Tumour DNA in blood could help monitor prostate cancer development
"It's vital to understand the genetic twists and turns that offer tumour cells an escape route to become resistant to treatment" - Nell Barrie, Cancer Research UK
Experts say that isolating traces of tumour DNA found in the blood of men with advanced prostate cancer could one day help to pinpoint when drug-resistant cancer cells evolve and potentially adapt treatment accordingly.
Professor Paul Workman, Interim Chief Executive at The Institute of Cancer Research, London, said: “Drug resistance is the single biggest challenge we face in cancer research and treatment, and we are just beginning to understand how its development is driven by evolutionary pressures on tumours.”
Following their latest findings, the team speculate that if patients underwent regular blood tests, doctors would be able to detect signs that the treatment has stopped working.
The study, part-funded by Cancer Research UK, was carried out by scientists at the Royal Marsden NHS Foundation Trust, The Institute of Cancer Research in London and the University of Trento in Italy.
The researchers performed complex genetic analysis on tumour DNA isolated from blood and biopsy samples from 16 men with advanced prostate cancer.
They found that the use of steroid drugs – called glucocorticoids – that are often used alongside hormonal therapy coincided with the appearance of particular genetic faults that may rekindle tumour growth.
The findings suggest that treatments given in the advanced stages of prostate cancer can act as an evolutionary force, applying pressure to the cancer cells as they acquire new genetic faults that help them grow.
Study leader Dr Gerhardt Attard, Cancer Research UK Clinician Scientist at The Institute of Cancer Research, London, and Honorary Consultant at The Royal Marsden NHS Foundation Trust, stressed that while blood tests could one day help personalise prostate cancer treatment, larger studies were still needed.
“We need to confirm these findings in larger numbers of patients but using these types of blood tests could allow true personalisation of treatment for prostate cancer patients, based on the cancer mutations we detect,” he said.
Nell Barrie, Science Information Manager at Cancer Research UK, said: "It's vital to understand the genetic twists and turns that offer tumour cells an escape route to become resistant to treatment. And this study provides an important first step towards working out how to use tumour DNA from blood samples as a way to monitor how prostate cancer evolves during treatment.
"Cancer Research UK scientists have played an important role in unravelling how groups of cancer cells can be genetically distinct, even within the same tumour. And these latest findings shed more light on how tumours evolve."
The study was published in the journal Science Translational Medicine and was mainly funded by Prostate Cancer UK with support from the Movember Foundation.