New test could detect men who would benefit from intensive prostate cancer treatment

New test could detect men who would benefit from intensive prostate cancer treatment - Bookmark - CommentsGo to comments Become an Independent member to bookmark this article Already a member? Log in A novel diagnostic test could enable doctors to identify prostate cancer patients in need of more aggressive care while protecting others from the side effects of redundant therapies, according to a study. The findings follow research led by University College London, which revealed that combining standard treatment with the hormone therapy abiraterone — which works by stopping testosterone from fuelling the cancer — halved mortality risks and slowed disease progression in high-risk cases. To determine which people would gain the most from this treatment, scientists investigated a tool known as Decipher. By analysing cellular genetics using a small portion of an existing tissue biopsy, the test measures how aggressive a tumour is and evaluates its likelihood of spreading. The test transforms this data into a score, ranging from calm and less likely to spread, to aggressive with a high risk of spreading. For the study, which will be presented at the European Society for Medical Oncology Congress 2026 in Madrid, researchers looked at Decipher scores for more than 6,000 men. They found higher scores consistently predicted worse outcomes. The score also predicted which patients whose disease had not yet spread to their lymph nodes and would benefit from abiraterone to prevent further spread. Dr Sarah Howlett, of the UCL Cancer Institute, said: “For men with very high-risk prostate cancer, preventing the cancer from spreading is critical, and understanding who benefits most from additional treatment can make a meaningful difference. “Our findings suggest that a genomic test could help personalise treatment: men with high-risk disease but a low Decipher score have low rates of cancer spread and could potentially be spared more intensive treatment, while men with a high score could be prioritised for it. “Showing the same pattern in both a large real-world dataset and a randomised clinical trial strengthens the findings. But further validation in other datasets is needed before the test is used routinely to make these decisions.” In January it was announced that thousands more men with prostate cancer would be eligible for abiraterone. It was previously only available to those whose cancer had spread, but NHS England widened this to include men whose high-risk cancer had not yet spread. Elai Davicioni, medical director of urology at cancer diagnostics firm Veracyte, which makes the Decipher test, said: “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. “These findings expand Decipher’s predictive evidence to another consequential treatment decision: whether adding abiraterone will provide meaningful benefit for a man with very high-risk prostate cancer.” Join our commenting forum Join thought-provoking conversations, follow other Independent readers and see their replies Comments