Researchers Find Known Biomarker Indicates Potential Death from Prostate Cancer
Biomarker helps distinguish agressive from indolent disease potentially sparing men from unnecessary treatment
Boston, MA – Researchers and physicians, in an effort to better treat prostate cancer, continue to look for new screening methods with an emphasis on discovering biomarkers that can determine the aggressiveness of the disease. Researchers from Brigham and Women’s Hospital (BWH), along with colleagues from Dana-Farber Cancer Institute and Sweden’s Orebro University Hospital and Karolinksa Institute, in a promising first step, have discovered that a known biomarker can measure prostate cancer progression. Specifically, lower incidences of the biomarker AMACR are associated with worse prostate cancer outcomes. Researchers believe that measuring AMACR at time of diagnosis could help determine aggressiveness of the disease and subsequently help direct treatment plans. Details of this research are published in the June 2005 issue of Cancer Epidemiology, Biomarkers & Prevention.
Prostate cancer is the second most common cancer in men and the cause of approximately 29,000 deaths a year. Currently, PSA testing – a simple blood test performed during a routine visit with a primary care physician – indicates presence of the disease, but there is little else available to physicians to help determine its aggressiveness. Subsequently, when prostate cancer is detected, physicians are often unable to determine if the disease is clinically significant. Without this knowledge, they often need to initiate treatment regimens that include radical prostatectomy resulting in side effects such as impotence and incontinence.
According to lead author, Mark A. Rubin, MD, BWH’s chief of Urologic Pathology and an associate professor at Harvard Medical School, this collaborative research effort represents the first step in what will ultimately be the discovery of a series of biomarkers to help clinicians address prostate cancer. “This study shows for the first time AMACR is associated with prostate cancer aggression. With this information, we hope to eventually develop an easy serum blood test, similar to PSA that will allow us to check for the presence and amount of the biomarker to help direct treatment. Clinicians will one day be able to more accurately diagnose the disease, reducing unneeded treatments or better identifying the men that will die from the disease if not aggressively treated.”
For more than a decade, researchers tracked 204 men treated with radical prostatectomy and 188 men prescribed watchful waiting, measuring amounts of alpha-methylacyl-CoA racemase (AMACR) – a protein present in men with prostate cancer. After analyzing tissue samples from these men, researchers found that lower AMACR tissue expression was associated with worse prostate cancer outcome. Among men with both low AMACR and high Gleason score, the risk of prostate cancer death was 18-fold higher than men without these risk factors. In addition, men with the lowest levels of AMACR expression were more than twice as likely to experience PSA recurrence – and subsequent disease recurrence – compared to those with higher levels. Based on this information, researchers believe that a one-time AMACR assessment at diagnosis could help identify the aggressiveness of the disease and if aggressive therapy is necessary.
The researchers also emphasized that this study helped identify the first biomarker that assesses cancer aggressiveness using death as an endpoint. This is important in that it demonstrates biomarkers can be used to predict death from a disease.
“BWH and our colleagues around the world hope to work with these cohorts for longer periods of time to learn more about how to identify disease progression,” Rubin said. “While prostate cancer identification and treatment have greatly advanced, we still need to learn more about this disease to preserve quality of life and save lives.”
Please contact BWH Media Relations for more information at (617) 534-1600 or BWHMediaRelations@partners.org.
BWH is a 747-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare System, an integrated health care delivery network. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832 and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives, dedication to educating and training health care professionals, and strength in biomedical research. With $370M in funding and more than 500 research scientists, BWH is an acclaimed leader in clinical, basic and epidemiological investigation - including the landmark Nurses Health Study, Physicians Health Studies, and the Women's Health Initiative. For more information visit www.brighamandwomens.org
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