Is Prostate Cancer Mortality Risk Linked to Genetic Markers and Can We Use Genetics to Decide on the Right Treatment for the Right Man?
ByCancer is genetics and genes do get messed up, that is what I have increasingly heard over the last four to five years. I am attending the upcoming AACR conference in Washington this April as a part of the Scientist-Survivor Program and our pre-assigned reading is all about genetics.
Increasingly, we are hearing about the possibility of genetic testing to determine which men with prostate cancer may benefit from aggressive therapy. There are a number of research pieces that support this concept. In particular, in some of the studies, the presence of 3 specific genetic abnormalities has been found to indicate a poor prognosis, while their absence confers a good prognosis.
Investigators at the Institute of Cancer Research in Great Britain followed men with prostate cancer for 11 years. They have reported that 85% of the men they followed without these specific 3 genetic markers were still alive, compared with only about 14% who did have the 3 gene alterations.
The 3 gene abnormalities were loss of the PTEN gene, rearrangement of the ERG gene, and rearrangement of the ETV1 gene. This study specifically analyzed the combined impact on survival of these gene aberrations. Previous studies had examined the effects of only 1 or 2 of these. In the study, approximately 6% of the patients had all 3 genetic indicators of a poor prognosis.
Why is this important? We do know that many men diagnosed with prostate cancer will live for years and years until they die of some other cause. However, many of us also die from prostate cancer. To be able to separate out these two risks groups will allow us to treat aggressively only those who are at the greatest risk while not heaping a bundle of morbidity issues on men who are not in direct and immediate danger from their cancer.
We continue to need reliable biologic markers to allow us to distinguish the aggressive form of the disease. Genetics might provide us with some of these much-needed biomarkers.
The research results were published in the January 26 issue of the British Journal of Cancer.
Some recent Pub Med abstracts about possible genetic bio-markers for prostate cancer:
PMID: 20118910; PMID: 20104229; PMID: 19861517; PMID: 19818074; PMID: 19716227;
PMID: 19657377; PMID: 19649210 PMID: 19584163; PMID: 19494719; PMID: 19465903;
PMID: 19402094; PMID: 19396168; PMID: 19339269; PMID: 19293179; PMID: 19212347
Joel T Nowak MA, MSW
