“How far off is a genomic test for prostate cancer and how will it change my treatment options?” Recently, a Breakthrough reader asked us: ASK GARVAN
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This answer comes from Professor Vanessa Hayes, Head of Garvan’s Human Comparative and Prostate Cancer Genomics Laboratory.
A diagnosis of prostate cancer can be very distressing for men and their families. The good news is that the chance of surviving for five years is 95%. Garvan is leading the charge to completely overhaul testing for prostate cancer. We are developing the next generation of DNA‑based testing, which will provide accurate diagnosis and have an enormous impact on treatment plans for men in Australia. The current early testing method (prostate-specific antigen) commonly leads to the diagnosis of some cancers that might never have caused symptoms. This can have overall detrimental effects on life span and quality of life through unnecessary treatment. One of the biggest clinical challenges is distinguishing which cancers are going to spread and become life- threatening, and which patients could be spared harsh treatment they might not need. To have any hope of targeting treatment in this way, we first need to understand the genetic drivers of each individual tumour. From previous studies, we know that prostate cancer has only small genetic changes and is more likely driven by large complex rearrangements of DNA. This is different to most cancers, which are driven by small DNA mutations in a number of key genes. Previously, we had no way of observing these DNA rearrangements or structural variants in prostate cancer. Last year, we completed a world first in comprehensive next‑generation mapping of an entire prostate cancer genome and this uncovered 10 times more large-scale DNA rearrangements than have previously been detected in prostate cancer. We know that next-generation DNA-based research can provide insights into prostate cancer and enable accurate diagnosis and treatments specific to the individual. We are working toward this goal of making a genomic test the ‘norm’ for those affected by this cancer, and when it is available it will drive world-best treatments.
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