Diagnosis
➤ Commercially available molecular biomarkers (i.e., Oncotype Dx
Prostate, Prolaris, Decipher, ProMark) may be offered in situations
where the assay result, when considered in toto with routine clinical
factors, is likely to impact management. Routine ordering of molecular
biomarkers is not recommended (Moderate Recommendation; EB-I).
➤ Any additional molecular biomarkers evaluated do not have sufficient
data to be clinically actionable or are not commercially available, thus
should not be offered. (Moderate Recommendation; EB-Ins)
➤ The Expert Panel recommends consideration of a commercially available
molecular biomarker (e.g., Decipher Genomic Classifier) in situations
where the assay result, when considered in toto with routine clinical
factors, is likely to impact management. In the absence of prospective
clinical trial data, routine use of genomic biomarkers in the post-
prostatectomy setting to determine adjuvant versus salvage radiation
or to initiate systemic therapies should not be offered. (Moderate
Recommendation; EB-I)
➤ In men with newly diagnosed prostate cancer eligible for active
surveillance, both MRI and genomics intend to identify clinically
significant cancers. The Expert Panel endorses their use only in
situations where the result, when considered with routine clinical
factors, is likely to impact management. This may include, for
instance, in the initial management of men potentially eligible for
active surveillance, where each of these approaches may provide
clinically relevant and actionable information. These tests may provide
information independent of routine clinical parameters and independent
of one another. (Weak Recommendation; IC-U-L)
