New Approach Improves Outcome Prediction for Prostate Cancer Patients

Researchers at the University of East Anglia have discovered why some prostate cancers are more aggressive, spread to different parts of the body, and ultimately cause death. The new study shows how the number of 'aggressive' cells in a tumor sample defines how quickly the disease will progress and spread. The findings also reveal three new subtypes of prostate cancer that could be used to stratify patients for different treatments.

"Prostate cancer is the most common cancer in men in the UK,” explained lead researcher Prof Colin Cooper. “It usually develops slowly and the majority of cancers will not require treatment in a man's lifetime. However, doctors struggle to predict which tumours will become aggressive, making it hard to decide on treatment for many men.”

The team developed a test to distinguish aggressive prostate cancers from less threatening forms of the disease, by applying a mathematical model known as latent process decomposition.

According to co-author Prof Vincent Moulton, "By applying the latent process decomposition process and analysing global prostate cancer datasets, we discovered an aggressive form of prostate cancer known as DESNT,  which has the worst clinical outcomes for patients."

In the latest study, published today in the British Journal of Cancer, the team studied gene expression levels in 1,785 tumour samples. They found that the amount of DESNT subtype cells in a sample is linked with the likelihood of disease progression—the more DESNT cells, the quicker the patient is likely to progress.

Co-lead researcher Dr Daniel Brewer said: "If you have a tumour that is majority DESNT you are more likely to get metastatic disease, in other words it is more likely to spread to other parts of your body. This is a much better indication of aggressive disease.

"We also identified three more molecular subtypes of prostate cancer that could help doctors decide on different treatment options for patients.