A genetic test could help recognize tumors destined to evolve into more aggressive forms well in advance
The prostate cancer It constitutes one of the most widespread neoplasms in the male population. It is the second most frequent form of cancer among men and the most common in Western countries, with approximately 1.4 million new diagnoses every year based on data from Global Cancer Observatory. Despite progress in diagnosis and therapies, the main clinical problem remains the distinction between the indolent forms, i.e. slow growing and often compatible with a good quality of life, and those that tend to evolve into metastases and a lethal course. A group of Italian researchers, however, may have found a way to predict the aggressiveness of the tumor thanks toanalysis of the three-dimensional architecture of DNA.
Prostate cancer: the limits of current diagnostics
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THE’standard diagnostic workup for prostate cancer is based today on the combined evaluation of various parameters. We start from Psa dosage (prostate specific antigen), and then proceed with therectal examination el’histological examination of multiple biopsies, if the preliminary results raise suspicions. However, the multifocal nature of the tumor and its clinical heterogeneity make it difficult to accurately predict its evolution. The concrete riskout of an abundance of caution, is therefore that unnecessary surgical interventions or pharmacological therapies are practiced even in patients with forms that prove to be less active over time. This has an impact on both the quality of life and the costs for the NHS.
Prostate cancer, The study
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For the study, published on Nature Communicationsthe researchers started from the hypothesis that thethree-dimensional organization of DNA can offer a more accurate prognostic indicator than conventional methods already at the time of diagnosis. In particular, experts focused onchromatin architecturethat is, the complex between genetic material and regulatory proteins. To verify this they applied 4f-SAMMY-seq technology. It turned out that the control tissues present a stable chromatinwhile tumor samples show patient-specific rearrangementsattributable to two subtypes: one with low reorganization and one with extensive reorganization of the genome. And paradoxically the latter it seems associated with better prognosis. By integrating data from biochemistry, molecular biology and bioinformatics, the team then defined a “signature” of 18 genes capable of predict the clinical course of prostate cancervalidated on international databases with over 900 patients.
From research to clinical diagnosis
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The “molecular signature” identified by the researchers could soon be used to stratify risk already at the time of diagnosis of prostate cancerand more precisely distinguish slow-growing tumors from those destined to evolve into aggressive forms. If further validated, the test would allow us to guide therapies, reduce the risk of over-treatment and improve patients’ quality of life.
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