A breakthrough from researchers led by the University of South Australia scientists has identified three new biomarkers for prostate cancer to help detect and differentiate potentially aggressive cases of the disease that kills more than 300 000 men annually.
The international team of scientists, led by UniSA Professor of Molecular Medicine Doug Brooks, says this will help pathologists when visualising prostate cancer in patient tissue samples.
The new biomarkers, when used together, will assist clinicians in determining which patients require immediate, radical treatment compared with those who need close monitoring.
With more than 1m men diagnosed with prostate cancer worldwide each year, the research breakthrough – published in the journal Cancers – is significant.
The UniSA-based team has collaborated with the Australian company Envision Sciences on the technology to improve management and treatment outcomes for patients.
“It is expected that this will lead to long-term improvements in how prostate cancer is diagnosed and graded,” Brooks says. “The biomarkers are remarkably sensitive and specific in accurately visualising the progress of the cancer and confirming its grade.
This discovery has led to the commercial development of a test designed to determine how advanced and aggressive the cancer is and whether immediate treatment is needed.”
Envision Sciences, which funded the development and translation of the technology at UniSA, has signed a commercialisation agreement with the largest tissue diagnostic pathology company in the US, Quest Diagnostics, to take the technology into clinical practice.
Pending a successful outcome in the US, it is expected that clinical trials using the innovative technology will be undertaken in Australia.
Study details
Prediction of Prostate Cancer Biochemical and Clinical Recurrence Is Improved by IHC-Assisted Grading Using Appl1, Sortilin and Syndecan-1
Jessica Logan, Ashley Hopkins, Douglas Brooks et al
Published in Cancers on 16 June 2023
Summary
A novel biomarker panel (Appl1, Sortilin and Syndecan-1) was demonstrated as a strong independent predictor for both clinical and biochemical recurrence outcomes, with a higher prediction performance than traditional grading. This suggests that panel-derived patient reclassifications improve risk stratification.
Abstract
Gleason scoring is used within a five-tier risk stratification system to guide therapeutic decisions for patients with prostate cancer. This study aimed to compare the predictive performance of routine H&E or biomarker-assisted ISUP (International Society of Urological Pathology) grade grouping for assessing the risk of biochemical recurrence (BCR) and clinical recurrence (CR) in patients with prostate cancer. This retrospective study was an assessment of 114 men with prostate cancer who provided radical prostatectomy samples to the Australian Prostate Cancer Bioresource between 2006 and 2014. The prediction of CR was the primary outcome (median time to CR 79.8 months), and BCR was assessed as a secondary outcome (median time to BCR 41.7 months). The associations of (1) H&E ISUP grade groups and (2) modified ISUP grade groups informed by the Appl1, Sortilin and Syndecan-1 immunohistochemistry (IHC) labelling were modelled with BCR and CR using Cox proportional hazard approaches. IHC-assisted grading was more predictive than H&E for BCR (C-statistic 0.63 vs. 0.59) and CR (C-statistic 0.71 vs. 0.66). On adjusted analysis, IHC-assisted ISUP grading was independently associated with both outcome measures. IHC-assisted ISUP grading using the biomarker panel was an independent predictor of individual BCR and CR. Prospective studies are needed to further validate this biomarker technology and to define BCR and CR associations in real-world cohorts.
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