MedWire News: Patients at low and high risk for death from prostate cancer can be identified by the presence or absence of the phosphatase and tensin homolog gene (PTEN) and gene rearrangements in ERG/ETVI, researchers report.
A Reid (The Institute of Cancer Research, Male Urological Cancer Research Centre, Surrey, UK) and colleagues used fluorescence in situ hybridization (FISH) assays to detect PTEN loss and ERG/ETVI gene rearrangements in 308 conservatively managed prostate cancer patients with survival outcome data.
Multivariate analyses failed to show any link between survival and ERG/ETVI gene rearrangements alone and PTEN loss alone.
However, the largest subgroup of patients (54%), lacking both PTEN gene loss and ERG/ETVI gene rearrangements, comprised a good prognosis group, as 85.5% were alive at 11 years. Conversely, in a poor prognosis subgroup comprising 6% of patients who had PTEN gene loss in the absence of ERG/ETVI gene rearrangements, only 13.7% were alive at 11 years.
Intermediate prognostic groups were identified also – men with rearranged ERG/ETVI and normal PTEN had an 11-year survival rate of 59.8%, while men with rearranged ERG/ETVI and PTEN loss had an 11-year survival rate of 41.0%.
Reid et al comment in the British Journal of Cancer that in patients in the good prognosis group, “the prostate cancer-specific deaths… did not only occur in the patients with the higher Gleason grades, but across the Gleason grades. These results highlight some inadequacy of Gleason grading in determining which patients require more intensive therapy for their prostate cancer.”
The researchers add that among patients in the poor prognosis group, “a proportion of patients… had a Gleason score of 7 or less. These data are also potentially of clinical importance as they identify a patient group who could be targeted to receive more intensive neoadjuvant and adjuvant therapy when other clinicopathological parameters recommended a more conservative approach.”
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