Nav: Home

New blood test predicts who will benefit from targeted prostate cancer treatments

May 03, 2017

A new blood test could predict which men with advanced prostate cancer will respond to new targeted treatments for the disease.

Researchers were able to detect tumour DNA in men's blood and pick out cancers with multiple copies of the androgen receptor gene, which many prostate cancers rely on to grow.

Men with multiple copies of the gene responded much less well than otherwise to the targeted therapies abiraterone and enzalutamide - now standard treatment for advanced prostate cancer.

These men could be spared treatments that are unlikely to work for them, and doctors could offer them alternative options instead.

The test will have to be assessed further in clinical trials, but the researchers say it costs less than £50 and could be used in clinical practice to personalise treatment.

A team at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust, along with colleagues in Europe, analysed blood samples from 265 men with advanced prostate cancer who were being treated with abiraterone or enzalutamide, either before or after docetaxel chemotherapy.

The study is published today (Thursday) in the journal Annals of Oncology, and was funded by Prostate Cancer UK with support from the Movember Foundation, Cancer Research UK, and the NIHR Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research (ICR).

Researchers took samples from patients on three different clinical trials, both before receiving abiraterone or enzalutamide, and again after their disease began to progress.

In the primary trial of 171 patients, men in whom a blood test detected multiple copies of the gene that carries the instructions for making the androgen receptor were four times more likely to die over the course of the study than those who did not. The study included both patients who had previously received chemotherapy and those who did not.

The findings were confirmed in a second group of 94 patients where men with multiple copies had an eight-fold shorter response to treatment than men with one or two copies of the gene.

The androgen receptor is known to play an important role in helping cancers to become resistant to treatment with abiraterone and enzalutamide, which are standard treatments for men whose cancer is resistant to traditional hormone blocking therapy and has spread round the body.

Dr Gerhardt Attard, Team Leader in the Centre for Evolution and Cancer at The Institute of Cancer Research, London, and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, said:

"Abiraterone and enzalutamide are excellent treatments for advanced prostate cancer and some men can take these drugs for years without seeing a return of their cancer. But in other men, these drugs do not work well and the disease rapidly returns. Currently there is no approved test to help doctors choose whether these are the best treatments for an individual.

"We have developed a robust test that can be used in the clinic to pick out which men with advanced prostate cancer are likely to respond to abiraterone and enzalutamide, and which men might need alternative treatments.

"Our method costs less than £50, is quick to provide results, and can be implemented in hospital laboratories across the NHS. We are now looking to assess our test in prospective clinical trials and would hope it can become part of standard patient care."

Dr Iain Frame, Director of Research at Prostate Cancer UK said:

"A man with incurable prostate cancer does not have time to waste taking drugs that will not work for him. To stop prostate cancer from being a killer, we need to move away from a one-size-fits-all approach to treatment. This test could be a significant step towards that and we'll be watching its development very closely. Thanks to our supporters, we are ramping up investment in prostate cancer research to get the right drug for the right man at the right time."

Dr Emma Smith, science information manager at Cancer Research UK, said:

"Developing tests that help doctors predict how likely a treatment is to work will prevent patients from suffering unnecessary side effects from treatments that are unlikely to benefit them. If further studies confirm this test is reliable, it could also help doctors choose better options for men whose prostate cancer is unlikely to respond to standard treatments."

Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, said:

"Drug resistance is the single biggest obstacle we face in treating cancer. We need to be able to assess a patient's disease individually so we know which therapies have the best chance of success, and which are unlikely to be effective.

"The test our researchers have developed is exactly what we need to tailor therapy to individual patients, so we can offer patients the treatment that is most likely to work for them. It's an important step towards further personalisation of cancer treatment."
-end-


Institute of Cancer Research

Related Prostate Cancer Articles:

ESMO 2020: Breast cancer drug set to transform prostate cancer treatment
A drug used to treat breast and ovarian cancer can extend the lives of some men with prostate cancer and should become a new standard treatment for the disease, concludes a major trial which is set to change clinical practice.
Major trial shows breast cancer drug can hit prostate cancer Achilles heel
A drug already licensed for the treatment of breast and ovarian cancers is more effective than targeted hormone therapy at keeping cancer in check in some men with advanced prostate cancer, a major clinical trial reports.
The Lancet: Prostate cancer study finds molecular imaging could transform management of patients with aggressive cancer
Results from a randomised controlled trial involving 300 prostate cancer patients find that a molecular imaging technique is more accurate than conventional medical imaging and recommends the scans be introduced into routine clinical practice.
Common genetic defect in prostate cancer inspires path to new anti-cancer drugs
Researchers found that, in prostate cancer, a mutation leading to the loss of one allele of a tumor suppressor gene known as PPP2R2A is enough to worsen a tumor caused by other mutations.
First prostate cancer therapy to target genes delays cancer progression
For the first time, prostate cancer has been treated based on the genetic makeup of the cancer, resulting in delayed disease progression, delayed time to pain progression, and potentially extending lives in patients with advanced, metastatic prostate cancer, reports a large phase 3 trial.
Men taking medications for enlarged prostate face delays in prostate cancer diagnosis
University of California San Diego School of Medicine researchers report that men treated with medications for benign prostatic hyperplasia (enlarged prostate) experienced a two-year delay in diagnosis of their prostate cancer and were twice as likely to have advanced disease upon diagnosis.
CNIO researchers confirm links between aggressive prostate cancer and hereditary breast cancer
The study has potential implications for families with members suffering from these types of tumours who are at an increased risk of developing cancer.
Distinguishing fatal prostate cancer from 'manageable' cancer now possible
Scientists at the University of York have found a way of distinguishing between fatal prostate cancer and manageable cancer, which could reduce unnecessary surgeries and radiotherapy.
Researchers find prostate cancer drug byproduct can fuel cancer cells
A genetic anomaly in certain men with prostate cancer may impact their response to common drugs used to treat the disease, according to new research at Cleveland Clinic.
ASCO and Cancer Care Ontario update guideline on radiation therapy for prostate cancer
The American Society of Clinical Oncology (ASCO) and Cancer Care Ontario today issued a joint clinical practice guideline update on brachytherapy (internal radiation) for patients with prostate cancer.
More Prostate Cancer News and Prostate Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Warped Reality
False information on the internet makes it harder and harder to know what's true, and the consequences have been devastating. This hour, TED speakers explore ideas around technology and deception. Guests include law professor Danielle Citron, journalist Andrew Marantz, and computer scientist Joy Buolamwini.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.