Breaking News
December 10, 2018 - Music improves social communication in autistic children
December 10, 2018 - Some Brain Tumors May Respond to Immunotherapy, New Study Suggests
December 10, 2018 - Banning junk food ads to combat childhood obesity
December 10, 2018 - Skin Autofluorescence Predicts T2DM, Heart Disease, Mortality
December 10, 2018 - Largest autism sequencing study to date yields 102 genes associated with ASD
December 10, 2018 - Statins associated with low risk of side effects
December 10, 2018 - Study explores how schools address adolescent self-harming practices
December 10, 2018 - Pregnancy in adolescence linked to increased risks of complications in young mothers
December 10, 2018 - Risk Analysis publishes special issue on communicating about Zika virus
December 10, 2018 - Botox May Help Prevent Post-Op A-Fib
December 10, 2018 - African-American mothers rate boys higher for ADHD
December 10, 2018 - Graphic warning labels cancel out cigarettes’ appeal to young people
December 10, 2018 - Australian researchers to study gas inhalational anaesthetic and likelihood of cancer return
December 10, 2018 - Individual neurons located within the brain have implications for psychiatric diseases
December 10, 2018 - Researchers improve bariatric surgery scoring system to extend prediction time for diabetic remission
December 10, 2018 - HPV type 16 or 18 associated with cervical cancer risk in young women
December 10, 2018 - Cervical cancer risk is higher in women with positive HPV, but no cellular abnormalities
December 10, 2018 - Combo therapy not needed if low RA disease activity achieved
December 10, 2018 - Novel therapeutic targets based on biology of aging show promise for Alzheimer’s disease
December 10, 2018 - UC San Diego professor receives NCI Outstanding Investigator Award for cancer research
December 10, 2018 - Study evaluates placental mesenchymal stem cell sheets for myocardial repair and regeneration
December 10, 2018 - Blueprint Medicines Announces Updated Results from Ongoing EXPLORER Clinical Trial of Avapritinib Demonstrating Broad Clinical Activity and Significant Symptom Reductions in Patients with Systemic Mastocytosis
December 10, 2018 - Study clarifies ApoE4’s role in dementia
December 10, 2018 - Eating disorders now a top priority with Australian Government
December 10, 2018 - Neuronal activity in the brain allows prediction of risky or safe decisions
December 10, 2018 - FDA Alerts Health Care Professionals and Patients Not to Use Drug Products Intended to be Sterile from Promise Pharmacy
December 10, 2018 - Improving dementia care and treatment saves thousands of pounds in care homes
December 10, 2018 - Heroin-assisted treatment can offer benefits, reduce harms
December 10, 2018 - People covered by Michigan’s expanded Medicaid program report improvements in health, finds study
December 10, 2018 - Hazelnuts improve micronutrient levels in older adults
December 9, 2018 - History of Partner Violence Tied to Menopause Symptoms
December 9, 2018 - Clean Up Safely After a Disaster|Natural Disasters and Severe Weather
December 9, 2018 - Drug wholesalers drove fentanyl’s deadly rise, report concludes
December 9, 2018 - Deprescribing could help manage polypharmacy in older adults
December 9, 2018 - Retraction of article “Joy of cooking too much” from journal
December 9, 2018 - FDA Warns of Rare Stroke Risk With MS Drug Lemtrada (Alemtuzumab)
December 9, 2018 - Feds say heroin, fentanyl remain biggest drug threat to US
December 9, 2018 - Eliminating microglia can reverse some aspects of stress sensitization, study shows
December 9, 2018 - New genetic insight could help treat rare debilitating heart and lung condition
December 9, 2018 - MiRagen Therapeutics Announces Final Safety, Biodistribution and Clinical Efficacy Data From Phase 1 Cobomarsen Clinical Trial in Patients With Mycosis Fungoides
December 9, 2018 - Work with your doctor to weigh pros, cons of treatment options for hyperthyroidism
December 9, 2018 - CWRU researcher secures $14.6 million funding for genetic study into Alzheimer’s disease
December 9, 2018 - High intensity statin treatment and adherence could save more lives
December 9, 2018 - Surgery patients use only 1/4 of prescribed opioids, and prescription size matters
December 9, 2018 - AXT offers Phi Optics upgrade to QPI systems for inverted light microscopes
December 9, 2018 - New booklet could help improve conditions of young pupils with albinism
December 9, 2018 - Few Physicians Work in Practices That Use Telemedicine
December 9, 2018 - Older Adults and Oral Health
December 9, 2018 - Health utility values improve after septorhinoplasty
December 9, 2018 - New EU-funded project provides insight into how the brain develops
December 9, 2018 - Expanded use of tele-emergency services can help strengthen rural hospitals
December 9, 2018 - Infections in the Young May Be Tied to Risk for Mental Illness: Study
December 9, 2018 - Profile: Native Hawaiians and Pacific Islanders
December 9, 2018 - Snoring poses greater cardiac risk to women
December 9, 2018 - Researcher takes further steps in understanding how and why cute aggression occurs
December 9, 2018 - Researchers create new light-activated tools for controlling neurons
December 9, 2018 - Spinal cord injury disrupts the body’s internal clock, study shows
December 9, 2018 - Babies recognize nested structures similar to our grammar
December 9, 2018 - UT Austin researcher receives $2.5 million CZI grant for neurodegenerative disease research
December 9, 2018 - Sleep problems found to be prevalent and increasing among college students
December 9, 2018 - Study reveals why some children are susceptible to the effects of maltreatment
December 9, 2018 - Study investigates influence of different opioids on driving performance
December 9, 2018 - Jazz Pharmaceuticals Announces First Patient Enrolled in Phase 3 Clinical Trial Evaluating JZP-258 for the Treatment of Idiopathic Hypersomnia
December 9, 2018 - Eliminating microglia prevents heightened immune sensitivity after stress
December 9, 2018 - Boys with social difficulties are at greatest risk of early substance use
December 9, 2018 - ‘Wrong’ connective tissue cells linked to worse prognosis in breast cancer patients
December 8, 2018 - Chronic, refractory schizophrenia patients benefit from targeted cognitive training
December 8, 2018 - Advertising in kids’ apps more prevalent than parents may realize
December 8, 2018 - New way to trace the transmission histories of rare genetic diseases
December 8, 2018 - ASH: A+CHP Bests CHOP for Peripheral T-Cell Lymphoma
December 8, 2018 - Results of pediatric genomic epilepsy tests often reclassified
December 8, 2018 - New way of controlling HIV latency to completely eradicate the virus
December 8, 2018 - Phasefocus to showcase the Livecyte 2 at ASCB
December 8, 2018 - KHN’s ‘What the Health?’ Is health spending the next big political issue?
December 8, 2018 - Mussels take in microplastic pollution fibers and flush most of them out again
December 8, 2018 - AHA: How to Stop Smoking … for Good
December 8, 2018 - Scientists overturn odds to make Parkinson’s discovery
December 8, 2018 - Health benefits of producing marula vinegar
December 8, 2018 - Failure of critical cellular energy sensor responsible for CKD progression, study finds
December 8, 2018 - Ethnicity can be reliable indicator of gut microbiota diversity
New genetic risk score could help guide screening decisions for prostate cancer

New genetic risk score could help guide screening decisions for prostate cancer

image_pdfDownload PDFimage_print

One of the biggest challenges in treating prostate cancer is distinguishing men who have aggressive and potentially lethal disease from men whose cancer is slow-growing and unlikely to metastasize.

For years, prostate-specific antigen (PSA) level, cancer grade and tumor stage have been used to sort prostate cancer patients into risk groups established by the National Comprehensive Cancer Network. These risk groups help determine treatment course.

But the longtime practice has shortcomings.

“These risk groups were developed decades ago and were optimized for what is called biochemical recurrence, which simply means that a man’s PSA level rises again sometime after treatment,” says Daniel Spratt, M.D., associate chair of research and assistant professor in the Department of Radiation Oncology at Michigan Medicine.

“It was not optimized for more meaningful outcomes like identifying which men will ultimately develop metastases or die of prostate cancer.”

That means men with prostate cancer are being left behind in the era of precision medicine, Spratt says.

The good news? Technology has advanced to the point where genetic information derived from tissue biopsied at diagnosis can much more accurately predict which men have aggressive prostate cancer. A genomic classifier score is assigned based on tests run on 22 genes known to increase the risk of developing metastatic disease.

The bad news? There has been no way to integrate these new gene expression biomarker risk scores into the NCCN risk groups that have traditionally been used to guide treatment.

“So what we did is basically say: We’ve got a flawed model,” says Spratt. “We’ve got these new biomarkers, but we don’t really know how to integrate them. Let’s see if we can merge them together to create a new, integrated system that is simple and easy to use, and standardize the use of these biomarkers.”

The study was reported in the Journal of Clinical Oncology.

New reporting methods

Four multicenter, retrospective cohorts of nearly 7,000 men, all of whom had gene expression biomarker scores, were used to design, test and validate a new model for assigning risk groups. Two new clinical-genomic systems were created: a simple three-tiered system and a more granular six-tiered system.

When the researchers tested the new risk group models against conventional NCCN risk groups for the development of metastatic disease and death from prostate cancer, they found that the new clinical-genomic groups were much more accurate predictors than the traditional NCCN risk groups.

The team also found some noticeable differences.

“What our new system does is not only more accurately identify men who have either indolent disease or aggressive disease, but it reclassifies almost 67 percent of men, potentially changing recommendations for their treatment,” says Spratt.

Implications for care

For men with a lower-risk, slow-growing disease who are much more likely to die of something other than prostate cancer, active surveillance is typically recommended. Through careful monitoring of the condition, they are able to defer treatment.

“It’s great because you spare the cost and side effects of treatment,” says Spratt. “However, in the community setting, only about 50 percent or less of men who we would normally say should go on active surveillance actually go on it. That’s because clinicians don’t have great confidence in the old NCCN risk grouping system.”

This new system creates a much larger pool of low-risk men eligible for active surveillance, and it gives more accuracy and confidence to doctors prescribing treatment.

On the other hand, the new risk group classification also identifies a much larger pool of high-risk men who, if left untreated, are likely to die of prostate cancer. This group would receive more intensive treatment, possibly including radiation, hormone therapy or clinical trials.

“This is similar to what the oncotype recurrence score is for breast cancer,” Spratt says. “Women who have a high oncotype score are told they have a large chance of absolute benefit from adding chemotherapy, while those with a low oncotype score may have a very small benefit -; but the absolute benefit is so small, it’s not worth the side effects and cost of the therapy.”

Spratt says this new clinical-genomic risk grouping system for prostate cancer is ready to be used today.

“This could radically change the way we perceive and treat localized prostate cancer,” he says.

Tagged with:

About author

Related Articles