An arranged marriage for precision medicine: hypoxia and genomic assays in localized prostate cancer radiotherapy

Bristow, R G; Berlin, A; Dal Pra, Alan (2014). An arranged marriage for precision medicine: hypoxia and genomic assays in localized prostate cancer radiotherapy. British journal of radiology, 87(1035), p. 20130753. British Institute of Radiology 10.1259/bjr.20130753

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Prostate cancer (CaP) is the most commonly diagnosed malignancy in males in the Western world with one in six males diagnosed in their lifetime. Current clinical prognostication groupings use pathologic Gleason score, pre-treatment prostatic-specific antigen and Union for International Cancer Control-TNM staging to place patients with localized CaP into low-, intermediate- and high-risk categories. These categories represent an increasing risk of biochemical failure and CaP-specific mortality rates, they also reflect the need for increasing treatment intensity and justification for increased side effects. In this article, we point out that 30-50% of patients will still fail image-guided radiotherapy or surgery despite the judicious use of clinical risk categories owing to interpatient heterogeneity in treatment response. To improve treatment individualization, better predictors of prognosis and radiotherapy treatment response are needed to triage patients to bespoke and intensified CaP treatment protocols. These should include the use of pre-treatment genomic tests based on DNA or RNA indices and/or assays that reflect cancer metabolism, such as hypoxia assays, to define patient-specific CaP progression and aggression. More importantly, it is argued that these novel prognostic assays could be even more useful if combined together to drive forward precision cancer medicine for localized CaP.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Dal Pra, Alan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0007-1285

Publisher:

British Institute of Radiology

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

16 Mar 2015 14:21

Last Modified:

12 Sep 2020 07:20

Publisher DOI:

10.1259/bjr.20130753

PubMed ID:

24588670

BORIS DOI:

10.7892/boris.64659

URI:

https://boris.unibe.ch/id/eprint/64659

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