Fusion Genes Predict Prostate Cancer Recurrence
Abstract
The clinical outcomes of prostate cancer are highly variable. Currently, over 80% of prostate cancer patients will never develop metastasis or suffer from prostate cancer related death. A small proportion of prostate cancer patients developed life-threatening metastasis, clinical relapse, and actually died from prostate cancer. The current treatment modalities of prostate cancer include radical prostatectomy, radiation therapy, hormonal therapy, or active surveillance/watchful waiting. Relatively young and healthy patients generally choose to undergo prostatectomy, while older patients choose radiation therapy. When prostate cancer proves relapsing or metastatic, additional anti-androgen treatment or chemotherapy will be used to treat the cancer. In some cases, a patient might opt for observation if the tumor is slow-progressing and non-life-threatening. As a result, a reliable method to predict the clinical behavior of prostate cancer early is needed to reach a correct decision. We recently have identified a panel of fusion genes. These fusion genes are formed when cancer cells reshuffle their DNA materials. Part of one gene is abnormally connected with part of another gene. Such misconnection results in alteration of gene function. Some genes gain additional function, while others lose theirs. Practically, such misconnection creates a "new" gene that is unique to the cancer cells. We found eight fusion genes that are widely present in prostate cancer that showed aggressive behavior. When prostate cancer patients are positive for any of these fusion genes, 90% of them end up with disease recurrence or actually dying following complete surgical removal of their prostate gland (radical prostatectomy). Almost all metastatic cancers retained or gained these fusion genes when compared to the fusions in the cancerous prostate gland. These results suggest that these fusion genes could be a driver underlying prostate cancer metastasis. Our proposed study can help patients in multiple ways. Fusion gene test could find immediate applications in two clinical contexts. In men who have undergone surgery, detection of fusions in the cancer suggests that additional treatments should be given immediately, since it is highly likely that the cancer will return. Cases without the fusion can feel reassured that they do not require additional treatments since the chances that the cancer returns are far lower. In addition, in men who have been diagnosed of prostate cancer but who have not undergone any type of treatment, the finding of the fusions genes would argue strongly against a conservative approach, such as active surveillance.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610541
Entities
People
- Jianhua Luo
Organizations
- United States Army
- University of Pittsburgh