A piece in today’s Sunday Times:
A simple new blood test could prolong the lives of thousands of men with prostate cancer.
The liquid biopsy — a cheaper, less invasive and less painful test than tissue biopsies — helps to identify men with prostate cancer who are less likely to respond to certain treatments, so they can switch to other therapies.
It would enable doctors to replace drugs that are unlikely to work with tailored treatment instead. Experts said this could save lives.
Researchers said the blood test can also help pick out men who are more likely to relapse.
Prostate cancer is the most common cancer in UK men, with more than 47,500 new cases diagnosed each year. Every 45 minutes someone will die from the disease in the UK, which works out at more than 11,500 deaths annually.
Details of the breakthrough will be presented today at the annual meeting of the American Society of Clinical Oncology, the world’s biggest cancer conference, which is being held online this year due to the coronavirus pandemic.
Researchers said the test will initially be used to treat prostate cancer patients involved in clinical trials before being rolled out for routine use.
Scientists at London’s Institute of Cancer Research (ICR) and Royal Marsden NHS Foundation Trust examined more than 1,000 blood samples from 216 men with advanced prostate cancer who were taking part in a clinical trial looking at the benefit of the targeted drug abiraterone, with or without an experimental drug, ipatasertib.
The new test found that men with high levels of tumour DNA at the start of treatment had a significantly worse outcome. They saw their disease progress 2½ months earlier on average.
Scientists also used the blood test to monitor patients to see if it could enable them to predict the response to therapy. Men who responded to treatment had the greatest fall in the amount of cancer DNA in the bloodstream, a 23% reduction, while those who partly responded to treatment had a reduction of 16%.
Conversely, men whose prostate cancer continued to get worse, or stayed the same, only saw a reduction of 1% or 4%, respectively.
Analysing the DNA from the tests, the researchers found specific genetic changes associated with drug resistance — which indicated whether the men were at risk of early relapse.
Johann de Bono, professor of experimental cancer medicine at the ICR and Royal Marsden, said: “Our study shows that a simple blood test could help us track how cancer evolves and responds to treatment — initially as part of clinical trials and eventually in routine care.
“These so-called liquid biopsy tests are minimally invasive, cost-effective and can be performed often and with ease.
“Tracking prostate cancer with a blood test instead of a painful surgical biopsy could significantly improve patients’ quality of life.”
Paul Workman, chief executive of the ICR, said: “These simple blood tests detect traces of cancer circulating in the bloodstream and help us anticipate cancer’s next move.
“They can help doctors come up with personalised treatment plans and stay one step ahead of the disease.
“This study showcases the value of liquid biopsies for guiding therapy. They are a faster, kinder, more flexible alternative to traditional tissue biopsies and are set to become a gold standard for cancer treatment.”
The research was funded by Roche and Genentech, the trial sponsors, as well as Cancer Research UK, Prostate Cancer UK, the Movember Foundation and the Prostate Cancer Foundation.
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