Dr. Klein on Predicting Tumor Aggressiveness With Oncotype DX Test in Prostate Cancer

Eric A. Klein, MD, professor, Department of Surgery, School of Medicine, member, GU Malignancies Program, Case Comprehensive Cancer Center, Case Western Reserve University, chairman, Glickman Urological & Kidney Institute, Taussig Cancer Institute, Cleveland Clinic, discusses the Oncotype DX test and how it is utilized to predict tumor aggressiveness in patients with prostate cancer.

Oncotype DX is a tumor profiling test that measures a group of 17 genes, determining the aggressiveness of the prostate cancer. Investigators have discovered that this form of genomic testing can predict the likelihood of developing prostate cancer or passing away from the metastatic disease later on in life, says Klein.

The Oncotype DX test is intended to be used in patients who are considering active surveillance, a safe management approach for early-stage, low-grade prostate cancer, says Klein. Active surveillance involves finding the right patient with the right tumor biology and instead of subjecting them to treatment and associated adverse events, closely monitoring them instead. Patients are typically revaluated every 6 months with a digital rectal exam and a prostate-specific antigen test, and once a year, an MRI of the prostate as well as another prostate biopsy, says Klein.

These tests, when done on an initial or subsequent biopsy can help determine whether a tumor has become more aggressive and which patients should receive active surveillance versus immediate intervention. Results showing a high score can indicate higher grade cancer that would call for treatment; that’s how the test should be utilized in this population, concludes Klein.