Genomic Classifier Gives Doctors Clear Picture for Prostate Cancer Treatment

By Pat Carragher - June 08, 2021

New data shows that the Decipher® Prostate Genomic Classifier can help doctors tailor treatment decisions for men with prostate cancer. The findings were presented at the American Society of Clinical Oncology Annual Meeting by Dr. Kosj Yamoah, section head of genitourinary oncology in the Department of Radiation Oncology at Moffitt Cancer Center.

In 2019, Moffitt partnered with Bay Pines VA Healthcare System and James A. Haley Veterans’ Hospital to expand its clinical research to include veterans being treated at the two Tampa Bay area VA facilities. The first study stemming from the partnership was the VanDAAM study, which stands for Validation of Decipher Test in African American Men with Prostate Cancer.

The initial findings confirm that the genomic classifier predicts aggressive prostate cancer in African American men with the same accuracy as in non-African American men and performs better than standard clinical-risk factors or nomograms in this population.

headshot of Dr. Kosj Yamoah
Dr. Kosj Yamoah, Radiation Oncology

“Prostate cancer disparities are a very complex problem which has sources in racial inequality as well as underlining socioeconomic determinants that ultimately impacts biology,” said Yamoah. “At a cellular level there may be differences in the way the tumor develops. We know it occurs younger in African American men. The frequency, the incidence and mortality are also higher. With incidences being high at an earlier age, you want to understand why that is for African American men. Part of this specific study was to remove some of the barriers to access by actually prioritizing enrollment of African American men.”

The study is open to men with low- and intermediate-risk newly diagnosed prostate cancer. Participants have samples of their biopsy tumor tissue analyzed to determine how aggressive the disease may be and, in turn, that information can be used by physicians to assist with treatment and follow-up recommendations.

“This study was designed to enroll an African American patient and match that patient with a non-African American counterpart,” said Yamoah. “We then performed genomic testing on their tumor tissue and watched to see how the genomics matched up in their clinical picture.”

Using the genomic classifier, researchers looked at 207 prostate cancer patients (102 African American men, 107 non-African American men). The study revealed significant genomic differences between African American men and non-African American men. Among men with low to favorable-intermediate clinical-risk disease, a combined 49% of African American men had high genomic-risk tumors, compared to only 10% of non-African American men.

African American men were also 3.9 times more likely to be reclassified as high risk for distant metastasis as compared to non-African American men.

“This study really reveals some interesting observations that allows us to really begin to understand how to address the disparities from multiple angles,” said Yamoah. “Allowing increased access to care is a great equalizer to outcomes, but also understanding how to personalize the care to subsets of African-American men who may have  more aggressive disease will be the direction to really attempt to eliminate racial disparities in prostate cancer.”

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