Individualizing precision therapy for advanced prostate cancer


There’s a very interesting article this week on the Hutch News pages of the Fred Hutchinson Cancer Research Center (in Seattle, WA). It addresses the degree to which metastatic prostate cancer may be “tailor-made” for individualized, precision cancer therapy.

The article, which is well worth reading, is based on recent work by Kumar et al., just published in Nature Medicine. The basic finding that they discuss is that, in men with metastatic prostate cancer,

  • There is wide variation in the genetic/genomic profiles of tumors from patient to patient, but …
  • If you look at the tumors of any one specific patient, there is very little genetic/genomic variation between the different tumors in that specific patient.

Rather than get into the details, we suggest that interested readers should just read the very straightforward discussion on the Hutch News web site. We would just point out that this finding adds additional relevance to the recent announcement from ASCO about the initiation of the TAPUR study.

The general implication is that if we can specifically categorize prostate cancers by genetic/genomic subtype, we may be able to make major advances in how to treat individual patients … and we may be able to induce much better responses to therapy for at least some of those patients relatively early in their disease state.

One Response

  1. Interesting article which I can relate to. Especially the comment on uniformity of mutations between tumor(s) within same patient. I hope they are right on uniformity within patients. One would hope that would make treatment approaches less complex.

    Personally, after having bone biopsy and molecular profiling this summer, an “actionable” DNA repair mutation was identified that “should” respond to PARP1 inhibition. Thus I am being treated with olaparib (a PARP1 inhibitor) . Unfortunately my CTCs and PSA are on the rise again. Next steps TBD.

    Also interesting that last fall after concluding Xofigo, my med/onc put me back on Xtandi as he believed that I once again had high AR signature expression. This did bring down my PSA from 2,200 to 1,800.

    Given my PSA is going up again (up 800 in a couple weeks) we’ve been tempted to resume Xtandi again, but there seems to be conflict between olaparib and Xtandi. They share the same pathway (3A4): one is a metabolizer and the other is an inducer. So holding off on that approach.

    All the best!

    Dominic

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