Munich, Germany (UroToday.com) Dr. Schlomm highlighted the importance of predicting when prostate cancers become aggressive. Currently, prostate cancer is thought to originate from heterogeneous tumors. Every tumor become aggressive with time and risk of metastatic disease increases with tumor size and age. He poses that molecular features may determine the speed of transition from local to locally advanced to metastatic disease.
If caught early, even up to 20% of patients with high-risk molecular features (PTEN deletion and p53 alteration) may completely cured after localized therapy. The question is how we can predict the speed at which these tumors can potentially grow so that we can treat them early.
Increasing genetic unstability causes advancement from local to advanced disease. Dr. Schlomm defines “molecular age” which can define aggressive phenotype of prostate cancer. Molecular age is defined as Tumor Volume divided by mutation/deletion load. Mutation/deletion loads are the sum of single nucleotide variants (SNV) plus any insertions/deletions of genes.
However, what defines the “tumor speed” is not the molecular age but the accelerator genes such as P53 genes. Dr. Schlomm provides a formula for speed as: Speed (S) = (Molecular age x (Quantitity Acceletor Genes)^(Quality Accelerator Genes). Speed increases depending the type of genes. The greatest speed is with combination PTEN/P53 genes and lowest is by ERG negative.
Dr. Schlomm summarizes that every tumor will become aggressive with time. Risk of metastatic disease increases with tumor size and molecular age. Molecular features such as accelerator genes determine the speed of transition. His hope is to create a molecular speedometer for each patient in order to precisely predict individual patient prognosis.
Presented By:
T. Schlomm, Hamburg (DE)
Reported By:
Mohammed Haseebuddin, MD, at the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany
Fox Chase Cancer Center