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Test Predicts Metastatic Potential of Prostate Cancer

Prostate cancer cells.

The ability to know whether prostate cancer will stay local or spread to the bone or distant organs is crucial in regard to deciding which treatment to pursue: conservative management or more aggressive therapy. Copy number alterations (CNAs)—mutations that delete or repeat large sections of DNA—are the key to determining cancer prognosis. Investigators have invented new, cost-effective technology, called the Next-Generation Copy Number Alteration, to detect CNAs and potentially aid in prostate cancer treatment selection.

According to lead investigator Harry Ostrer, MD, of the Department of Pathology, Albert Einstein College of Medicine, "We have demonstrated that CNAs can be detected rapidly and accurately with the new Next-Generation Copy Number Alteration (NG-CNA) assay. The impact of this information is two-fold: to assure aggressive therapy at the time of diagnosis for men with metastasis-prone disease and provide a rationale for active surveillance (and not overtreatment) for men with indolent disease."

The study findings were published in The Journal of Molecular Diagnostics. Using NG-CNA, scientists are able to examine 902 genomic sites spanning across 194 genomic areas. This technology not only processes samples faster, but also costs less than other CNA-detecting assays. "For example, with NG-CNA the cost of DNA extraction, library preparation, and sequencing reagents can be $20 to $40 per sample, compared to nearly $1,000 for whole genome sequencing," explained Dr. Ostrer.

The first author of the study, Viacheslav Fofanov, PhD, of the School of Informatics, Computing, and Cyber Systems at Northern Arizona University, added, "Massively multiplexed assays, like the NG-CNA assay, provide an entry into personalized medicine applications at a fraction of the cost of traditional whole genome sequencing approaches."

In addition, the results of the NG-CNA assay are easier to decipher than whole genome sequencing. Hundreds to thousands of samples are able to be processed in 36 hours, and these samples need less data storage than whole genome sequencing. "This allows our approach to move from large reference laboratories to smaller, more resource-constrained independent laboratories as needed," noted Dr. Ostrer.

Even cell lines, surgical samples, and biopsies are able to be analyzed using the NG-CNA. The data from the NG-CNA is used to compute the metastatic potential score (MPS) of the sample. Metastatic potential score has been linked to predicting prostate cancer, triple-negative breast cancer, and lung adenocarcinoma metastases.

"We believe the addition of the NG-CNA assay onto a standard cancer gene testing platform will augment personalized medicine by identifying aggressive tumors and genetic mutations that are predictors of response to targeted therapies," claimed Dr. Ostrer.

For More Information

Fofanov VY, Upadhyay K, Pearlman A, et al (2018). Rapid next-generation sequencing method for prediction of prostate cancer risks. J Mol Diagn, 21:49-57. DOI:10.1016/j.jmoldx.2018.07.007 

Image courtesy of Griersonj5

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