Biomarkers used for medicine, or precision medicine, are a part of a relatively new clinical toolset. They are categorized in 3 primary ways according to their clinical applications. They are classified as molecular biomarkers, cellular biomarkers or imaging biomarkers. All 3 types of biomarkers have a clinical role in narrowing or guiding treatment decisions and follow a sub-categorization of being predictive, prognostic, or diagnostic. A case-control design was used to test the association of gene expression with outcome. Systemic (SYS) progression cases were men post-prostatectomy who developed systemic progression within 5 years after PSA recurrence. PSA progression controls were matched men post-prostatectomy with PSA recurrence but no evidence of clinical progression within 5 years. Using expression arrays optimized for paraffin-embedded tissue RNA, cancer-related genes were evaluated–including 570 genes implicated in prostate cancer progression. Genes from 8 previously reported marker panels were included. A systemic progression model containing 17 genes was developed. This model generated Similar AUCs were generated using 3 previously reported panels. In secondary analyses, the model predicted the endpoints of prostate cancer death with hazard ratios and respectively (log-rank p-values of 0.0007 and 0.0005).