‘Tailored test’ will aim to help men with prostate cancer

The test could help predict which men will respond to targeted treatments.
The test could help predict which men will respond to targeted treatments.
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A new blood test costing less than £50 could predict which men with advanced prostate cancer will respond to targeted treatments of the disease.

Researchers were able to detect tumour DNA in men’s blood and pick out cancers with multiple copies of the androgen receptor gene, which many prostate cancers rely on to grow.

Men with multiple copies of the gene responded much less well than otherwise to the targeted therapies abiraterone and enzalutamide – now standard treatment for advanced prostate cancer.

This means these men could be spared treatments that are unlikely to work for them, and doctors could offer them alternative options instead.

The test will have to be assessed further in clinical trials, but the researchers say it could be used in clinical practice to personalise treatment.

A team at The Institute of Cancer Research, London, and the Royal Marsden NHS Foundation Trust, along with colleagues in Europe, analysed blood samples from 265 men with advanced prostate cancer who were being treated with abiraterone or enzalutamide, either before or after docetaxel chemotherapy. The study is published today in the journal Annals of Oncology, and was funded by Prostate Cancer UK with support from the Movember Foundation, Cancer Research UK, and the NIHR Biomedical Research Centre at the Royal Marsden NHS Foundation Trust and the Institute of Cancer Research.

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Researchers took samples from patients on three different clinical trials, both before receiving abiraterone or enzalutamide, and again after their disease began to progress. In the trial of 171 patients, men in whom a blood test detected multiple copies of the gene that carries the instructions for making the androgen receptor were four times more likely to die over the course of the study than those who did not. The study included patients who had previously received chemotherapy and those who did not. The findings were confirmed in a second group of 94 patients where men with multiple copies had an eight-fold shorter response to treatment than men with one or two copies of the gene.

Dr Iain Frame, director of research at Prostate Cancer UK, said: “A man with incurable prostate cancer does not have time to waste taking drugs that will not work for him. To stop prostate cancer from being a killer, we need to move away from a one-size-fits-all approach to treatment. This test could be a significant step towards that and we’ll be watching its development very closely. Thanks to our supporters, we are ramping up investment in prostate cancer research to get the right drug for the right man at the right time.”

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