Differences in how cancer cells mutate and what fuels their growth mean that even for two patients with prostate cancer, one treatment approach can work better for one patient than the other.
Dr. Shuang George Zhao, associate chair for research in the University of Wisconsin Department of Human Oncology and a UW Carbone Cancer Center researcher, has been developing clinic-use screening tools that can help oncologists optimize treatment plans for prostate cancer patients. These tools can personalize care plans and give patients their optimal approach while minimizing uncomfortable or toxic side effects.
Zhao has led a collaborative effort of scientists from multiple research centers to develop a gene signature, called PORTOS, that uses 24 genes to predict radiation dose escalation response for patients who had prostate removal surgery, and those whose primary treatment is radiation. Their gene signature was developed on Veracyte’s Decipher assay platform.
Two Phase III randomized clinical trials, RTOG 0126 and SAKK 09/10, validated the PORTOS gene signature’s ability to identify patients who could benefit from radiation dose escalation, as well as identifying which patients would not. This approach is the first biomarker validated in randomized trials as predicting radiation dose response among any cancer type.
Zhao has also collaborated on research that adapted the PAM50 gene panel originally designed for breast cancer to predict which prostate cancer patients will benefit from the addition of hormone therapy after prostate removal surgery.
In a randomized clinical trial (NRG GU-006) of nearly 300 patients with recurrence and no signs of metastasis, tumors were tested for their PAM50 subtype and grouped as luminal B (n=127) or non-luminal B (n=168). Patients with luminal B tumors saw a significant benefit from apalutamide compared to those who received the placebo. There was no benefit for patients with non-luminal B tumors.
Together, these advances are bringing truly personalized prostate cancer care closer to everyday clinical practice.