UC Irvine

Prostate Cancer (PCa) is a non-cutaneous malignancy in men. Considering the severity of the disease, it is essential to consider the early detection and screening of prostate-specific antigen for decreasing the incidence of death due to this disease. Decipher is a genomic test that has gained increasing attention in estimating the risk of developing a recurrence or metastatic PCa disease in patients. Therefore, this study is focused on evaluating the association of Decipher score risk with recurrence of prostate cancer patients based on their medical, genetic predictors, and demographics (e.g., races) by conducting a systematic review. Moreover, the study would also assess whether Decipher score risk can be a good predictor for prostate patients’ metastasis and prostate cancer-specific mortality in men and clinical decision-making regarding Treatment Recommendations for patients. The research study reviewed 120 research articles, and the results of the systematic review have been presented in the form of themes. The studies' review indicated that Decipher acts as a genomic metastasis signature to predict metastatic disease among patients and make better decisions about treating the disease. Moreover, this genomic test can also be used in conjunction with MRI for identifying the lesions that may carry the biological potential for early metastases. Furthermore, the studies also identified that treatment options for PCa might range from ART and SRT to RP; however, the selection of treatment methodology depends upon the GC score and risk stratification. The results further suggested that the occurrence of PCa is two folds greater among AA men than non-AA men. The increasing incidence of PCa among AA and discrimination within AA's health and socio-economic conditions plays a significant role in treating AA. In this scenario, the Decipher score plays an essential role in making treatment decisions. Hence, this research has reviewed the evidence of benefits of the Decipher test, placed the usage into clinical context, made recommendations to help providers and patients know which treatment might be more appropriate based on the GC score, and when they should consider using the Decipher score based on the works of literature. To conclude, further trials are still required for validating the Decipher biomarkers. All treatment options should be managed based on the individual risk profile and sensitivity to particular medical treatment. As a future direction, scientists could enhance decipher score ability to be run on blood samples of a patient instead of tumor tissue, which will help patients to use decipher test as a screening test at the asymptomatic level. In this way, this test can be routinely done for patients with a family history of prostate cancer, and the biopsy will not be required during the screening stage.