Optimal management of clinically localized prostate cancer presents a unique challenge to physicians and patients, because it is a highly variable and often slow growing, nonaggressive cancer. Prolaris® was developed to aid physicians in predicting disease aggressiveness in conjunction with other clinical parameters. Prolaris® measures the expression level of genes involved with tumor proliferation to predict disease outcome.
Identifying Patients Suitable for Prolaris®
Prolaris® testing is particularly well-suited for post-prostatectomy patients with higher risk features to better estimate the risk of biochemical recurrence (BCR). Managing patients before and after BCR is a complex issue. As noted in a 2007 review by the European Association of Urology: “The clinical course of patients with BCR is highly variable. Some experience rapid clinical progression (CP) to metastases. For others, a rising PSA may pose no threat to longevity. Improved methods for risk stratification allow for identification of patients who require treatment. Furthermore, these methods aid in determination of the pattern of disease recurrence, thereby guiding treatment modality. For patients with BCR, an assessment of the risk that recurrent disease poses to longevity or quality of life should be made. Many patients have indolent disease that grows slowly and requires no treatment, but some will have rapid progression to metastasis.”
Prolaris® testing assesses the prostate cancer aggressiveness in conjunction with other clinical parameters. Prolaris® provides a quantitative measure of the RNA expression levels of multiple genes related to the progression of tumor cell division. The 46-gene expression signature includes cell cycle progression genes selected based upon correlation with prostate tumor cell proliferation: low gene expression associated with a low risk of disease progression and high gene expression associated with disease progression.
Benefits of Prolaris® Testing
Prolaris® provides unique additional information about a patient’s prognosis and may be used with other clinical factors, such as the Gleason score and PSA levels, in helping the doctor make treatment recommendations. Prolaris® can identify intermediate-risk patients who may be candidates for surveillance as well as patients who may be potentially at higher risk and benefit from closer monitoring or additional therapy.
Management of Patients Assessed by Prolaris®
In the treatment of prostate cancer, Prolaris® is prognostic at the point of diagnosis and in the post-surgery setting. At diagnosis, Prolaris® can help identify patients with less aggressive cancer who may be candidates for active surveillance. In addition, Prolaris® can define patients who appear clinically low-risk but have a more aggressive disease that requires more aggressive treatment. Prolaris® testing is also well suited for use in post-prostatectomy patients that have higher risk features after surgery to better estimate their risk of disease recurrence (BCR) and therefore adjust the level of monitoring or add additional therapy.
What is the unique advantage of Myriad PROLARIS® testing
Prolaris® is the first prognostic test that offers a look inside the molecular biology of prostate cancer to help physicians determine its aggressiveness. In combination with other variables, such as the Gleason score, and PSA levels, Prolaris® provides a personalized assessment of risk.
Men with prostate cancer have many treatment options. There are four standard types of treatment:
- Active surveillance
- Radiation Therapy
- Hormone Therapy
- New Therapies including:
- High-intensity focused ultrasound
- Proton beam radiation therapy
- Chemotherapy and biologic therapy
These treatments may also be used alone or in combination.
Prostate Cancer and Myriad Prolaris® FAQs
How do I order a test?
Please contact us and let us know if you would like to order a test for a patient. One of our representatives will get in touch with you and advise on the workflow, and provide the necessary forms and sample collection kits. Once the samples have been collected, we will coordinate the shipment of the sample to the laboratory. Once testing is completed, the report will be sent to you.
How is Prolaris® genetic testing performed?
The patient’s clinician orders the Prolaris® test kit and completes a test request form, and sends the form together with the sample to the Myriad lab. Two types of samples may be used for the test – either a prostate needle biopsy sample for recently diagnosed cases, or a prostate excision sample for post-prostatectomy cases. These samples tested for RNA expression levels for 46 genes.
How long does it take for Prolaris® results?
Results usually take 3-4 weeks and are sent to the healthcare provider who ordered the test.