Veracyte Announces that Findings Published in JCO Precision Oncology Suggest Potential of Decipher GRID-Derived Gene Signatures to Predict Treatment Response in Recurrent Prostate Cancer

Veracyte, Inc. (Nasdaq: VCYT) announced that new data published in JCO Precision Oncology suggest that gene expression signatures derived from the company’s Decipher Genomics Resource for Intelligent Discovery (GRID) database may help advance understanding of the genomic drivers impacting patient response to treatment for recurrent prostate cancer. The findings, from the Phase 2 STREAM study, suggest the potential to use transcriptomic signatures to identify patients in this setting who may benefit from more intensive salvage therapy as well as those who may need alternative care such as chemotherapy.

“The STREAM study showed that, despite treatment with six months of androgen deprivation therapy and enzalutamide, nearly 50% of patients receiving radiation therapy for prostate cancer that has returned experience relapse within three years,” said Andrew Armstrong, M.D., ScM, professor of Medicine and director of Research, Duke Cancer Institute Center for Prostate and Urologic Cancers, and senior/corresponding author for the manuscript. “Using the Decipher GRID database, we found that men in the STREAM study with luminal differentiated genotypes had excellent outcomes, while those whose tumors had a basal, luminal proliferating genotype or other specific genomic characteristics such as PTEN loss had a higher risk of recurrence despite these therapies.”

The three-center, prospective Phase 2 STREAM study was led by Dr. Armstrong and Duke University colleague Rhonda L. Bitting, M.D. The trial evaluated the safety and efficacy of adding six months of enzalutamide to androgen deprivation therapy (ADT) and salvage radiotherapy in patients with rising prostate-specific antigen (PSA) following radical prostatectomy and radiotherapy (RT). A previous publication demonstrated that 51% of men remained free of disease at three years following treatment.

Using prostatectomy tissue from 31 study participants, all of whom had NCCN intermediate- (12.9%) or high-risk (87.1%) disease, researchers conducted a retrospective analysis using the Decipher GRID database to determine whether specific genomic signatures could help predict which patients would benefit from the aggressive therapy regimen, and which may require additional or alternative care.

Results suggest that patients in the study who experienced shorter progression-free survival (PFS) over three years had a luminal proliferating tumor subtype, loss of the PTEN gene and/or higher homologous recombination deficiency (HRD) signature scores. Patients with luminal differentiated or luminal A-type tumors and/or higher postoperative ADT responsiveness genomic signature scores were more likely to have durable responses and long-term remissions with the aggressive systemic regimen of ADT and enzalutamide combined with salvage radiotherapy.