Predicting Aggressive Prostate Cancer With CtDNA Testing

Circulating tumor DNA (ctDNA) testing offers a faster, more accurate way to predict and manage aggressive prostate cancer.

Highlights:

Metastatic castration-resistant prostate cancer (mCRPC) is an advanced stage of prostate cancer
High ctDNA% identifies aggressive mCRPC
A new tool simplifies ctDNA testing, ensuring timely and accurate prostate cancer management

Metastatic castration-resistant prostate cancer (mCRPC) is lethal and causes more than 375,000 deaths every year worldwide. While new treatments have extended the survival rate, it has a poor prognosis due to resistance to hormone therapies and disease aggression ().

ctDNA: Predicting Aggressive Prostate Cancer

Prognostic classification schemes and nomograms are used clinically to estimate disease aggression, treatment selection, and patient management. However, these methods are not capable of identifying mCRPC.

Medical Management of Prostate Cancer
Prostate cancer is the second most common cancer in men after skin cancer and it is the sixth leading cause of death in men worldwide.

‘Did You Know
Prostate cancer is the second-leading cause of #cancer death in American men. #prostatecancer #cellfreeDNA #medindia’

Circulating tumor DNA (ctDNA) is released into the blood and mix with the cell-free DNA (cfDNA) released from apoptotic cells. ctDNA fraction (ctDNA%) is the proportion of tumor-derived cfDNA used as a cancer prognostic factor.

A high ctDNA% indicates a more aggressive prostate cancer. It can be used to identify how likely the tumor is to spread, resistance to treatment, therapy response, and survival expectations.

ctDNA testing is used to detect specific genetic mutations in the tumor DNA. For example, patients with mutations in their BRCA2 gene can be given a targeted treatment called PARP inhibitors. However, if the ctDNA% is too low, mutations cannot be detected and give erroneous results.

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New Tool to Make Prostate Cancer Testing Faster and Accurate

To make ctDNA testing more efficient, researchers have created a large database of prostate cancer patients and linked their ctDNA% results to their clinical details like blood tests and treatment histories. Using this information, a new predictive tool was developed that estimates a patient’s ctDNA% based on routine blood tests.

This tool helps doctors prioritize patients for ctDNA testing, those likely to have high ctDNA%, and take immediate treatment actions. For patients with low ctDNA% can undergo tumor biopsies.

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This new approach simplifies ctDNA testing, making it more practical for everyday clinical care. It can improve patient outcomes by ensuring timely and accurate testing while reducing delays in treatment.

With more ctDNA testing becoming commercially available, this tool can help make these advanced diagnostics a routine part of cancer management, potentially saving more lives.

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Reference:

Diagnosis of prostate cancer using cell-free DNA methylation profiles from expressed prostatic secretions - (https://ascopubs.org/doi/10.1200/JCO.2023.41.6_suppl.389)

Source-Medindia