Is new oncogenic signature test really as good as the PR?

According to an article published on line in Cancer Research, a research team at the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia is claiming that they have identified an “oncogene signature” that is highly predictive for aggressive forms of prostate cancer.

The paper by Ju et al. (along with a supporting blog post on the Kimmel Cancer Center’s web site) suggests that a three-oncogene signature (c-Myc, Ha-Ras, and v-Src), where all three oncogenes have previously been associated with poorer outcomes after diagnosis of prostate cancer, demonstrates the ability to distinguish tumor from normal prostate with a predictive value for prostate cancer of 98 to 99 percent.

The current claims are based on a blinded but retrospective analysis of data from 350 patients through which the research team was able to use the oncogene signature to distinguish between men who died of prostate cancer as opposed to those who those who survived. Most specifically, they were able to identify men who died — on average —  30 months after diagnosis and treatment.

According to the Kimmel blog post, the test was able to distinguish “patients with clinically relevant prostate cancer from normal prostate in men with elevated prostate-specific antigen (PSA) levels.” The research team also claims that their test “is superior to several previously published gene tests and to the Gleason scale” in assessing the aggressiveness of specific prostate cancers.

As with other claims for other oncogenic signature tests currently in development, the real question is going to be whether this test can be shown to be effective and accurate when used prospectively as opposed to retrospectively. We need to be careful in understanding that this test is certainly not yet “ready for prime time.” The research appears to be very interesting, but confirmation of value in clinical practice is a different issue.

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