UCL Study Validates Decipher Test to Refine Prostate Cancer Treatment
Researchers from University College London (UCL) have presented findings at the European Society for Medical Oncology (ESMO) Congress 2026 demonstrating that a genomic test can significantly refine treatment decisions for men with high-risk prostate cancer. The validation of the Decipher genomic test provides clinicians with a precise metric to determine which patients require intensive hormone therapy and which might safely avoid its associated side effects.
The study analyzed a substantial dataset, including 27,607 men in real-world clinical settings and 401 participants from the STAMPEDE clinical trial. The results show a direct correlation between a patient’s Decipher score and their long-term prognosis. Specifically, researchers found that for every 0.1 increase in the Decipher score, the risk of distant metastasis increases by 49% (hazard ratio 1.49). Furthermore, a 0.1 increase in the score is associated with a 38% increase in the risk of death from the disease (hazard ratio 1.38).
The score allows clinicians to predict metastasis risk with higher accuracy than standard clinicopathological factors.
This genomic tool is particularly valuable for identifying candidates for abiraterone, a potent hormone therapy. While the STAMPEDE trial previously established that adding abiraterone to standard care can halve the risk of death for men with high-risk localized prostate cancer, the treatment can carry significant side effects. The new data suggests the Decipher test can pinpoint patients with non-metastatic, high-risk disease—particularly those where the cancer has not yet spread to the lymph nodes (N0 disease)—who stand to benefit most from this aggressive intervention.
By providing a more granular risk assessment than standard clinicopathological factors like PSA density, the test allows for a more personalized approach. Patients with lower genomic risk scores may potentially be spared intensive hormone regimens, while those with higher scores can be fast-tracked to the most effective combinations available.
The validation of this genomic test coincides with a broader technological shift in how prostate cancer is diagnosed and managed in the United Kingdom. On October 23, 2026, the National Institute for Health and Care Excellence (NICE) recommended the use of five AI tools—including AI-Rad Companion Prostate MR and DeepHealth Prostate—to improve the accuracy of MRI analysis within the NHS. These tools, like the Decipher test, reflect a growing reliance on precision diagnostics to reduce unnecessary biopsies and tailor treatment plans.
UCL researchers noted that while the Decipher test has been used in various clinical contexts, this latest validation using trial-quality data alongside massive real-world cohorts strengthens the case for its routine implementation. By resolving conflicting treatment paths for high-risk cases, the tool aims to ensure that intensive therapy is reserved for those whose genomic profile indicates the highest necessity.
