New Test Could Flag Which Men Need Aggressive Prostate Cancer Treatment and Which Do Not
A new diagnostic test could help doctors decide on treatment for men with prostate cancer, researchers have said. Analysing a tissue-based molecular test called Decipher, they sought to determine which men with high-risk prostate cancer were most likely to benefit from stronger treatment and which might avoid unnecessary medication and side effects.
Researchers at University College London (UCL) carried out the analysis. At its centre was abiraterone, a hormone therapy that was shown in the STAMPEDE clinical trial to cut the risk of death in half among men with high-risk, localized prostate cancer.
The findings were presented at the European Society for Medical Oncology (ESMO) Congress 2026 in Madrid, held from 23 to 27 October.
To determine whether Decipher could help guide that decision, researchers examined test scores from more than 27,000 patients in real-world data and from 401 men with non-metastatic prostate cancer who had participated in the STAMPEDE abiraterone trial.
Higher Decipher scores predicted worse outcomes, meaning the cancer is more likely to spread and additional treatment may be valuable. A low Decipher score suggested more intensive treatment may be unnecessary.
A UCL news release noted that treating someone more aggressively than necessary could lead to increased side effects and poorer quality of life. Because prostate cancers differ at the molecular level, not every patient benefits from adding hormone therapy.
Lead researcher Dr Sarah Howlett of the UCL Cancer Institute said in a statement that for men with very high-risk prostate cancer, preventing the spread of the disease is critical. Understanding who benefits most from additional treatment can make a meaningful difference, she added.
According to the researchers, the findings suggest genomic testing could help tailor treatment. Men with high-risk prostate cancer and low Decipher scores may face a lower risk of spread and could avoid more intensive therapy, while those with high scores may be the strongest candidates for additional treatment.
