Impact of Genomic Classifiers on Risk Stratification and Treatment Intensity in Patients With Localized Prostate Cancer
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Le résumé fourni par la source
BACKGROUND: Tissue-based genomic classifiers (GCs) have been developed to improve prostate cancer (PCa) risk assessment and treatment recommendations. PURPOSE: To summarize the impact of the Decipher, Oncotype DX Genomic Prostate Score (GPS), and Prolaris GCs on risk stratification and patient-clinician decisions on treatment choice among patients with localized PCa considering first-line treatment. DATA SOURCES: MEDLINE, EMBASE, and Web of Science published from January 2010 to August 2024. STUDY SELECTION: Two investigators independently identified studies on risk classification and treatment choice after GC testing for patients with localized PCa considering first-line treatment. DATA EXTRACTION: Relevant data extracted by 1 researcher and overread by a second. Risk of bias (ROB) was assessed in duplicate. DATA SYNTHESIS: Ten studies reported risk reclassification after GC testing. In low ROB observational studies, very low- or low-risk patients with PCa were more likely to have their risk levels classified as the same or lower (GPS, 100% to 88.1%; Decipher, 87.2% to 82.9%; Prolaris, 76.9%). However, 1 randomized trial found that GC testing with GPS reclassified 34.5% of very low-risk and 29.4% of low-risk patients to a higher risk category. Twelve observational studies indicated that treatment decisions after GC testing either remained unchanged or slightly favored active surveillance. In contrast, analyses from a single randomized trial found fewer choices for active surveillance after GPS testing. LIMITATIONS: Heterogeneity in screening patterns, risk-determination cutoffs, pathology, and clinical practices. Studies on treatment choice were moderate to high ROB. CONCLUSION: Although GC tests do not consistently influence risk classification or treatment decisions, the differences observed between observational and randomized studies highlight a need for well-designed trials to explore the role of GC tests in patients with newly diagnosed PCa considering first-line treatment. PRIMARY FUNDING SOURCE: U.S. Department of Veterans Affairs. (PROSPERO: CRD42022347950).
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of Genomic Classifiers on Risk Stratification and Treatment Intensity in Patients With Localized Prostate Cancer
- Date Crossref
- 01/02/2025
- Éditeur
- American College of Physicians
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Moffitt Cancer Center pays non établi dans la noticeÉtablissement de santé
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Duke University and Department of Radiation Oncology pays non établi dans la noticeUniversité ou école supérieure
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Durham VA Health Care System pays non établi dans la noticeÉtablissement de santé
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University of Utah Department of Pathology pays non établi dans la noticeUniversité ou école supérieure
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McGill University Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Duke Medical Center pays non établi dans la noticeÉtablissement de santé
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Duke University Hospital pays non établi dans la noticeÉtablissement de santé
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Duke University Health System pays non établi dans la noticeUniversité ou école supérieure
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Department of Health Outcomes and Behavior pays non établi dans la noticeInstitution
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Wellstar Paulding Medical Center Department of Radiation Oncology pays non établi dans la noticeÉtablissement de santé
Moffitt Cancer Center, and Department of Radiation Oncology — Duke University et Durham VA Health Care System, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.