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Mar 26, 2013 · Leave a Reply

Personalizing Care for Prostate Cancer

By Center for Individualized Medicine @samuelsmith5209

While PSA testing and Gleason scores go a long way toward helping physicians stage prostate cancer and guide treatments according to the cancer’s progression, more than 50,000 American men each year have their prostates removed only to find out after surgery that it was unnecessary.

Why? Because nearly half of all men whose needle biopsy shows prostate cancer actually have an insignificant form of the disease. But there’s no way to tell until pathologists can examine the resected prostate. Using molecular biomarkers also is inadequate in accurately stratifying the seriousness of a man’s prostate cancer. Even the best contemporary molecular and pathological techniques tend to underestimate the number of men whose prostate cancer might benefit from aggressive treatment.

In other words, there’s no really good way to tell whether a prostate cancer requires aggressive treatment. That's expensive -- It costs time in the operating room, time away from work, not to mention the mental and physical cost of having a reproductive organ removed only to find out later that it wasn't necessary.

The Biomarker Discovery Program is developing new cancer genome tests using next generation sequencing, which could help doctors deliver the best therapy to men with prostate cancer.

     Read the Biomarker Discovery Program Prostate Cancer Working Group’s latest publication.
     Here’s a listing of recent publications from the Working Group.

Specifically, the Prostate Cancer Working Group has found a handful of gene alterations that are present in aggressive prostate cancers and absent in indolent ones. Deletions and truncations of PTEN, VPS13B, and PDE4D showed significant association to significance and tumor aggressiveness.

A number of commercial laboratories provide assessment of PTEN by fluorescence in situ hybridization (FISH) testing and immunohistochemistry. The Biomarker Discovery Program Prostate Working Group, however, estimates that use of these and other assays underestimates PTEN loss.

Next generation sequencing is able to identify small PTEN abnormalities that are important in prostate cancer prognosis but undetectable using many current technologies.

A test based on NGS will determine the presence or absence of these abnormalities, and define a tumor as having a low risk or high risk of progression based on comparison with a content database.

Findings referenced on this blog are for informational purposes and cannot replace the professional advice of a trained physician. Patients should consult with their providers .

 

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