Metastasis in prostate cancer can now be predicted

Scientists have created a cheaper, faster, reproducible diagnostic technique that has the potential to predict the risk of metastasis in prostate cancer.

For patients who are newly diagnosed, or patients previously treated, the risk of metastasis in prostate cancer is a crucial factor of whether to choose conservative management or undergo further treatment. For prostate as well as other cancers, primary tumour growth or spread is driven by amplifications or deletions of portions of the genome known as copy number alterations (CNAs). Now recently reported in The Journal of Molecular Diagnostics, a new assay to assess CNAs that is cheaper, faster, reproducible, and requires less tissue than other diagnostic techniques have the potential to significantly enhance prostate cancer evaluation.

The occurrence of metastasis in prostate cancer

Metastases occur in roughly 16% of prostate cancers and account for 8% of all male cancer deaths. Accurate prediction at the time of diagnosis can identify men at risk for metastasis who would benefit from aggressive therapy.

The detection of CNAs in prostate tissue or blood can indicate whether previously diagnosed disease have progressed. The amplified and deleted genes represent novel targets for treating aggressive prostate cancer.

“We have demonstrated that CNAs can be detected rapidly and accurately with the new Next-Generation Copy Number Alteration (NG-CNA) assay.” Explains lead investigator Harry Ostrer, MD, of the department of pathology, Albert Einstein College of Medicine, USA. “The impact of this information is two-fold: to assure aggressive therapy at the time of diagnosis for men with metastasis-prone disease and provide a rationale for active surveillance (and not overtreatment) for men with indolent disease.”

The road to personalised medicine

According to the researchers, massively multiplexed assays, similar to the NG-CNA assay, provide an entry into personalised medicine applications at a fraction of the cost of traditional whole genome sequencing approaches.

Moreover, the results are easier and quicker to decipher than whole genome sequencing. As the new assay allows hundreds to thousands of samples to be processed in a single run, with a typical turn-around time of 36 hours. Samples evaluated with the NG-CNA assay also require less data storage than whole genome sequencing.

In previous work, the researchers developed the metastatic potential score (MPS) as an indicator of metastatic potential, using data from other measurement techniques. They found the MPS to be highly predictive of prostate cancer, triple negative breast cancer, and lung adenocarcinoma metastases. In the current investigation, NG-CNA assay data was used to compute the MPS in 70 prostate cancer surgical research samples with known clinical outcomes, and the results were highly correlated with that of the Oncoscan CNV assay.

“We believe the addition of the NG-CNA assay onto a standard cancer gene testing platform will augment personalised medicine by identifying aggressive tumours and genetic mutations that are predictors of response to targeted therapies.” says Ostrer.