Prostate cancer is the second most common cancer for men in the United States. About one man in nine will be diagnosed with the disease at some point in his life.
Researchers at Huntsman Cancer Institute (HCI) at the University of Utah (U of U) are working to individualize treatment for metastatic prostate cancer patients and potentially predict survival and treatment outcomes. A study recently published in The Lancet’s EBioMedicine Journal describes new insights into how unique genetic traits of metastatic prostate tumors that are shed into the blood of cancer patients can be used for applying to the care of and potential molecularly targeted treatments in individual patients.
The work was led by Manish Kohli, MD, a prostate cancer researcher at HCI and faculty member in the Department of Internal Medicine at U of U Health, and involved collaborations with many organizations throughout the United States and Australia. The researchers began by collecting plasma from patients with advanced prostate cancer and following patients for nearly a decade. They used this plasma to study genetic changes in the patient’s DNA, called circulating tumor DNA.
"We were able to see how new mutations and other types of clonal alterations evolve as prostate cancer progresses," Kohli says. "We were also able to prognosticate longevity of life in patients with and without these genomic changes, much better than we can at present."
With this knowledge, researchers can now observe correlations between the emerging changes in the DNA and the effects of treatment. These possible correlations identified will be validated in additional studies. And, if results are positive, they anticipate future molecularly targeted clinical trials in metastatic prostate cancer patients, again using liquid biopsies.
"This study has been able to help us understand how cancer changes its genetic make-up—even in each individual patient. It provides us with the means to target those genetic alterations in the future," Kohli says.
This work was started while Kohli was a faculty member at the Mayo Clinic and completed while at HCI. The collaboration also included an academic, non-commercial partnership with industry Predicine Inc. It was supported by the National Institute of Health, the Prostate Cancer Foundation, and the Victorian Cancer Agency. Future work will be supported by the National Cancer Institute grant P30 CA042014 and Huntsman Cancer Foundation.