PHG Foundation | New insight for prostate cancer treatment and prognosis

New insight for prostate cancer treatment and prognosis
Analysis of a study published in a science journal | By Dr Anna Pokorska-Bocci | Published 16 February 2011

Study: SMAD4-dependent barrier constrains prostate cancer growth and metastatic progression
By: Ding Z. et al. (28 authors total)
In: Nature
Link: http://dx.doi.org/10.1038/nature09677

What this study set out to do:
To identify genes involved in the development of early-stage prostate cancer into an aggressive form with the goal of improving patient management.

How they went about it:
To determine the genetic fingerprint of aggressive prostate cancer, mice lacking a gene called Pten were analysed. Such mice develop cancer, but it doesn’t spread elsewhere in the body. Further analysis showed that absence of Pten caused an aggressive (spreading) form of cancer if it was associated with the silencing of another gene, Smad4, which in turn regulated two further genes.

Outcome:
Researchers identified a combination of four genes involved in the processes of cell division and cell invasion that could play a critical role in the development of early-stage prostate cancer into an aggressive, lethal form.

Conclusion:
This study will facilitate the development of a molecular prognostic assay that may complement the current standard of care to improve management of prostate cancer patients, a current major unmet need.

Our view:

Over 200,000 new cases of prostate cancer are diagnosed in U.S. each year thanks to the PSA screening tests, which can detect early stage disease, allowing prompt treatment. However, for a large number of patients, condition is benign, with very slow disease progression, and is unlikely to be life-threatening. Current methods of predicting how the disease will evolve are accurate only in about 60 - 70% of cases and many men who actually have very low risk of disease progression therefore undergo treatments and surgery with little benefit; for this reason, PSA screening is not offered in the UK, for example (see previous news). A test based on the results of the new study could improve the accuracy of prognosis to 90%. Several companies have started developing genetic tests based on these findings, which could be available in near future to help prognosis and treatment decisions for early-stage prostate cancer
PHG Foundation | New insight for prostate cancer treatment and prognosis