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Researchers have discovered that the most common type of prostate cancer has two different ways of developing in the body, opening up new possibilities for identifying which patients need treatment.
Prostate cancer is the most common form of cancer in men, with one in eight diagnosed with the disease during their lifetime. Most prostate cancers They are adenocarcinomas – a type of cancer that forms in the glandular tissue that lines certain internal organs. But while the disease can kill, for many patients the risk is low.
“The key problem in prostate cancer is identifying the 15% of men who will have more aggressive cancers that will spread to other organs and actually cause death,” said Professor David Wedge of Manchester Cancer Research Centre. , who led the study.
He said: “If we can identify those men, we can give them more robust treatment… and we can leave the other 85% of men alone. That is beneficial because the surgery itself has many side effects.”
Now Wedge and his colleagues say they have found a new way to classify adenocarcinomas that could help them do just that.
writing in the diary Cellular genomics, researchers report how they sequenced the genomes of 159 patients with prostate adenocarcinoma. They then used three different approaches, including artificial intelligence (AI), to analyze patterns within the genomes, including how DNA was damaged and the order in which certain genetic alterations occurred.
All three approaches pointed to the same result: that prostate cancers fell into two main groups (or “evotypes”) that were related to how they changed in the body over time and the mechanisms involved.
Crucially, when researchers looked at the results of blood tests performed after patients underwent treatment, they found that those with one evotype were twice as likely to show signs of disease recurrence than those with the other.
Wedge said: “Often those men will have metastases, [so] The cancer has already spread to other organs.”
The team says the findings suggest that a genetic test could be used to determine whether patients with prostate adenocarcinoma have the more or less aggressive evotype, allowing treatment to be better tailored to them and potentially given sooner.
Wedge said it is now important to explore whether evotype type could be associated with factors such as the patient’s age and ethnicity, while the team is also looking at whether other cancer types have evotypes.
Professor Joe O’Sullivan, a prostate cancer oncologist at the Northern Ireland Cancer Center in Belfast, who was not involved in the work, welcomed the study.
He said: “Identifying two different subtypes of prostate cancer based on the genetic evolutionary pathway could help both treatment stratification and potentially open up new possibilities for drug discovery.”