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Research Round Up
New urine DNA test used with PSA can eliminate unncessary biopsies and reduce fear of overtreatmentA new urine test can aid early detection of and treatment decisions about prostate cancer, a study from the University of Michigan Comprehensive Cancer Center finds.
The test supplements an elevated prostate specific antigen, or PSA, screening result and could help some men delay or avoid a needle biopsy, while pointing out men at highest risk for clinically significant prostate cancer.
The test looks for a genetic anomaly that occurs in about half of all prostate cancers: an instance of two genes changing places and fusing together. This gene fusion, TMPRSS2:ERG, is believed to cause prostate cancer. But because the gene fusion is present only half the time, the researchers also included another marker, PCA3. The combination was more predictive of cancer than either marker alone.
"Testing for TMPRSS2:ERG and PCA3 significantly improves the ability to predict whether a man has prostate cancer," says lead author Scott Tomlins, M.D., Ph.D., a pathology resident at the U-M Health System. "We think this is going to be a tool to help men with elevated PSA decide if they need a biopsy or if they can delay it."
In a recent study published in Science Translational Medicine, researchers looked at urine samples from 1,312 men. The men all had elevated PSA levels and had undergone either a biopsy or surgery to remove their prostates. The researchers evaluated the urine samples for TMPRSS2:ERG and PCA3 for low, intermediate and high scores, indicating their risk of cancer. They then compared this to biopsy results.
Biopsies indicated cancer in 21 percent of men from the low-score group, 43 percent in the intermediate group and 69% in the high group. Further, the urine test scores correlated with how aggressive the cancer was. Only 7% of men in the low-score group had an aggressive tumor while 40 percent of those in the high-score group did.
"Many more men have elevated PSA than actually have cancer, but it can be difficult to determine this without biopsy. This test will help in this regard. The hope is that this test could be an intermediate step before getting a biopsy," says senior study author Arul Chinnaiyan, M.D., Ph.D., director of the Michigan Center for Translational Pathology.
The Michigan Center for Translational Pathology hopes to offer the new combined test to U-M patients within the year. PCA3 screening alone is available to U-M patients as follow-up to elevated PSA. Men with questions about prostate cancer screening should speak to their doctors or call the U-M Cancer AnswerLine at 800-865-1125.
U-M Cancer Center Receives $3.5 milion Grant to Study Breast Cancer Stem CellsResearchers at the University of Michigan Comprehensive Cancer Center have been awarded a $3.5 million grant from Susan G. Komen for the Cure to study cancer stem cells in an aggressive form of breast cancer that disproportionately affects African-Americans.
Triple-negative breast cancer is resistant to the latest targeted therapies that have helped to advance breast cancer treatment. Among women with breast cancer, this subtype represents about 15 percent of diagnoses in white American women, 26% in African-American women and 82% in African women.
"We urgently need to develop novel approaches to treat triple-negative breast cancer in order to reduce racial disparities. Through this Komen grant, we propose to develop novel therapies capable of attacking and destroying the lethal seeds driving these cancers, the cancer stem cells," says principal investigator Max S. Wicha, M.D., distinguished professor of oncology and director of the U-M Comprehensive Cancer Center.
Cancer stem cells are the small number of cells within a tumor that are believed to fuel the tumor's growth and spread. Wicha and colleagues were the first to identify cancer stem cells in solid tumors, finding them in breast cancer tissue in 2003.
Researchers believe traditional cancer treatments often become ineffective because they do not kill the cancer stem cells, and that the key to future treatments is to develop drugs that target and kill these cells. Research suggests that triple-negative breast cancers have a higher proportion of cancer stem cells.
This grant will fund the study of tumor cells from African and African-American women to look for molecular differences in triple-negative tumors and the impact of targeting breast cancer stem cells within them. The researchers plan to launch at least three phase I clinical trials to investigate new treatments that target cancer stem cells. Based on the results of these trials, a larger randomized clinical trial will be planned.
"If the cancer stem cell model is correct, then the successful targeting of this cell population should result in significantly improved outcome for women with breast cancer," Wicha says.
University of Michigan Comprehensive Cancer Center
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