DNA  Deficiencies in Prostate Cancer

An estimated one-fifth or more men with metastatic castration-resistant prostate cancer (mCRPC) harbor defects in genes involved in their DNA repair pathway (e.g., BRCA2, BRCA1, and others). 

Early evidence suggests these defects may be predictive of therapeutic responses to PARP inhibitors and to platinum chemotherapy.  Besides being predictive of therapeutic response there are other studies examining these alterations as general prognostic biomarkers and in association with response to currently available treatments. 

In a similar manner a smaller number of men, 5%-10% with mCRPC have evidence of defects in their DNA mismatch repair pathway, which may predict therapeutic response to immune checkpoint inhibitors. 

The loss of function of both of these critical DNA repair pathways serves as new candidate as predictive biomarkers for treatment strategies that represent net gains in the personalization of the treatment for prostate cancer. 

Additionally, more than ten percent of men with mCRPC carry some type of genetic alterations of DNA repair in their germline DNA (what they are born with or inherit from their parents). These mutations may indicate a moderate to high heritable cancer risk which has important implications for a Cancer Thriver’s family. 

PMID:  29555412

Urol Oncol. 2018 Mar 16. pii: S1078-1439(18)30070-X. doi: 10.1016/j.urolonc.2018.02.014. [Epub ahead of print]

Joel T. Nowak, MA, MSW wrote this Post.  Joel is the CEO/Executive Director of Cancer ABCs. He is a Cancer Thriver diagnosed with five primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma, and the rare cancer Appendiceal cancer.