Cross-Comparison Individual Patient-Level Analysis of Three Gene Expression Signatures in Localized Prostate in Over 50,000 Men
Bibliographic record
Abstract
PURPOSE The 22-gene Decipher genomic classifier (GC) (22-gene GC) is the only gene expression test with National Comprehensive Cancer Network (NCCN) level 1 evidence for localized prostate cancer (PCa) treatment decision making. It is unclear whether other commercial signatures—Genomic Prostate Score (GPS) or Prolaris (cell cycle progression [CCP])—correlate sufficiently to explain differences in evidence strength. This study assesses correlation between these three classifiers on a per-patient basis by performing a cross-comparison of these signatures in a large cohort of patients diagnosed with PCa. MATERIALS AND METHODS: Primary PCa biopsy samples underwent whole-transcriptome gene expression microarray analysis. 22-gene GC scores were calculated using the commercially locked model. To reduce bias, GPS and CCP signatures were retrained for prediction of metastasis to harmonize end points. Pearson correlations and linear regressions (univariable/multivariable) adjusting for age, grade group, prostate-specific antigen (PSA), and T stage were calculated between signatures. RESULTS Among 50,881 patients (median age 68 years, median PSA 6.2 ng/mL), 60% were NCCN intermediate-risk. The GPS-derived and CCP-derived models had poor goodness-of-fit to 22-gene GC ( R 2 = 0.36 and 0.32, respectively). Multivariable analysis adjusting for clinical factors showed similar results. Given the many variables that may contribute to or correlate with the 22-gene GC, a multivariable R 2 analysis was performed to assess how much of the variation could be attributed to known factors. A variance analysis revealed approximately 60% of 22-gene GC variation remained unexplained. GPS-derived and CCP-derived models accounted for 24.7% and 22.7% of variance, respectively, with additional contributions from Gleason score. CONCLUSION Correlation between 22-gene GC and either GPS-derived or CCP-derived signatures is minimal to moderate. These tests are not interchangeable, and their use should be guided by the specific evidence supporting each signature.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".