by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development.

The findings and conclusions in this document are those of the author(s) who are responsible for its contents and do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (eg, employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.

This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be acknowledged.

Bookshelf ID: NBK594816PMID: 37729441

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Boyer MJ, Carpenter D, Gingrich JR, et al. Prognostic Value of Genomic Classifier Testing for Prostate Cancer: A Systematic Review. Washington (DC): Department of Veterans Affairs (US); 2023 Mar.
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