Can Liquid Biopsies and Tumor Biomarkers Personalize Prostate Cancer Treatment?

Excerpt:

“Experimental, minimally invasive ‘liquid biopsy’ blood tests might soon help to personalize prostate cancer treatment by predicting androgen resistance and survival benefits from particular treatments, researchers announced at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 3–7 in Chicago.

“Liquid biopsies detect circulating tumor cells (CTCs) or bits of tumor DNA (ctDNA). Not all tumors shed cells or DNA into a patient’s bloodstreams, but most do. And when they do, they can reveal a lot about themselves—including molecular signatures that can be targeted with specific treatments.

“Recent years have seen an explosion of candidate biomarkers for prostate cancer and other malignancies, including both liquid biopsies and tumor-sample gene panels. Most candidate biomarkers have been prognostic gene-mutation signatures that can estimate patient survival regardless of what treatment strategies are attempted. These prognostic tests can be useful for risk-stratifying patients who are participating in clinical studies, or in communicating prognosis to a patient and his loved ones.”

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Prostate Surgery To Be Done With High-Intensity Ultrasound Device

“The FDA has announced a de novo clearance for a minimally invasive high-intensity focused ultrasound (HIFU) prostate tissue ablation device called Sonablate 450. This clearance marks the first time HIFU technology will be used in the United States.

“ ‘It is anticipated that ablative urological surgeons in the US will quickly master and adapt this technology for their patients,’ said Herbert Lepor, MD, professor and Martin Spatz Chairman, Department of Urology, New York University School of Medicine, in a statement. ‘HIFU offers the opportunity for the precise delivery of ablative energy to the prostate. Thus, it can be adapted to whole gland or focal gland ablation.’

“Sonablate 450 is used on patients with low-to-high-risk prostate cancer with a PSA lower than 10 ng/mL who have progressed on external beam radiation therapy. The device utilizes a fully integrated probe with dual ablation transducer and focuses ultrasound energy at a targeted location in the prostate gland called the focal point, which is heated to nearly 195 degrees Fahrenheit (90 degrees Celsius). The tissue targeted at the focal point is destroyed, but tissue surrounding the targeted area remains unharmed.”


Circulating Tumor Cells Provide Genomic Snapshot of Breast Cancer

“The genetic fingerprint of a metastatic cancer is constantly changing, which means that the therapy that may have stopped a patient’s cancer growth today, won’t necessarily work tomorrow. Although doctors can continue to biopsy the cancer during the course of the treatment and send samples for genomic analysis, not all patients can receive repeat biopsies. Taking biopsies from metastatic cancer patients is an invasive procedure that it is frequently impossible due to the lack of accessible lesions. Research published October 10th in the journal Breast Cancer Research suggest that tumor cells circulating in the blood of metastatic patients could give as accurate a genomic read-out as tumor biopsies.

“Counting the number of circulating (CTCs) can tell us whether a patient’s cancer is aggressive, or whether it is stable and responding to therapy,” says the article’s first author Sandra V. Fernandez, Ph.D., assistant professor of Medical Oncology at Thomas Jefferson University. “Our work suggests that these in the blood also accurately reflect the genetic status of the parent tumor or its metastases, potentially giving us a new and easy to source of genomic information to guide treatment.”


Robot-Assisted Prostate Cancer Surgery as Safe but More Expensive as Open Surgery in Older Men

“Minimally invasive robot-assisted surgery, which has become the main choice for surgically removing cancerous prostate glands during recent years, is as safe as open surgery for Medicare patients over age 65, a study shows. As of 2009, more than 60 percent of all radical prostatectomies in the U.S. were done robotically.”


Minimally Invasive Treatment May Slow Disease Progression of Metastatic Breast Cancer in Liver While Maintaining Quality of Life

“A minimally invasive treatment that delivers cancer-killing radiation directly to tumors shows promise in treating breast cancer that has spread to the liver when no other treatment options remain, according to research being presented at the Society of Interventional Radiology’s 39th Annual Scientific Meeting. In the largest study of its kind to date, researchers reviewed treatment outcomes of 75 women (ages 26-82) with chemotherapy-resistant breast cancer liver metastases, which were too large or too numerous to treat with other therapies. The outpatient treatment, called yttrium-90 (Y-90) radioembolization, was safe and provided disease stabilization in 98.5 percent of the women’s treated liver tumors.”