Nav: Home

Individualized model could help guide treatment of non-metastatic prostate cancer

March 12, 2019

A new risk model, easily accessible on a web interface, can predict the survival of non-metastatic prostate cancer patients, as well as the effect of different treatment approaches on survival. The modeling approach, developed by David Thurtle of the University of Cambridge, UK, and colleagues, is described this week in PLOS Medicine.

Among men with non-metastatic prostate cancer, a number of treatment options may be appropriate, ranging from "watchful waiting" to surgery and aggressive therapies. Prognosticating prostate cancer-specific mortality, all-cause mortality, and the impact of treatment are of crucial importance to inform decision making and avoid over-treatment of indolent disease and under-treatment of aggressive disease. In the new study, researchers developed the PREDICT Prostate model, using data from the UK National Cancer Registration and Analysis Service on 10,089 men diagnosed with non-metastatic prostate cancer between 2000 and 2010 in Eastern England as well as 2,546 men diagnosed in Singapore. The model--estimating 10- and 15-year survival outcomes--was constructed and validated using the men's age, level of PSA (prostate specific antigen), tumour histological grade, biopsy core involvement, disease stage and primary treatment.

The new PREDICT Prostate risk model predicted survival outcomes with concordance indices up to 0.84 (95% CI: 0.82-0.86). There were no significant differences between predicted and observed prostate-cancer-specific or overall deaths in the UK dataset. However, the study was limited by a relatively small external validation cohort and the inability to account for delayed changes to treatment beyond 12 months.

"The model does not require any additional tests beyond standard of care, and is freely available for use," the authors say, adding that it "has the potential to enable well-informed and standardized decision-making and reduce both over- and under-treatment."
-end-
Research Article

Funding:

This work was supported by The Urology Foundation Research Scholarship (DRT), http://www.theurologyfoundation.org, and by The Evelyn Trust (REF 16/16) Cambridge (DRT, PDP, and VJG), http://evelyntrust.com. Infrastructure support was received from Cancer Research UK Cambridge Centre. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The researchers are independent of the sponsors.

Competing Interests:

The authors have declared that no competing interests exist.

Citation:

Thurtle DR, Greenberg DC, Lee LS, Huang HH, Pharoah PD, Gnanapragasam VJ (2019) Individual prognosis at diagnosis in nonmetastatic prostate cancer: Development and external validation of the PREDICT Prostate multivariable model. PLoS Med 16(3): e1002758. https://doi.org/10.1371/journal.pmed.1002758

Image Credit: marijana1, Pixabay

Author Affiliations:

Academic Urology Group, Department of Surgery, University of Cambridge, Cambridge, United Kingdom
Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
National Cancer Registration and Analysis Service (Eastern Region), Fulbourn, Cambridge, United Kingdom
Department of Urology, Singapore General Hospital, Singapore
Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
Cambridge Urology Translational Research and Clinical Trials, Cambridge, United Kingdom

In your coverage please use this URL to provide access to the freely available paper: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002758

PLOS

Related Cancer Articles:

Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Cancer genomics continued: Triple negative breast cancer and cancer immunotherapy
Continuing PLOS Medicine's special issue on cancer genomics, Christos Hatzis of Yale University, New Haven, Conn., USA and colleagues describe a new subtype of triple negative breast cancer that may be more amenable to treatment than other cases of this difficult-to-treat disease.
Metabolite that promotes cancer cell transformation and colorectal cancer spread identified
Osaka University researchers revealed that the metabolite D-2-hydroxyglurate (D-2HG) promotes epithelial-mesenchymal transition of colorectal cancer cells, leading them to develop features of lower adherence to neighboring cells, increased invasiveness, and greater likelihood of metastatic spread.
UH Cancer Center researcher finds new driver of an aggressive form of brain cancer
University of Hawai'i Cancer Center researchers have identified an essential driver of tumor cell invasion in glioblastoma, the most aggressive form of brain cancer that can occur at any age.
UH Cancer Center researchers develop algorithm to find precise cancer treatments
University of Hawai'i Cancer Center researchers developed a computational algorithm to analyze 'Big Data' obtained from tumor samples to better understand and treat cancer.
New analytical technology to quantify anti-cancer drugs inside cancer cells
University of Oklahoma researchers will apply a new analytical technology that could ultimately provide a powerful tool for improved treatment of cancer patients in Oklahoma and beyond.
Radiotherapy for lung cancer patients is linked to increased risk of non-cancer deaths
Researchers have found that treating patients who have early stage non-small cell lung cancer with a type of radiotherapy called stereotactic body radiation therapy is associated with a small but increased risk of death from causes other than cancer.
Cancer expert says public health and prevention measures are key to defeating cancer
Is investment in research to develop new treatments the best approach to controlling cancer?
UI Cancer Center, Governors State to address cancer disparities in south suburbs
The University of Illinois Cancer Center and Governors State University have received a joint four-year, $1.5 million grant from the National Cancer Institute to help both institutions conduct community-based research to reduce cancer-related health disparities in Chicago's south suburbs.
Leading cancer research organizations to host international cancer immunotherapy conference
The Cancer Research Institute, the Association for Cancer Immunotherapy, the European Academy of Tumor Immunology, and the American Association for Cancer Research will join forces to sponsor the first International Cancer Immunotherapy Conference at the Sheraton New York Times Square Hotel in New York, Sept.

Related Cancer Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#532 A Class Conversation
This week we take a look at the sociology of class. What factors create and impact class? How do we try and study it? How does class play out differently in different countries like the US and the UK? How does it impact the political system? We talk with Daniel Laurison, Assistant Professor of Sociology at Swarthmore College and coauthor of the book "The Class Ceiling: Why it Pays to be Privileged", about class and its impacts on people and our systems.