Prediction of potentially lethal forms of prostate cancer

An international, multi-institutional group of researchers appears to have been able to validate a new way to predict risk for aggressive forms of localized prostate cancer that have a high probability for progression to metastatic disease and prostate cancer-specific mortality.

This new methodology is based on the methylation of specific pieces of DNA in a patient’s biopsy and/or post-surgical tissue to develop a so-called DNA methylation score.

The entire text of the paper by Zhao et al. describing this new system is available on line for those who want to have a look. It is highly technical and your sitemaster is not going to even try to summarize the details. However, …

The bottom line is that this new methodology seems to be able to predict risk for prostate cancer-specific mortality with higher accuracy than a patient’s Gleason score. The authors claim that:

the methylation score could markedly improve the selection of patients at high risk for metastatic-lethal progression, which is particularly relevant for those patients (over 25% in the testing dataset) who may be misclassified as low risk and forego potentially life-saving adjuvant treatment.

It will quite certainly take more time and more studies to fully validate this new methodology and assess whether it is a clinically practical and cost-effective way to evaluate risk for men diagnosed with prostate cancer at time of biopsy or after radical prostatectomy. At present, this is almost certainly a test that can only be carried out in the setting of a research laboratory with certain very specific technical capabilities.

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