Test accurately predicts prostate cancer recurrence after surgery

A 46-gene diagnostic test accurately predicted, based on biopsy specimens, which men would develop biochemical recurrence (BCR) or metastatic disease following radical prostatectomy, a recently published study found.

Study data on the Prolaris test (Myriad Genetics, Inc., Salt Lake City) were published online ahead of print in the Journal of Urology (Feb. 10, 2014).

"This study represents a great advance in the treatment of prostate cancer. The results from three different institutions show that Prolaris can better define patient prognosis and improve care," said first author Jay T. Bishoff, MD, of Intermountain Health Care in Murray, UT. "Having a test that identifies which patients are likely to fail surgery is a big clinical advantage for physicians. Patients with a low score may be candidates for active surveillance, while patients with a high score indicative of aggressive cancer may benefit from more intensive medical treatments."

The study evaluated biopsy specimens in 582 men who underwent radical prostatectomy. Biopsy samples were evaluated from three cohorts of contemporary patients in the United States and Germany. The clinical endpoints were metastatic disease and BCR. In all cohorts, the Prolaris test was a statistically significant predictor of BCR and was the single strongest predictor of metastatic disease when compared to Gleason score or PSA.

In the pooled analysis, each one-unit increase in the Prolaris score translated into a fivefold increased risk of metastases and a 1.6-times increased risk of BCR.

"The Prolaris test answers an important clinical question for all urologists concerning their surgical candidates… do my patients have an aggressive prostate cancer or not and therefore need more aggressive treatment?" said study co-author Michael Brawer, MD, of Myriad Genetics.

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