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Efforts to unravel the genetic fingerprints of prostate cancer are lagging behind other cancers, including bad cancer, experts agree. But the mutations observed in DNA repair genes in men with advanced disease have emerged as promising therapeutic targets that could fill this gap.
Earlier this year, the National Comprehensive Cancer Network (NCCN) updated its guidelines. for prostate cancer, recommend to physicians to test for inherited mutations in DNA repair genes, such as BRCA1 and BRCA2 in men clbadified as " high-risk, very high-risk, regional, or 1
The NCCN also recommends that physicians consider testing men with prostate cancer who have a strong family history of this disease, including brothers or fathers diagnosed before the age of 60.
recommendations come, at least in part, from a pivotal study of 2016 in The New England Journal of Medicine which found that nearly 12% of men with prostate cancer were living with one of these genetic errors, men with high-risk localized prostate cancer and 2% with low to intermediate risk 2
"We are at the point where the data support the idea that there is a significant subset, "says Ravi Madan, MD, clinical director of the genito-urinary malignancies branch at the National Cancer Institute in Bethesda, Maryland However, when doing tests – early in the illness, or after first-line treatment – remains an open question, he says.
For the time being, most advances in cancer treatment the prostate come from the targeting of hormonal factors. systemic, according to Dr. Madan and others. And genomic tests, increasingly performed at the time of diagnosis, may not measure the errors in DNA repair genes, but they may detect some point mutations that could help guide the decisions of the DNA repair genes. newly diagnosed patients.
There will be nearly 165,000 new cases of prostate cancer in the United States in 2018. 3 Although research has shown that most diagnosed men die from other causes , prostate cancer is the second leading cause of death In men (behind lung cancer), about 29,430 deaths are expected this year.
The hormonal strategies used by physicians to fight these slow-growing cancers include blocking or removing androgens in the testes, or when receptors block cancer cells with next-generation drugs, such as 39, enzalutamide or apalutamide. 4 Another drug that is currently undergoing generalized testing, abiraterone acetate, an enzyme that acts as a secondary source of androgen production, that researchers suspect come from the cancer cells themselves and feeds growth.
While these strategies represent the most effective therapies in the clinic today, Dr. Madon says: and immunotherapy could revolutionize the treatment of prostate cancer in the next decade. In a recent article entitled "The Winds of Change: Emerging Therapies in Prostate Cancer", Dr. Madan and researchers from Monash University in Melbourne, Australia, are focusing on these evolving areas, particularly in advanced diseases. ] 5 The article was published in the 2018 American Society of Clinical Educational Oncology Book before the meeting of the company in June 2018 in Chicago
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