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New blood test can monitor steroid changes in prostate patients

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A blood test has been developed that can show when prostate cancer treatments turn bad.

It follows the discovery more than a decade ago that steroid drugs given alongside hormone therapy may promote cancer-fuelling tumour mutations.

The new test looks for cancer DNA circulating in the blood that can reveal when this starts to happen.

Scientists carried out complex genetic analysis of biopsies and blood samples from 16 men with advanced prostate cancer.

“This study provides an important first step towards working out how to use tumour DNA from blood samples as a way to monitor how prostate cancer evolves during treatment”

Nell Barrie

They confirmed that treatment with anti-inflammatory steroid drugs called glucocorticoids could favour the survival of malignant mutant cells.

In several patients, use of the drugs coincided with the emergence of “androgen receptor” mutations and progression of the cancer to more treatment-resistant forms.

Dr Gerhardt Attard, from The Institute of Cancer Research in London, said: “Our study showed that a steroid treatment given to patients with advanced prostate cancer and often initially very effective, started to activate harmful mutations and coincided with the cancer starting to grow again.

Institute of Cancer Research

Gerhardt Attard

“In the future, we hope to routinely monitor genetic mutations in patients with advanced disease using just a blood test – enabling us to stop treatments when they become disease drivers and select the next best treatment option,” he said.

“We need to confirm these findings in larger numbers of patients but using these types of blood tests could allow true personalisation of treatment for prostate cancer patients, based on the cancer mutations we detect,” he added.

The study, funded by Prostate Cancer UK and Cancer Research UK, is reported in the journal Science Translational Medicine.

Dr Matthew Hobbs, deputy director of research at Prostate Cancer UK, said: “There are currently too few treatment options for men living with advanced stage prostate cancer.

“Not only do we desperately need to find more treatments for this group of men, we also need to understand more about when those that are available stop working and why.

“This research is important as it shows that there might be a new way to monitor how a man’s cancer is changing during treatment and that could help us to pinpoint the stage at which some drugs stop being effective,” he said.

Nell Barrie, science information manager at Cancer Research UK, said: “It’s vital to understand the genetic twists and turns that offer tumour cells an escape route to become resistant to treatment.

“This study provides an important first step towards working out how to use tumour DNA from blood samples as a way to monitor how prostate cancer evolves during treatment,” she said.


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