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A new diagnostic test could improve the prostate cancer experience for millions of men.
Researchers from University College London (UCL) analyzed a tissue-based molecular test called Decipher to find out which men with high-risk prostate cancer were most likely to benefit from stronger treatment – and which could avoid unnecessary drugs and side effects.
The analysis focused on abiraterone, a hormone treatment that in the STAMPEDE clinical trial was shown to cut the risk of death in half in men with high-risk localized prostate cancer.
The results were presented at the European Society for Medical Oncology (ESMO) 2026 Congress in Madrid, October 23-27.
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Not all cancers are the same, and treating a person more aggressively than necessary could have “increased side effects and poorer quality of life”, notes a UCL press release.
Because prostate cancers differ at the molecular level, not all patients benefit from the addition of hormone therapy.
Adding a hormone treatment called abiraterone to standard treatment for men with high-risk localized prostate cancer could cut the risk of death in half, the trial found.
To determine whether Decipher could help guide this decision, researchers looked at test results from more than 27,000 patients in real-world data and from 401 men with non-metastatic prostate cancer who participated in the STAMPEDE trial of abiraterone.
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Higher Decipher scores predicted worse outcomes, meaning the cancer is more likely to spread and additional treatment may be helpful. A low Decipher score suggests that more intensive treatment might be unnecessary.
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Lead researcher Dr Sarah Howlett from the UCL Cancer Institute commented in a statement that for men with very high-risk prostate cancer, preventing the spread of the disease is “essential”.
“Understanding who benefits most from additional treatment can make a significant difference,” she added.
A genomic test could help personalize treatments for prostate cancer patients, researchers have suggested. (iStock)
The results suggest that genomic testing could help tailor treatment, according to the researcher.
Men with high-risk prostate cancer and low Decipher scores may face a lower risk of spread and avoid more intensive treatment, while those with high scores may be the best candidates for additional treatment.
Identifying the same pattern in a large real-world data set and in a randomized clinical trial strengthens the findings, Howlett noted.
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“But further validation in other data sets is needed before the test is used systematically to make these decisions,” she said.
Elai Davicioni, medical director of urology at Veracyte, maker of Decipher tests, also commented: “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. »
Men with high-risk prostate cancer and low Decipher scores may face a lower risk of spread and avoid more intensive treatment, while those with high scores may be the best candidates for additional treatment. (iStock)
Fox News senior medical analyst Dr. Marc Siegel, who was not involved in the study, also commented on the findings.
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“Prostate cancer varies from person to person,” he said. “Medical science is increasingly aware that there is no one-size-fits-all solution.”
Localized prostate cancer, which has not yet spread, may contain mutations that predict how aggressive the disease is and whether it might respond to targeted therapies, Siegel noted.
About one in eight American men will be diagnosed with prostate cancer in their lifetime, according to the American Cancer Society. (iStock)
Some targeted therapies are used more in the widespread prostate cancer, according to the doctor, because they include “more powerful anti-androgens, which act not only on the testicles, but also on the adrenals.”
Hormonal therapies have “significant side effects,” including fatigue, and “don’t always help,” he added.
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Siegel said the strength of the study was the combination of a randomized treatment group and the Decipher tests, which helped identify in advance which patients were most likely to respond to intensive hormone therapy.
“This is the personalized, precise approach of the near future,” he said.
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Prostate cancer is the second leading cause of cancer death behind lung cancer, according to the American Cancer Society.
About one in eight Americans will be diagnosed with prostate cancer in their lifetime.
Gn Health
