Prostate cancer can be divided into two different genomic subtypes with implications for treatment strategies, new research has shown.
Examining the genomic landscape of 159 prostate tumours using a range of sophisticated computational approaches including artificial intelligence, researchers have shown that prostate tumours follow distinct evolutionary pathways. Based on their evolutionary trajectory, prostate cancers can be divided into two subtypes or 'evotypes', with one 'evotype' associated with more aggressive prostate cancer than the other.
Professor David Wedge of Manchester Cancer Research Centre, who led the study published in Cell Genomics, told the Guardian: 'The key problem in prostate cancer is identifying those 15 percent of men who will have more aggressive cancers that will spread to other organs and that will actually cause death. If we can identify those men, we can give them more robust treatment … and you can leave alone the other 85 percent of men. That is beneficial because the surgery itself has a lot of side effects.'
Prostate cancer is the most common cancer in men in the UK, with around one in six men affected. However, it is commonly an 'indolent' cancer, meaning that it generally doesn't spread to other tissues, and is a disease that many die 'with' rather than 'of' – only a subset of men will have a cancer that will spread. A wide range of efforts to easily distinguish aggressive from indolent cancers has been made over the past decades, with limited success.
If evotype classification could be adopted in prostate cancer diagnostics, allowing men with the more aggressive subtype to be quickly identified and treatment targeted accordingly, this could lead to personalised cancer treatment for prostate cancer. It could benefit many men with indolent cancer who could then avoid the side effects of unnecessary surgery to remove the prostate, which include long-term effects such as incontinence and erectile dysfunction.
Professor Colin Cooper, from University of East Anglia's Norwich Medical School, who was also involved in the study, said: 'We hope that the findings will not only save lives through better diagnosis and tailored treatments in the future, but they may help researchers working in other cancer fields better understand other types of cancer too.'
Sources and References
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Genomic evolution shapes prostate cancer disease type
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Artificial Intelligence reveals prostate cancer is not just one disease
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Study offers hope in identifying high-risk prostate cancer patients
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Artificial intelligence reveals prostate cancer is not just one disease
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Prostate cancer is not just one disease, reveals new study
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