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Scientists unveil 'Rosetta Stone' of prostate cancer

Genetic map will help decode complexity of disease and tailor bespoke treatments

Mark Gould

Friday, 22 May 2015

Researchers have described their genetic map of advanced prostate cancer as the "Rosetta Stone" of the disease. They say it gives clinicians the ability to decode the complexity of the disease and translate these results into personalised treatments

A study*, led in the UK by scientists at the Institute of Cancer Research (ICR) London in collaboration with teams across the United States, published in the journal Cell, shows that nearly nine in 10 men had gene mutations that could be targeted with drugs.

Researchers analysed the genetic codes of tumours from 150 patients with metastatic prostate cancer, whose disease had spread to other parts of the body. They found that 89% had genetic aberrations for which there were existing drugs or treatments undergoing clinical trials.

They also learned that 8% of men were born with genetic faults in the BRCA1 and BRAC2 genes that predispose them to the disease, strengthening the case for screening people with a family history of the disease.

Nearly all men with advanced disease develop resistance to hormone therapy, which is used to prevent prostate cancer cells from growing.

In the study, nearly two-thirds of the patients had mutations in a molecule that interacts with the male hormone androgen, which is targeted in current treatments. Scientists at the ICR believe this could open up new avenues for hormone therapy.

Trials at the Royal Marsden/ICR have already shown prostate cancer patients with BRCA mutations can benefit from drugs called Parp inhibitors which disrupt cancer cells' DNA repair mechanism.

One of these drugs, called olaparib, is now licensed by the EU to treat women with ovarian cancer, who carry BRCA mutations.

The research is part of a move towards treating cancer - not just by its site of origin - such as breast, lung or prostate - but with medicines which target the individual genetic mutations driving the disease which can be common across several cancers.

Dr Iain Frame, director of research at Prostate Cancer UK said: "This is incredibly exciting and ground-breaking research. It suggests for the first time the list of genetic mutations to search for in order to build up a blueprint of a man's prostate cancer once it has spread.

"This could provide the information about the best routes of attack in each individual case which is crucial if we are to reduce the number of men dying needlessly from this disease."

* Dan Robinson, et al. Integrative Clinical Genomics of Advanced Prostate Cancer. Cell Volume 161, Issue 5, p1215–1228, 21 May 2015. DOI: 10.1016/j.cell.2015.05.001

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