International DNA study heralds new era for prostate cancer trials
The vast majority of advanced prostate tumours contain genetic faults that make them sensitive to drugs already available or in development, according to a major study.
The findings, published in the journal Cell, could open the door to dozens of new trials for men with the disease.
Previous large-scale genetic studies of prostate cancer have tended to rely on tumour samples taken from men at earlier stages of the disease.
The new study, a collaboration between researchers at eight centres across the US and the UK, took biopsy samples from 150 men who had previously had surgery to remove their prostate tumour, and hormone treatment, after which their disease had spread and become resistant.
The tumour samples were taken from the men’s lymph nodes, bone, liver and other tissues.
Around 90 per cent of them were found to contain previously-known DNA errors, linked to sensitivity to existing or experimental drugs.
About a quarter of the samples contained faults in genes like BRCA1, BRCA2 and ATM, which are involved in DNA repair. Faults in these genes are linked to sensitivity to drugs called PARP inhibitors, originally developed to treat breast and ovarian cancers but now being tested in prostate cancer.
“This study provides a strong argument that the genomics driving advanced prostate cancer is fundamentally different than primary prostate cancer”, said Dr Eliezer Van Allen, from Dana-Farber Cancer Institute, one of the study’s lead authors.
Professor Johann de Bono, from The Institute of Cancer Research in London, where some of the work was carried out, said the findings were “hugely encouraging”.
"We have for the first time produced a comprehensive genetic map of the mutations in prostate cancers that have spread round the body.
“This map will guide our future treatment and trials for this group of different lethal diseases,” he added.
According to Dr Kat Arney, Cancer Research UK’s science information manager, the study is “impressive and important”.
“As we move towards an era of precision medicine, where treatments are tailored according to the makeup of an individual patient’s cancer, this finding will help new clinical trials to be set up, to test whether these drugs could help some of the many thousands of UK men with advanced prostate cancer,” she said.