A genetic biomarker test for patients with aggressive prostate cancer has identified patients most likely to respond to radiation and hormone therapy or to develop metastases, allowing providers to tailor treatment regimens to high risk patients.
A genetic biomarker test has been shown to accurately predict how men with high-risk prostate cancer will respond to radiation and hormone therapy, according to a recent meta-analysis presented at the annual meeting of the ‘American Society for Radiation Oncology.
The study, which included examining biopsy samples collected from 3 large randomized clinical trials, indicated that doctors could use the results of genetic tests to individualize treatment for men with aggressive forms of cancer. prostate.
“For a man with high risk prostate cancer, this genetic score can be a very powerful prognostic tool that can tell us if he is likely to be cured from treatment or if he is likely to see his. cancer reappearing… I see this as a great opportunity to change the standard of care for patients in the future by using genomics to personalize therapy, ”said Paul L Nguyen, MD, lead author of the study, professor at Harvard Medical School, in a statement. Nguyen is also vice president of clinical research and director of genitourinary radiation oncology at the Dana-Farber Cancer Institute in Boston, Massachusetts.
Two-thirds of deaths attributed to prostate cancer occur in patients with high-risk prostate cancer, who often undergo radiation therapy and 2 years of hormone therapy as standard treatment. Balancing the risk of survival and quality of life is often a major concern for many patients; hormone therapy can cause uncomfortable side effects, including hot flashes and loss of libido, as well as possible cardiovascular and cognitive changes.
The researchers focused on identifying prognostic biomarkers, which could be used to develop more precise treatment guidelines and point to which ones might benefit from less treatment and which patients might benefit from additional treatment with new agents. hormonal.
The researchers used the Decipher biopsy test, which examines the activity of 22 genes in prostate tumors and produces a score that indicates the aggressiveness of a patient’s cancer.
“We are optimistic that this score can tell us which men should have their treatment de-intensified, which means they will receive less hormone therapy, and which men should have their treatment intensified, which means they will receive treatment. Second-generation supplemental hormone therapy… .With this genetic marker, we hope to personalize therapy for men with high-risk prostate cancer rather than having a one-size-fits-all approach, ”said Nguyen.
Decryption scores were calculated using RNA from 385 archival biopsy samples collected in 3 major prostate cancer trials. The genetic signature predicted which patients had a greater likelihood of developing distant metastases (HR, 1.24; 95% CI, 1.11-1.39), who had a higher risk of death due to their prostate cancer (HR, 1.27; 95% CI, 1.13-1.43), and who were more likely to die from any cause (HR, 1.12; 95%, 1.05-1.20). The 10-year distant metastasis rate was 29% for patients with scores indicating a higher risk of metastasis and 13% for those with scores indicating lower risk.
Although the Decipher test was previously validated using tissue samples taken after patients underwent radical prostatectomy, the investigators’ current analysis looked at tissue taken before patients received treatment, when ‘they were originally diagnosed.
“This study is the first to validate a genetic biomarker for high-risk prostate cancer using archival pretreatment tissues from large prospective randomized trials …. Using archival tissue samples from a wide range of centers and patients — hundreds of cancer centers across the country “shows that this test can be useful for many men with high-risk disease,” Nguyen said.
Additionally, the age of the samples meant researchers could look at long-term outcomes for patients with high-risk prostate tumors, potentially allowing patients to benefit from full follow-up for 20 to 30 years.
Nguyen stressed that the Decipher test needs further study to confirm its validity before it can be widely adapted.
The genetic biomarker test predicts the outcome of recurrence and survival in men with high-risk prostate cancer. Press release. American Society of Radiation Oncology. October 25, 2021. Accessed November 1, 2021. https://www.newswise.com/articles/genetic-biomarker-test-predicts-recurrence-and-survival-outcomes-for-men-with-high-risk-prostate – Cancer