New 3-in-1 blood test to aid precision prostate cancer therapy

Modesto Morganelli
Giugno 19, 2017

They say it could one day lead to a PARP inhibitor called olaparib becoming standard treatment for advanced prostate cancer.

Testing again during treatment can tell whether the tumour is shrinking, allowing people who are not responding to switch to alternatives within weeks. It was funded by the Prostate Cancer Foundation, Prostate Cancer UK, Movember, Cancer Research UK and the National Institute for Health Research (NIHR) via the Experimental Cancer Medicine Centre network, and the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research (ICR).

The study, published in the journal Cancer Discovery, also identified which genetic mutations prostate cancers use to resist treatment with olaparib.

"Not only could the test have a major impact on treatment of prostate cancer, but it could also be adapted to open up the possibility of precision medicine to patients with other types of cancer". The test could potentially be adapted to monitor treatment with PARP inhibitors for other cancers.

While some patients respond to the drugs for years, others either fail to respond at an early stage or develop resistant cancer. This means that cancer cells regain the ability to fix themselves, causing tumours to grow.

Blood samples from 49 men with advanced prostate cancer were collected by researchers, as part of the phase II clinical trial of a drug called olaparib.

The drugs do not generally work on cancer cells with functioning BRCA genes, because these are primary DNA fix tools that make PARP unnecessary. This compared to an average rise of 2.1% in patients who did not respond to the drug.

The scientists also conducted a detailed investigation of the genetic changes in cancer DNA among men who stopped responding to olaparib.

"We think it could be used to make clinical decisions about whether a PARP inhibitor is working within as little as four to eight weeks of starting therapy", he said.

They found that the cells acquired genetic changes that cancelled out the DNA fix defects making them susceptible to the drug.

Lynparza, which is already approved for ovarian and recently produced good results in breast cancer, is now in clinical development against prostate tumours.

Professor Paul Workman, chief executive of the Institute of Cancer Research, said: "Blood tests for cancer promise to be truly revolutionary. That is why Prostate Cancer UK is investing so heavily in this area, including supporting this research released today".

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