What tumor markers have you seen in clinical trials for prostate cancer? Dr. Anton Titov, MD. Which prostate cancer tumor might indicate that local prostate cancer will become metastatic cancer? Dr. Anton Titov, MD. Tumor markers for prostate cancer might show that caner is likely to spread slower or faster. Perhaps other prostate cancer markers can indicate that the cancer will stay dormant. Dr. Jack Cuzick, PhD. Our biggest research was a clinical trial of over 3,000 men. This was not a clinical trial. It was a clinical trial of men with localized prostate cancer. They were treated by active surveillance. They were not given radical treatment of prostate cancer initially. These patients were treated for prostate cancer more than 10 years ago in the UK. So we have gone back and collected all of the original biopsy specimens for these men. I have done a whole range of tumor biomarker research on these biopsy specimens. We are able to confirm that Ki-67 is an important molecular marker for prostate cancer. Ki-67 tumor marker indicates higher risk of aggressive prostate cancer. But Ki-67 tumor marker was very much overwhelmed and essentially replaced by an gene expression profile tumor marker. This new gene expression tumor marker was developed by Myriad Genetics. Dr. Jack Cuzick, PhD. This tumor marker of prostate cancer is called “Prolaris". This is a mixture of 31 genes that participate in cell cycle progression. This tumor marker seems to be more predictive of subsequent death from prostate cancer. It predicts death from prostate cancer better than anything we have actually found so far. It is a stronger prediction marker than Gleason grade. Prolaris gene expression tumor marker is stronger that the histological features of prostate cancer. It is more predictive of prostate cancer progression than PSA levels. “Prolaris” marker is a big step forward in prostate cancer prognosis prediction. Because there are many men, particularly in the United States, that are being treated by radical prostate cancer treatment. You could do a Prolaris diagnostic test. You could then find that patients had a low level of cancer progression risk. They would be more than happy to learn about better prognosis of prostate cancer. Their prostate cancer can be treated more conservatively. Dr. Jack Cuzick, PhD. Active surveillance could be a prostate cancer therapy option in these patients. Again, this genetic diagnostic test for prostate cancer underscores how important is the individual approach to every patient with cancer. It is important to do a molecular profile of the tumor. Patient should know a gene expression patterns of their tumor. You have to ensure that unnecessary cancer treatment does not happen. Dr. Anton Titov, MD. There are many side effects associated with the aggressive treatment of prostate cancer. Absolutely true! The mortality rate in prostate cancer is about 20%. So only one in five patients diagnosed with prostate cancer will die from it. Yet the vast majority of patients with prostate cancer get radical treatment. So there is much scope for reducing treatment in prostate cancer.
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