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Decipher Genomic Classifier — SCE Medical Oncology MCQ

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ModerateUrological CancersDecipher Genomic ClassifierSCE Medical Oncology

A 55-year-old man with localised prostate cancer has genomic classifier testing (Decipher) performed on his prostatectomy specimen. The Decipher score is 0.85 (high-risk). What does this test provide that standard clinicopathological factors do not?

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Correct answer: B — Decipher is a 22-gene genomic classifier that predicts metastatic risk independently of Gleason grade

Decipher (GenomeDx) is a 22-gene RNA expression classifier validated on prostatectomy specimens to predict 5/10-year metastatic risk. It provides independent prognostic information beyond standard clinicopathological variables (Gleason, margin status, PSA, pathological stage). Clinical utility: high Decipher scores may support adjuvant (rather than salvage) radiotherapy, addition of ADT to salvage RT, and intensification of systemic therapy. Decipher is increasingly used in clinical decision-making, though not yet routinely NHS-funded in the UK.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer