Authors' results and conclusions: The available clinical studies described two commercial tests, positioned as prognostic tools for use in prostate cancer management. These purport to provide additional information for clinicians and patients to arrive at a decision for active surveillance or more radical treatment, with greater confidence afforded by traditional prognostic information alone. However, there is uncertainty about the clinical utility of these tests, even when taking into account the highest level of evidence available; it remains to be verified whether genetic expression of the unique gene panels involved are robust to heterogeneous sampling of prostate tissue at the time of biopsy. Also, the need for tissue which has previously been fixed for histological analysis is of some concern. This is the most obvious reason for the relatively high number of patients for whom a valid test results could not be obtained. Together with dependence on reverse transcription of RNA, it would appear that this is a contributor to the potentially prohibitive cost of at least one of these assays for which pricing was available.

Authors' recommendations: Molecular prognostic tests are designed to guide and manage the treatment pathway of patients; however there is currently uncertainty around the clinical utility of tests such as those described in this Brief. Based on a small study of clinician preferences and the uptake of similar tests for the prognosis of breast cancer, it would appear that there is hesitancy about the use of the technology in clinical practice, and it appears that changes to clinical management based on the prognostic information provided by these genetic tests are unlikely to occur. Therefore HealthPACT recommends that no further research be conducted on their behalf at this point in time.

Project Status: Completed

Year Published: 2014

URL for published report: Not Available

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Adelaide Health Technology Assessment

Contact Address: School of Public Health, Mail Drop 545, University of Adelaide, Adelaide SA 5005, AUSTRALIA, Tel: +61 8 8313 4617

Contact Name: ahta@adelaide.edu.au

Contact Email: ahta@adelaide.edu.au

Copyright: Adelaide Health Technology Assessment (AHTA)