A Systematic Review of Decipher Genomic Classifier Risk Scores for Prostate Cancer in African-Americans

Prostate Cancer (PCa) is a non-cutaneous malignancy in men, and Decipher being a genomic test, 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 has also assessed 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 patient treatment recommendations. The research study has reviewed 74 research articles, and the systematic review results 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 Magnetic Resonance Imaging (MRI) for identifying the lesions that may carry the biological potential for early metastases. Furthermore, this review also identified that treatment options for PCa might range from Adjuvant Radiation Treatment (ART) and Salvage Radiation Therapy (SRT) to Radical Prostatectomy (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 African-Americans (AA) men as compared to non-AA men. Thus, 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 test score plays an essential role in making treatment decisions. To conclude, further trials are still required for validating the Decipher biomarkers, and scientists should enhance the decipher test ability to be run on a patient's blood samples instead of tumor tissue, which will help patients use decipher as a screening test at the asymptomatic level.