Progress and Promise in Prostate Cancer Research

In prostate cancer – the most common cancer in men aside from skin cancer – scientists are working to answer some of the most basic questions about the disease while developing an array of new treatments.

Using the prostate-specific antigen (PSA) blood test, doctors are often able to detect prostate cancer at an early stage. But it remains difficult to determine which prostate cancers are likely to spread – and therefore require aggressive treatment – and which are either idle or slow-growing, and can be dealt with by “observation or active surveillance.” This uncertainty could result in unnecessary treatment for some patients.

A recent study led by Julia Hayes, MD, a medical oncologist in the Lank Center for Genitourinary Oncology at Dana-Farber, found that observation is a reasonable alternative to initial treatment for the estimated 70 percent of men whose prostate cancer is classified as low-risk at diagnosis. Other recent findings include:

• Dana-Farber scientists have found that patients with advanced prostate cancer live longer if they are initially treated with a hormone-blocking drug and chemotherapy agent at the same time.

• Using a technique known as whole-genome sequencing, Dana-Farber and other scientists have mapped the full genetic blueprint of multiple prostate tumors. The technique enabled them to identify several new genes and a category of genomic changes that are important drivers of prostate cancer growth.

Research continues along along multiple tracks including a number of clinical trials testing drugs that target abnormal genes in prostate cancer. Some examples:

Investigators are working to identify additional biomarkers – substances in blood, urine, or other tissues – that can be used to diagnose prostate cancer and to better predict the course of the disease.

• In 2010, Provenge^®, a vaccine that prompts the immune system to attack cancer cells, received approval from the Food and Drug Administration for men with advanced prostate cancer. Today, scientists are working on other immune system-based strategies for prostate cancer treatment.

• Researchers at the Dana-Farber/Harvard Cancer Center (DF/HCC) are probing the biological reasons why prostate cancer in obese men often has a worse prognosis than in other men. The research may result in better treatments for men at risk for more aggressive forms of the disease.

• Because prostate cancer growth is often driven by the male hormone androgen, treatment with androgen-blocking drugs is frequently prescribed. DF/HCC investigators are working to identify genes that cause some prostate tumors to resist such drugs.

• African American men and Jamaican men of African descent have the highest prostate cancer rates in the world. At the National Institutes of Health, researchers are studying genetic and other factors that may contribute to these elevated rates.

A “Dream Team” of prostate cancer researchers funded by the Prostate Cancer Foundation and the American Association for Cancer Research Stand Up to Cancer Program are studying prostate cancer cells for genetic abnormalities that can indicate which patients are likely to respond to certain drug agents.