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New Blood Marker may predict Prostate Cancer
spread
Newswise — Researchers report finding a new blood biomarker
that enables close to 98 percent accuracy in
predicting the spread of prostate cancer to
regional lymph nodes.
Their study is published in the March 1 issue of Clinical
Cancer Research, a journal of the
American Association for Cancer Research.
When cancer spreads beyond a solid tumor, it often does so at
a microscopic level that typically cannot be
identified by conventional imaging methods
such as CT scans.
The new blood test measures levels of endoglin, a plasma
biomarker that has been previously shown to
predict the spread of colon and breast
cancer.
In this study, researchers concluded for the first time that
endoglin could help predict whether a
patient’s prostate cancer would spread
beyond the solid tumor site into their lymph
nodes.
“For prostate cancer, we have hit the limit of our ability to
classify risk in these patients before
initial surgery.
"We currently use prostate specific antigen, Gleason grade
and a rectal exam, but the predictive value
of those three tests is inadequate for
predicting what cancers will spread.
"Conventional imaging modalities used for clinical staging in
prostate cancer are inadequate to detect
small but clinically significant lymph node
metastases.” said study author Shahrokh F.
Shariat, MD, chief urology resident at the
University of Texas Southwestern Medical
Center.
“Although it is recognized that pelvic lymphadenectomy can
provide important staging and prognostic
information, it is still not clear in whom
this procedure should be done.
"Doing pelvic lymphadenectomy on all
patients is not universally practiced, as
this procedure could be time consuming and
is not without morbidity.
"As such, it would be of tremendous benefit to have an
accurate blood marker that identifies
patients in whom pelvic lymphadenectomy
should be done,” said co-author Claus G.
Roehrborn, MD, professor and chairman of
Urology at the University of Texas
Southwestern Medical Center.
Shariat and his colleagues observed 425 patients who had
undergone surgery to remove both their
prostates and associated pelvic lymph nodes.
Researchers measured the levels of plasma endoglin using a
commercially available blood test. Higher
plasma endoglin levels were associated with
an increased risk of cancer spread to the
lymph nodes. Each 1 ng/mL increase of plasma
endoglin increased the risk for cancer
spread into the lymph nodes by 17 percent.
When researchers added endoglin levels to their usual methods
of prediction, the accuracy improved from
89.4 percent without endoglin to 97.8
percent.
Blood levels of endoglin may allow doctors to predict the
risk of cancer spread at an earlier stage
and with higher accuracy than currently
available methods.
“Despite strides in the management of prostate cancer,
approximately 25 percent to 30 percent fail
primary curative treatment such as radical
prostatectomy and radiotherapy. This is
often due to spread of cancer cells beyond
the original tumor site.
"Use of plasma endoglin could help identify patients at risk
for lymph nodes metastasis who should
undergo pelvic lymphadenectomy.
"In addition, it may spare patients at low risk of lymph node
metastasis the potential morbidity of an
unnecessary lymphadenectomy,” Shariat said.
The authors stressed that some limitations of this study
should be noted.
The retrospective study, the standard lymph node sampling,
and the small number of events support the
need for multicenter prospective studies
before the clinical use of endoglin as a
marker for predicting lymph node metastasis
in patients with clinically localized
prostate cancer.
“Ultimately endoglin will need to be combined with three of
four other markers to predict risk with
greater certainty.
"The problem with biomarkers is that there is a tremendous
variability among patients, but this moves
us forward from what we were able to do with
imaging and with our other commonly used
methods,” Shariat said.
The study was funded through a grant from the National
Institutes of Health.
The mission of the American Association for Cancer Research
is to prevent and cure cancer. Founded in
1907, AACR is the world's oldest and largest
professional organization dedicated to
advancing cancer research.
The membership includes nearly 27,000 basic, translational,
and clinical researchers; health care
professionals; and cancer survivors and
advocates in the United States and more than
70 other countries.
AACR marshals the full spectrum of expertise from the cancer
community to accelerate progress in the
prevention, diagnosis and treatment of
cancer through high-quality scientific and
educational programs. It funds innovative,
meritorious research grants. The AACR Annual
Meeting attracts more than 17,000
participants who share the latest
discoveries and developments in the field.
Special Conferences throughout the year present novel data
across a wide variety of topics in cancer
research, treatment, and patient care. AACR
publishes five major peer-reviewed journals:
Cancer Research; Clinical Cancer Research;
Molecular Cancer Therapeutics; Molecular
Cancer Research; and Cancer Epidemiology,
Biomarkers & Prevention.
Its most recent publication and its sixth major journal,
Cancer Prevention Research, is the only
journal worldwide dedicated exclusively to
cancer prevention, from preclinical research
to clinical trials.
The AACR also publishes CR, a magazine for cancer survivors,
patient advocates, their families,
physicians, and scientists. CR provides a
forum for sharing essential, evidence-based
information and perspectives on progress in
cancer research, survivorship, and advocacy.
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