A new genomic test could help identify which men with high-risk prostate cancer require aggressive treatment, potentially improving patient outcomes and reducing unnecessary side effects.
A groundbreaking diagnostic test known as Decipher may significantly enhance the treatment experience for millions of men diagnosed with prostate cancer. Researchers from University College London (UCL) conducted an analysis of this tissue-based molecular test to determine which high-risk prostate cancer patients are most likely to benefit from more aggressive treatments, such as abiraterone hormone therapy, and which patients might be able to avoid unnecessary medication and its associated side effects.
The analysis specifically focused on abiraterone, a hormone therapy that has been shown in the STAMPEDE clinical trial to reduce the risk of death by half among men with high-risk, localized prostate cancer. The findings were presented at the European Society for Medical Oncology (ESMO) Congress 2026, held in Madrid from October 23 to 27.
Not all cancers are the same, and treating patients more aggressively than necessary can lead to increased side effects and a diminished quality of life, as noted in a UCL news release. Prostate cancers can vary significantly at the molecular level, meaning that not every patient will benefit from the addition of hormone therapy.
To assess whether Decipher could assist in guiding treatment decisions, researchers analyzed test scores from over 27,000 patients in real-world data, along with 401 men with non-metastatic prostate cancer who participated in the STAMPEDE trial. The results indicated that higher Decipher scores were associated with worse outcomes, suggesting a greater likelihood of cancer spread and a potential need for additional treatment. Conversely, a low Decipher score indicated that more intensive treatment may be unnecessary.
Dr. Sarah Howlett, the lead researcher from the UCL Cancer Institute, emphasized the importance of preventing the spread of disease for men with very high-risk prostate cancer. “Understanding who benefits most from additional treatment can make a meaningful difference,” she stated.
The findings imply that genomic testing could play a crucial role in personalizing treatment. Men with high-risk prostate cancer and low Decipher scores may have a lower risk of disease progression and could potentially avoid more aggressive therapies. In contrast, those with high scores may be the most suitable candidates for additional treatment. Howlett noted that identifying this pattern in both a large real-world dataset and a randomized clinical trial bolsters the study’s conclusions.
However, she cautioned that further validation in additional datasets is necessary before the test can be routinely used to guide treatment decisions. Elai Davicioni, the medical director of urology for Veracyte, the company that produces the Decipher test, echoed this sentiment. “We believe this growing evidence gives physicians a stronger reason to use Decipher before making decisions that can affect both cancer outcomes and patients’ quality of life,” he stated.
Dr. Marc Siegel, a senior medical analyst at Fox News who was not involved in the study, also weighed in on the findings. He noted that prostate cancer varies significantly from person to person, and medical science is increasingly recognizing that treatment is not a one-size-fits-all approach. Localized prostate cancer, which has not yet metastasized, may contain mutations that predict the disease’s aggressiveness and its potential response to targeted therapies.
Siegel pointed out that certain targeted therapies are becoming more prevalent in the treatment of widespread prostate cancer, including more powerful anti-androgens that act not only on the testes but also on the adrenal glands. He acknowledged that hormone therapies can have significant side effects, such as fatigue, and do not always provide the desired benefits.
The strength of the study, according to Siegel, lies in its combination of a randomized treatment group with Decipher testing, which helps identify in advance which patients are most likely to respond positively to intensive hormone therapy. “This is the personalized, precise approach of the near future,” he remarked.
Prostate cancer is the second-leading cause of cancer death in men, following lung cancer, according to the American Cancer Society. Approximately one in eight American men will receive a prostate cancer diagnosis during their lifetime.
As the medical community continues to explore personalized treatment options, the Decipher test represents a significant advancement in the effort to tailor prostate cancer therapies to individual patient needs, potentially improving outcomes and quality of life for many.
According to Fox News, the implications of this research could reshape how high-risk prostate cancer is treated in the future.