Prostate cancer impacts men from all ethnic and racial groups, and is thr fifth leading cause of cancer-related mortality in men. Certain genetic mutations have been associated with the development and metastasis of cancer. People may carry genetic variants that make prostate cancer more likely, such as changes in genes that are related to testosterone metabolism, and genetic mutations can also tell clinicians and researchers more about a patient's disease. Some genetic mutations can be used as biomarkers in the targeted treatment of prostate cancer.
For patients in Sweden, screening that identifies mutations in DNA from tumors found in circulation may now become routine in the treatment of metastatic prostate cancer. People with certain genetic mutations will have access to specific types of therapies that are best for treating their type of cancer.
"It's great news that this test is now being implemented in clinical routine," noted Johan Lindberg, a senior researcher at the Karolinska Institutet, among other appointments. "It gives more patients with metastatic prostate cancer access to individualized treatment. The test has been optimized to detect mutations in very small amounts of DNA, which has previously been a problem for this patient group."
The test that will be used is based on research that has been published in several journals including Genome Medicine and Clinical Cancer Research.
As of May 2022, if a patient with metastatic castration-resistant prostate cancer carries mutations in either BRCA1 or BRCA2, they have been able to take a medication called Olaparib. The mutations in these genes can now be identified by sequencing DNA that can be found in circulation, which has broken off of tumor cells. This so-called cell-free DNA can provide clinicians with a genetic snapshot of the mutations in the tumor.
Scientists are also planning for this technique to be used on a larger scale in the coming years, and are preparing for closer collaborations between researchers and clinicians, in this case those at the Karolinska Institutet and Karolinska University Hospital.
"The development of precision-medical analyses is advancing rapidly, and an active skills and knowledge exchange between university and hospital is needed if we're to keep up," said Dr. Mikael Björnstedt, head of clinical pathology and cancer diagnostics at Karolinska University Hospital.
Sources: Karolinska Institutet, Genome Medicine, Clinical Cancer Research