How much value to put on the numbers in the Decipher Grid?

Posted by topf @topf, Apr 14, 2025

Have you paid any attention to the numbers in your Decipher grid? Or are you just focused on the overall score? The grid pages say “Research Use Only”, but I still wonder how important they may be.

While my score is low at 0.2, there are some features in the grid that worry me:

1) 81st percentile on RT Sensitivity, with a status of “resistant”. It seems that a higher sensitivity score implies more resistance, in line with higher scores being bad. Does this result have implications for RT?

2) 98th percentile for Glycolisis. Does this imply that my tumor is less testosterone dependend and feeds of sugar?

Any insights are highly welcome!

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

handera | @handera | Apr 15, 2025

In reply to @topf "How did you access OpenEvidence without an NPI? Or do you have one?" + (show)

It’s been a long time since I used OpenEvidence. I never had to enter a NPI when I began using it, maybe they updated their account set-up requirements….

I switched to perplexity.ai many months ago and like the fact that it provides direct links to the all source materials it uses in for its answers.

As soon as Grok3 was available I began using it and now use it almost exclusively, although I wish it would provide direct links to its source materials like perplexity.ai.

thmssllvn | @thmssllvn | Apr 16, 2025

In reply to @topf "Yes, I saw that. He was mainly referring to the 15 year mortality risk. You need..." + (show)

I had the Decipher Test at 4.5
(Lower half of intermediate?) then somewhere it corresponds to the NCCI
categories. BTW the new UK categories will be published on 22 May 2025, 5x not our 3.
As Dr. Scholz had suggested AI will play a role in figuring out all the relationships to further assist clinicians at some point.

edwardbrown1 | @edwardbrown1 | Feb 7 9:31pm

I really appreciate this line of discussion, especially comments by @handera. With a Decipher score of 0.92 putting me in the 98 percentile for risk, so making me very anxious. I have tried to engage my oncologists and even a distinguished research professor at Johns Hopkins Medicine. None could provider any insights. Understandably, the mountain of molecular biology information provided by Vercyte in the Decipher GRID report is way, way beyond the routine standard of care for prostate cancer. Being a PhD biochemist, I have tried myself to learn more about the aberrant genes in my prostate specimens. Of the 60 genes/ expression signatures listed in my GRID report, 19 are listed as of high risk. However, I have to continually remind myself that these results are all only statistical associations. The analyses are not correlations, much less suggesting any insights on differential responses toward therapy and outcomes. Fortunately, my RT and ADT have driven my PSA to undetectable, which has helped my anxiety.
Can any of you suggest clinical researchers anywhere who are engaged with Veracyte to more deeply understand their data? I would really appreciate any recommendations. Thanks again.

handera | @handera | Feb 8 7:05am

In reply to @edwardbrown1 "I really appreciate this line of discussion, especially comments by @handera. With a Decipher score of..." + (show)

@edwardbrown1

Using SuperGrok I found the following research physicians you may want to investigate regarding your questions.

- Dr. Ashley Ross, MD, PhD (Urologic Oncologist, Associate Professor of Urology at Northwestern Medicine)

- Dr. Alan Dal Pra, MD (Director of Clinical Research, Associate Professor of Radiation Oncology at University of Miami Miller School of Medicine)

- Dr. Shuang Zhao, MD (University of Wisconsin-Madison)

- Dr. Emily Grist, PhD (University College London Cancer Institute)

- Dr. Elai Davicioni, PhD (Medical Director for Urology at Veracyte)

- Duke University Team, Including Dr. Edward Schaeffer)

Sorry to hear your Decipher Score was so high.

If you’re interested in a contrarian view (especially since you’re a PhD biochemist) get a copy of “Cancer as a Metabolic Disease - On the Origin, Management, and Prevention of Cancer”, by Thomas N. Seyfried, PhD.

Seyfried is biochemical geneticist who has studied the lipid biochemistry of cancer for 40+ years. His book reads like a biochemistry textbook on steroids, so it’s not for those unfamiliar with biochemistry.

edwardbrown1 | @edwardbrown1 | Feb 8 9:35am

In reply to @handera "@edwardbrown1 Using SuperGrok I found the following research physicians you may want to investigate regarding your..." + (show)

@handera I appreciate all this detail! I asked a pretty arcane question, so am doubly thankful. I will follow up. And I've ordered Thomas Seyfried's book. It's great to have such an engaged community of fellow PC patients.

heavyphil | @heavyphil | Feb 9 6:49am

I never had a Decipher test 6 years ago; but I really didn’t need one since my Gleason 4+3 was very extensive throughout the gland.
But you are quite correct in that your test IS showing contradictory results:
0.2 is pretty low and means non-aggressive, but high glycolysis means that you have cells with a high metabolic rate - they’re REALLY active in terms of growth or division; this ‘could’ indicate a more aggressive cell….so what’s going on here??
I think you really need to ask a MO what the numbers mean; you’ll hurt your brain trying to ask Dr Google.
But remember, just because cells are very actively metabolizing, it does NOT mean that they won’t be responsive to treatment. Sometimes very active cases of anything can be completely derailed by simple treatment. Best,
Phil