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Three Genes Could Help Determine How to Treat Prostate Cancer

Update Date: Sep 11, 2013 02:09 PM EDT

Prostate cancer is a type of cancer where doctors often treat it with the wait-and-see approach. Due to the fact that low-risk prostate tumors are not fatal, waiting is better than immediate treatment and surgery. In a new study, researchers found another technique that can help doctors monitor prostate cancer even more closely. The researchers from the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center (CUMC) discovered three genes that doctors could look at in determining whether or not the prostate cancer is low-risk or aggressive.

"Most of the 200,000 prostate cancers diagnosed each year in the U.S. are slow growing and will remain so, but the three-gene biomarker could take much of the guesswork out of the diagnostic process and ensure that patients are neither overtreated nor undertreated," said study leader Cory Abate-Shen, PhD, the Michael and Stella Chernow Professor of Urological Oncology at CUMC.

For this study, the research team specifically looked at aging genes that are tied to cellular senescence. Cellular senescence occurs when older cells stop dividing naturally but remain metabolically active. This phenomenon has been tied to tumor suppression and benign prostate lesions. The researchers used a technique called gene set enrichment analysis and were able to identify 19 genes. They then used a computer algorithm known as a decision-tree learning model and found three specific genes, which were FGFR1, PMP22 AND CDKN1A.

The researchers concluded that by studying the level of expression in these genes in combination with current cancer-staging detection methods, doctors would be able to get an even better idea of which prostate cancer cases would greatly benefit from active surveillance. The researchers also found that if the tumors did not have these genes, they were more likely to become aggressive.

In order to test the effects of using these three biomarkers, the team conducted a blind retrospective study. In this study, the researchers recruited 43 patients that were all diagnosed with low-risk prostate cancer. The patients had already been monitored for 10 years. In the group, 14 of the patients' cancer became aggressive. The team used the three-gene panel test and found that the test was effective in identifying the 14 patients with aggressive tumors.

"The bottom line is that, at least in our preliminary trial, we were able to accurately predict which patients with low-risk prostate cancer would develop advanced prostate cancer and which ones would not," said Dr. Abate-Shen. The researchers now plan on conducting a larger, prospective clinical trial.

The paper titled, "A molecular signature predictive of indolent prostate cancer," was published in Science Translational Medicine.

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