Specific Gene Expression Predicts Risk for Prostate Cancer

Posted on March 8th, 2009 by

Specific Gene Expression Predicts Risk for Prostate Cancer

Expression of the PTOV1 gene helps predict the likelihood of the development of prostate cancer among men with high-grade prostatic intraepithelial neoplasia (HG-PIN). These results were recently published in the journal Clinical Cancer Research.

HG-PIN refers to a condition in which cells in the prostate appear abnormal under a microscope but are not cancerous. Men with HG-PIN are considered to be at a higher risk of ultimately developing prostate cancer and are screened more stringently for the disease than men not considered to be at a high risk. However, for the significant portion of patients with HG-PIN who never develop prostate cancer, stringent monitoring and prostate biopsies may be unnecessary (biopsies are associated with anxiety, pain, risk for infection, time for the procedure, and increased medical costs). The identification of patients with HG-PIN who may or may not be at a high risk for developing prostate cancer can help decrease unnecessary biopsies while maintaining optimal screening for those who are at high risk.

As the field of genetic testing is gaining momentum in oncology, researchers continue to explore associations between the expression of specific genes and related outcomes; this research is aimed at individualizing therapeutic approaches according to a patient’s genes. Researchers from Spain recently conducted a clinical trial to evaluate the potential relationship between expression of the PTOV1 (prostate tumor overexpressed-1) gene and the risk of developing prostate cancer among men with HG-PIN.

This trial included 140 patients with HG-PIN; 79 of these patients had been diagnosed with prostate cancer (positive control), and 11 patients had been diagnosed with bladder cancer but not prostate cancer (negative control). All patients underwent a prostate biopsy. Expression levels of PTOV1 were measured and compared among the groups. Patients were followed for an average of more than one year with approximately 2.5 subsequent biopsies during that time.

  • PTOV1 expression was significantly higher among patients with HG-PIN that eventually developed into prostate cancer compared with those whose HG-PIN never developed into prostate cancer.
  • PTOV1 levels were the only single marker upon analysis of several variables that could predict progression to prostate cancer among men with HG-PIN at initiation of the trial.

The researchers concluded that PTOV1 levels may help predict which patients with HG-PIN are at greatest risk for developing prostate cancer. It is suggested that patients at high risk undergo immediate screening biopsies for prostate cancer. Further study evaluating HG-PIN is warranted so that optimal screening measures may be implemented for patients with HG-PIN.

Reference: Morote J, Fernandez S, Alana L, et al. PTOV1 expression predicts prostate cancer in men with isolated high-grade prostatic intraepithelial neoplasia in needle biopsy. Clinical Cancer Research. 2008; 14: 2617-2622.

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