Gene based test predicts prostate cancer aggressiveness
A gene based test could predict prostate cancer aggressiveness and guide treatment.
Researchers at Dana Farber Cancer Institute have found a molecular signature, consisting of four specific genes that can predict whether prostate cancer is likely to spread.
The findings could spare men with non-aggressive forms of the disease from receiving unnecessary treatment. According to Ronald DePinho, MD, "The vast majority of prostate cancers would not become life-threatening, even if left untreated. But because we can’t accurately forecast which are likely to spread and which aren’t, there is a tendency to unnecessarily subject many men to draconian interventions.”
The research team that also included scientists from Brigham and Women’s Hospital and Harvard School of Public Health found the four-gene/protein signature more accurately predicted prostate cancer's course than the currently used Gleason score that gauges aggressiveness of cancer from microscopic examination of tissue samples.
For the current study, the scientists analyzed prostate cancer tissue from men participating in a national health study, many of whom died from the disease.
Used in combination with the Gleason scale, the researchers found they could predict prostate cancer metastasis with 90 percent accuracy. Using the gene/protein signature alone was accurate 83 percent of the time.
The molecular signature was identified as Pten, Smad4, SPP1, and CyclinD1. DePinho explains the work was accomplished “By integrating a variety of techniques – computational biology, genetically engineered model systems, molecular and cellular biology, and human tissue microarrays." He adds, "...we’ve identified a signature that has proven effective in distinguishing which men with prostate cancer are likely to progress and die from their disease and those who are not."
The scientists say they hope to develop a clinical test within a year that can predict who is at risk of prostate cancer spread from aggressive disease. The gene based test will in turn allow physicians to deliver appropriate prostate cancer treatment and spare other men from unnecessary treatment for the disease that are costly and can lead to decreased quality of life.
Nature (2011): doi:10.1038/nature09677
"SMAD4-dependent barrier constrains prostate cancer growth and metastatic progression"