New Diagnostic Test Could Transform Prostate Cancer Treatment

A new diagnostic test has the potential to significantly enhance the experiences of millions of men dealing with prostate cancer.

Researchers from University College London (UCL) investigated a tissue-based molecular test named Decipher. Their goal was to identify which men with high-risk prostate cancer could benefit from more aggressive treatments while also pinpointing those who might be able to sidestep unnecessary medications and side effects.

The focus of their study was on abiraterone, a hormone therapy that, according to results from the STAMPEDE clinical trial, can notably reduce the risk of death by half for men with high-risk, localized prostate cancer.

These results were shared during the European Society for Medical Oncology (ESMO) Congress 2026, which took place in Madrid from October 23-27.

Not every cancer behaves the same way, and over-treatment may lead to “increased side effects and poorer quality of life,” as highlighted in a UCL press release.

Given that prostate cancers vary at the molecular level, the introduction of hormone therapy doesn’t benefit all patients uniformly.

To assess whether Decipher could guide treatment decisions, the team looked at test scores from over 27,000 patients using real-world data, as well as involving 401 men with non-metastatic prostate cancer who participated in the aforementioned STAMPEDE trial.

Essentially, higher Decipher scores indicated poorer outcomes, suggesting that the cancer has a higher likelihood of spreading and that further treatment may be warranted. Conversely, a low Decipher score could imply that more aggressive treatment is not required.

Lead researcher Dr. Sarah Howlett from the UCL Cancer Institute expressed that for men facing very high-risk prostate cancer, it is “critical” to prevent the disease from spreading.

“Identifying who gains the most from additional treatment can bring about a meaningful difference,” she stated.

The implications of these findings suggest genomic testing could greatly assist in customizing treatment approaches. Men with high-risk prostate cancer who have low Decipher scores could have a reduced risk of the disease spreading, allowing them to avoid more rigorous therapies. On the flip side, those with higher scores may be the ones most in need of additional treatment.

According to Howlett, the consistency of these findings across a large real-world data set as well as a randomized clinical trial reinforces their significance.

“Nonetheless, more validation in other datasets is required before this test can be routinely used for such decisions,” she added.

Elai Davicioni, the medical director of urology at Veracyte, the company behind the Decipher test, commented that this growing evidence indicates a stronger rationale for physicians to utilize Decipher before making decisions that could influence both cancer outcomes and patients’ quality of life.

Dr. Marc Siegel, a senior medical analyst who did not participate in the study, highlighted the variability of prostate cancer between individuals. He noted that “medical science is increasingly recognizing that it’s not a one-size-fits-all situation.”

Localized prostate cancer, which has not advanced to other areas, may harbor mutations that predict how aggressively the cancer will behave and whether it will respond to specific therapies.

Siegel also pointed out that more targeted therapies are being employed for widespread prostate cancer, encompassing “more powerful anti-androgens that work not just on the testes but also on the adrenals.”

While hormone therapies can offer significant benefits, they also come with notable side effects, including fatigue, and don’t always yield positive results, he noted.

Siegel praised the study’s robustness, stemming from its combination of randomized treatment groups and Decipher testing. This approach allowed for the advance identification of patients who would likely respond well to more intense hormone therapy.

“This represents the personalized, precise approach of the near future,” he observed.

Prostate cancer is acknowledged as the second-leading cause of cancer-related deaths, following lung cancer. The American Cancer Society states that one in eight American men will be diagnosed with prostate cancer at some point in their lives.