How does a low Decipher score impact your management of patients with unfavorable intermediate-risk prostate cancer?

Do you consider omission of ADT for these patients? Do other clinicopathologic factors affect your recommendations? This question is part of our ASTRO 2026 collaboration, inspired by the Special Session: Biomarkers in Prostate Radiotherapy Presentation "Genomic Stratification of Benefit from Short-Term Androgen Deprivation with Dose-Escalated Radiotherapy in Intermediate-Risk Prostate Cancer: An Ancillary Study of NRG/RTOG 0815" by Dr. Angela Jia, MD, PhD

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Do you omit ADT for patients with unfavorable intermediate-risk prostate cancer and a low Decipher score?

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3 Answers

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Radiation Oncology · Dana-Farber Cancer Institute

Answered on

In the NRG-GU010 trial, those patients were randomized to RT alone vs. RT + ADT, reflecting a hypothesis that these patients may not need ADT, although we will have to wait for the trial to read out to be sure. However, what we do know is that with widespread use of MRI-guided biopsies and PSMA PET ...

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Radiation Oncology · Case Western Reserve University/ University Hospitals Seidman Cancer Center

Answered on

Yes, in the era of conventional staging (CT and bone scans), I do consider omitting ADT in selected patients with a low Decipher score. I consider it a lot more in the era of MRI and PSMA PET for staging.

NRG/RTOG 0815 wasn't designed around current FIR/UIR definitions. As we saw in the 10-year long...

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Radiation Oncology · Indiana Radiotherapy PC

Answered on

Does not

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