A six-gene signature has been identified that can be used in a test to predict survival in men with aggressive prostate cancer. This study is the first to demonstrate how prognostic markers may be useful in a clinical setting.

Blood from 202 men with treatment-resistant prostate cancer was used to find six genes that are characteristic of treatment-resistant prostate cancer. When the six-gene signature is present, the men were high-risk and had a survival time of 7.8 months. When it was absent, the men were low-risk and had a survival time of more than 34.9 months.

Previously, prognosis in advanced prostate cancer could only be determined through clinical predictors, or, occasionally, tumor biopsies with only moderately predictive results. This six-gene model was efficacious in determining length of survival in this study.

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“There is an urgent need for predictive models that help assess how aggressive the disease is in prostate cancer patients, as survival can vary greatly,” said William K. Oh, MD, chief of the Division of Hematology and Medical Oncology at The Mount Sinai Medical Center, who led the research team. “Our six-gene model, delivered in a simple blood test, will allow clinicians to better determine the course of action for their patients, determine clinical trial eligibility, and lead to more targeted studies in late-stage disease.”

Oh explained, “The genes noted in the model suggest possible changes in the immune system related to late-stage disease that warrant further study as a target for immune-based therapies.” His research team is conducting additional studies to determine the feasibility of the six-gene signature in other types of prostate cancer. They are also studying how stable the signature is during the course of a patient’s illness and how predictive the signature is in patients whose prostate cancer is treated with immune-based therapies.

This research was published in The Lancet Oncology (2012; doi:10.1016/S1470-2045(12)70263-2).