Under the headline “Cool!” researchers at Mayo Clinic (USA) used next-generation gene analysis to determine that some of the more aggressive prostate cancer tumors have similar genetic origins. This may help in predicting who will have progression of cancer.
Background: This study is the first of its kind: It used next-generation genomic sequencing in adjacent Gleason patterns, allowing us to correlate genome changes and what we see under the microscope (grade). The standard method for evaluating prostate biopsy tissue is a numeric system called Gleason grading. A pathologist looks at the tumor under the microscope, and gives it a Gleason score based on the pattern of its cells. As many prostate cancer samples have more than one pattern, the two most prominent patterns are added together to give a Gleason score. The highest Gleason scores represent the most aggressive, potentially life-threatening cancer.
The study: The study looked at Gleason score 7 tumors, a score linked to a higher risk of progression (compared to low grade tumors, many of which don’t need any treatment). The tumors all appeared to have a common genetiv origin. These DNA changes in the aggressive cancers were also seen in lower Gleason pattern tumors, suggesting that the gene analysis could identify which cancers might be aggressive (before the pathologist could by looking under the microscope). In fact, the Gleason pattern 3 tumors had more gene alterations in common with its corresponding Gleason pattern 4 tumor (than they did when compared to Gleason pattern 3 tumors from other patients).
My take: This is just what the doctor ordered. Many prostate cancers never needed to be diagnosed! And yet 10s of thousands die every year of the disease. So how do we know which cancers to ignore and which to treat? We need more guidance, and this study points the way to a future when care can be far more individualized than it is today.
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