Multi-site Decision Impact Study for Decipher

The clinical utility of Decipher will be evaluated at two time-points:

• Post RP - within 6 months after surgery
• PSA rise - defined as PSA detectable and rising on 2 or more subsequent determinations

Patient cases will be retrospectively selected from at least 5 sites. Participating urologists at each site will be asked to each identify a minimum of 10 to a maximum of 50 suitable cases retrospectively. The resulting cases will then be de-identified, aggregated and evenly randomly distributed among the participating urologists via a secure on-line survey platform . All study participants (ie: urologists) will be masked to the original actual treatment decision and patient outcome.

The design of this study is such that any participating urologist may or may not review a patient originating from their own clinical practice, but will not review a case they themselves identified. Patient cases will be de-identified and randomized amongst participating urologists . By the retrospective nature of this study, cases may be several years post-RP. It is not expected that that participation in this study will have any impact on actual clinical management of patients.

Participants will be asked to complete two web-based electronic Case Report Questionnaires (eCRQ):

• Pre-Decipher: will collect information on their recommended treatment decision and their decision confidence based on the de-identified clinical and pathological information provided for each patient case.
• Post-Decipher: will collect their treatment recommendation and decision confidence for each de-identified patient case in the presence of the Decipher test results.

Inclusion criteria

Patient cases eligible for this study were treated with radical prostatectomy and have one or more adverse features present as defined by AUA and NCCN guidelines:

• Pathological T3 stage of disease (i.e., ECE or SVI)
• Positive surgical margins, or
• Detectable PSA, defined as PSA detectable and rising on 2 or more subsequent determinations

Exclusion criteria

• Metastatic Disease (M+) prior to surgery
• Failure of PSA to nadir after surgery
• Received any neo-adjuvant prostate cancer treatment before radical prostatectomy
• Received any adjuvant chemotherapy
• Required patient clinical data (Section 5.3) is not available for evaluation of eligibility criteria
• Lack of documented treatment or management recommendation on file
• Tissue specimen is inadequate for sampling and analysis