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How to cite: Bhagwat D. A deeper look into the favorable intermediate-risk patients. Grand Rounds in Urology. September 2025. Accessed Mar 2026. https://grandroundsinurology.com/a-deeper-look-into-the-favorable-intermediate-risk-patients/
Summary
Deepika Bhagwat, MD, Senior Medical Science Liaison at MDxHealth, examines the role of genomic prostate score (GPS) testing in treatment decision-making for patients with favorable intermediate-risk prostate cancer. Dr. Bhagwat introduces the MDxHealth prostate cancer pathway, which includes urine- and tissue-based assays such as SelectMDx, ConfirmMDx, and the genomic prostate score. She explains how GPS is optimized for biopsy tissue, requiring only small RNA amounts, while providing clinically meaningful endpoints such as adverse pathology, prostate cancer–specific death, and metastases.
Dr. Bhagwat focuses on a retrospective study published in BJUI Compass in March 2025. This study evaluates the influence of GPS results on treatment selection between active surveillance and definitive therapy in 324 men with favorable intermediate-risk prostate cancer across both academic and community practices.
Dr. Bhagwat reports that for every 20-point increase in GPS score, the likelihood of selecting active surveillance decreases by approximately 76 percent. She notes that patients with GPS scores between 0 and 19 are more likely to choose surveillance compared to those with higher scores. Among patients with scores of 20–40, 63 percent opt for monotherapy, while 72 percent with scores of 41–200 also choose monotherapy. A smaller subset selects multimodal therapy. At the 12-month follow-up, 91 percent of patients who initially chose surveillance remain on it, with only eight experiencing disease progression requiring treatment escalation.
Dr. Bhagwat emphasizes that GPS offers valuable stratification in favorable intermediate-risk prostate cancer, helping avoid overtreatment in lower-risk patients while identifying those who may benefit from more intensive therapy. She concludes that genomic testing supports a personalized approach to treatment planning and may significantly influence real-world clinical practice.
The Global Summit on Precision Diagnosis and Treatment of Prostate Cancer is a unique multi-disciplinary forum organized to inform the key health care stakeholders about the emerging advances in clinical case and research and create a consensus-based vision for the future of precision care and educational and research strategy for its realization. The mission of the Summit is to fill the currently existing gap between the key experts of in vivo imaging, the world authorities in the in vitro fluid- and tissue-based molecular diagnostics, including genomics, and thought leaders in the development of novel observation strategies (e.g., active surveillance, or AS) and therapeutic interventions.
ABOUT THE AUTHOR
Deepika Bhagwat, MD, BCMAS, is a Clinical Faculty Member at Midwestern Career College in Columbus, Ohio. In this role, Dr. Bhagwat leads presentations on clinical knowledge, instructs didactics on anatomical structures, creates simulation labs, and conducts lectures and exams. She specializes in urologic oncology, infectious disease, and diagnostic testing.
