JAMA: There are two forms of metastatic prostate cancer, which can guide treatment

Scientists have identified two subtypes of metastatic prostate cancer that respond differently to treatment.

Based on the early detection of clinically relevant subtypes of breast cancer and non-metastatic prostate cancer, the researchers determined the genetic characteristics that can divide metastatic prostate cancer into two types: intraluminal and basal

Intraluminal tumors responded well to testosterone blockade therapy, while basal tumors did not benefit from hormone therapy

"These subtypes are important because they respond very differently to hormone therapy," said Zhao Shuang, a professor of oncology at the University of Wisconsin School of Medicine and Public Health, who helped guide the research

On September 23, Zhao, together with colleagues from the University of California, San Francisco and other institutions, published his findings in JAMA Oncology

About 20 years ago, scientists discovered the luminal and basal subtypes of breast cancer, and found that each subtype responded better to different treatments

Since breast cancer and prostate cancer have many similarities, including their sensitivity to hormone therapy, Zhao's team investigated whether these similarities extend to different prostate cancer subtypes in 2016

The new research expands the analysis of metastatic cancer, the spread of disease from the prostate

Therefore, in order to determine enough samples for analysis, Zhao's team turned to a number of large, nationwide studies of patients with metastatic prostate cancer

"We pooled all the data together to form the largest metastatic prostate cancer cohort to date," Zhao said

Scientists use computational methods to compare gene expression patterns in tumor biopsies

As they saw in localized prostate cancer, Zhao's team also determined the intracavitary and basal types of metastatic cancer

Because the doctors treating the study patients did not know these subtypes at the time, they had to decide which treatment they thought might be the most effective without this information

"We found that, like localized prostate cancer, hormone therapy seems to be more effective in intraluminal tumors than in basal tumors," Zhao said

Although there are two distinct subtypes, the researchers also found that the spectrum of tumors depends on their luminescence or base

Since metastatic tumors are difficult to perform biopsy, Zhao hopes to develop a blood test that can more easily determine the luminescence or basal properties of metastatic prostate cancer

"Now that we have discovered this pattern, how do we translate it into a test that can benefit metastatic patients?" He is also the co-director of the Cycling Biomarker Core at the University of Wisconsin-Madison Carbon Cancer Center, a research center How to develop this blood test
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"The only way to make it widely used is to make it simpler
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