Prostate Cancer Canada and the Movember Foundation today announced $4 million for three leading Canadian researchers to predict how well prostate cancer will respond to treatment based on men’s biological markers, specifically in their tumour cells and blood.

Their work opens a path to more personalized care with fewer side effects and a better chance of survival.

Dr. Tarek Bismar from the University of Calgary, Dr. Hansen He from University Health Network and Dr. Kim Chi from BC Cancer will receive the grants to answer the question: How can we use a man’s tumour biology to offer better care at three critical points of their prostate cancer journey?

“Today, we can’t effectively identify how well men will respond to treatment. If we can understand that, we can select the best option for the prostate cancer a man has. Drs. Bismar, He and Chi will search for flags in a man’s tumour biology and genetics to help determine its severity,” says Stuart Edmonds, Vice President, Research, Health Promotion and Survivorship, Prostate Cancer Canada.

Dr. Tarek Bismar, University of Calgary

Low-risk prostate cancer: Using blood to give men peace of mind

Dr. Bismar’s team is looking at men with slow-growing prostate cancer that has not spread outside the prostate, and is less likely to advance. Using molecular flags in a man’s blood, he wants to find out whether men considering active surveillance are at risk of developing aggressive prostate cancer.
Men diagnosed at this stage are often given the option to begin active surveillance, where disease progression is followed by monitoring cancer growth.

Dr. Bismar’s findings could offer peace of mind to some men that their cancer is unlikely to progress and will allow them to undergo fewer biopsies and avoid unnecessary treatments that can have life-changing side effects, like sexual or urinary dysfunction.

On the other hand, men identified as likely to develop aggressive cancer can be more closely monitored and will know that their disease is being managed until they move to the next stage of treatment.

“This would be the initial step toward personalized medicine, and would tremendously ease concerns of patients, minimize side effects and allow for better quality of life,” says Dr. Bismar.

Dr. Hansen He, University Health Network

Intermediate-risk prostate cancer: Are aggressive or less-invasive treatments best?

Dr. He’s team is using a combination of two biological markers to determine how men with intermediate-risk prostate cancer, which has not spread and is less likely to spread outside the prostate, should be treated.

Now, doctors must decide between two types of treatments, each with its benefits and risks. Aggressive treatments like surgery present a lower risk of disease progression, but cause side effects including sexual and urinary dysfunction that affect a man’s quality of life. Active surveillance is the less-invasive option with fewer side effects, but can pose a higher risk of disease progression.

Dr. He’s findings could help direct treatment more appropriately for men who might rely on active surveillance when they need more aggressive options. Likewise, some may not have to experience life-changing side effects from aggressive treatments when they can be effectively treated using active surveillance.

Dr. Kim Chi, BC Cancer

Advanced prostate cancer: blood markers can hold predictive power

Dr. Chi’s team is using liquid biopsies, a type of blood sample, to determine which treatment will work best for men with advanced prostate cancer that has spread outside the prostate and is currently incurable.

These men are diagnosed at later stages and have multiple treatment options that may prolong life, but it is unknown which of them will work best. These men could undergo treatments with no benefit, with side effects, while their cancer continues to grow.

“Predictive markers help us decide what treatments to use and when – a requirement to do ‘personalized’ or ‘precision’ medicine,” says Dr. Chi. “At this time, we don’t have any markers that have been proven to be useful for advanced prostate cancer, so this research is important.”

Dr. Chi’s findings could help predict how a man will respond to treatment before they start, eliminating “trial by error” treatments and increasing survival rates.

“This research is exciting because we will be using a blood-based test to identify alterations (mutations and other genetic changes) in prostate cancer genes and use this to decide treatments for each patient,” Dr. Chi adds. “We will also gain insight into the genetic makeup of advanced prostate cancer, which helps us understand how it progresses.”