A genetic study mapping the mutations found in advanced prostate cancer tumors could pave the way for the treatment of almost 90% of men who have advanced stages of the disease using new or existing drugs.
The scientists, a collaboration led by The Institute of Cancer Research (ICR) in the UK, have hailed their research as the “Rosetta Stone” of prostate cancer, because it has allowed them to decode the disease in a similar way to how the stone allowed historians to translate Ancient Egyptian. They found that prostate cancer isn’t just a single variety, but is actually made up of many different diseases. This should allow for more tailored and personalized treatment.
Johann de Bono, who led the British team, says that they have “for the first time produced a comprehensive genetic map of the mutations in prostate cancers that have spread round the body. [...] Our study shines new light on the genetic complexity of prostate cancer as it develops and spreads – revealing it to be not a single disease, but many diseases each driven by their own set of mutations.” Their study is published in the journal Cell.
Prostate cancer is the most common form of cancer in men, with over 200,000 diagnosed within the United States each year. It can be treated if caught early enough, but once it starts to spread around the body it is often too late and eventually lethal.
The team was able to look at a large selection of tumors that have spread from the original site – metastatic cancers – which are often difficult to access. They found that nearly two thirds of the men in the study showed tumor mutations in the region that codes for a molecule that interacts with the hormone androgen. It is this that is normally targeted in current treatments for advanced forms of the cancer, though it can only be managed for a limited amount of time as patients eventually develop resistance to this.
“Cancer becomes lethal at the stage when it spreads round the body and stops responding to treatment – but until now it has been incredibly difficult to find out exactly what is going on genetically at that critical point,” explained Paul Workman from the ICR. “This major new study opens up the black box of metastatic cancer, and has found inside a wealth of genetic information that I believe will change the way we think about and treat advanced disease.”
They believe that this research could pave the way for new hormone therapies using drugs that already exist in different combinations, depending on what mutations each patient has. This is in line with a movement to treat cancers not just at their site of origin, but by trying to target the exact mutations that are driving the tumors.