Evaluation Of The Decipher Prostate Cancer Classifier To Predict Metastasis And Disease-Specific Mortality From Genomic Analysis Of Diagnostic Prostate Needle Biopsy Specimens.

4Background: Accurate risk stratification after diagnosis of prostate cancer (PCa) is key to optimal treatment decision-making. Decipher RP is an extensively validated genomic classifier used to determine biological potential for metastasis. Here, in a multi-institutional cohort, we aimed to evaluate its ability to predict metastasis and prostate cancer-specific mortality from analysis of PCa needle biopsy tumor tissue specimens. Methods: We identified 175 patients treated with either first-line RP or first-line radiation therapy (RT) + androgen deprivation therapy (ADT) with available genomic expression profiles generated from diagnostic biopsy specimens obtained from three tertiary referral centers: Cleveland Clinic, Brigham and Women’s Hospital and Johns Hopkins. The core with the highest grade was sampled and Decipher was calculated based on a locked random forest model. Cox univariable and multivariable (MVA) proportional hazards model and survival c-index were used to evaluate the performance of Dec...