Study Identifies Biomarkers to Stratify Patients for Prostate Cancer Treatment

A new study has identified biological markers that may distinguish between low-risk and intermediate- and high-risk prostate cancer, ultimately helping to guide treatment decisions, according to the Mayo Clinic.

The study, published in Mayo Clinic Proceedings, determined that genetic alterations associated with intermediate- and high-risk prostate cancer may also be present in some cases of low-risk prostate cancers.

More than half of the 200,000 American men diagnosed each year with prostate cancer by biopsy could be considered at low risk of progression to cancer, the researchers wrote. Men with low-risk cancer are candidates for active surveillance, but some choose surgery to mitigate potential disease progression.

According to the researchers, the Gleason score remains the most clinical and pathological feature for determining risk. However, because the needle biopsy procedure may only capture Gleason pattern 3, it may miss Gleason patterns 4 and 5, which carry a higher risk of aggressive disease progression.

For the study, the researchers performed DNA sequencing with a high-tech genomic tool called mate-pair sequencing on specific Gleason patterns from frozen cancer specimens from 126 men who had their prostate glands removed. Five genes were found to be more frequently altered in Gleason patterns 4 and 5, which were also found more commonly in Gleason pattern 3 associated with higher Gleason patterns.

The researchers noted that identifying these alterations in a Gleason pattern 3 could signal a higher likelihood that Gleason pattern 4 is nearby and help stratify patients for active surveillance or definitive treatment. Men with low-risk cancer who harbor these alterations may consider treatment, such as surgery.

“We have discovered new molecular markers that can help guide men in their decisions about the course of their prostate cancer care,” lead study author George Vasmatzis, PhD, co-director of the Center for Individualized Medicine Biomarker Discovery Program, said in a press release. “Overtreatment has been an issue for the group of men that our study targets. We found that the presence of genetic alterations in low-risk cancer can help men decide whether treatment or active surveillance is right for them.”

References

Vasmatzis G, Kosari F, Murphy SJ, et al. Large chromosomal rearrangements yield biomarkers to distinguish low-risk from intermediate- and high-risk prostate cancer. Mayo Clinic Proceedings. 2019. https://doi.org/10.1016/j.mayocp.2018.06.028

Mayo Clinic discovers biological markers that could guide treatment for prostate cancer [news release]. May Clinic’s website. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-discovers-biological-markers-that-could-guide-treatment-for-prostate-cancer/. Accessed January 3, 2019.