Translational research

Prostate cancer

Prostate cancer is the second most common cancer in men, with 1 in 6 diagnosed in their lifetime. This equates to approximately 1.46 million men diagnosed globally each year, with a further 5 million living with the disease.

Many developed nations offer population-based screening for men. For example, in the United Kingdom the NHS states that all men over the age of 50 can be offered, or ask, for prostate screening using a blood-based prostate specific antigen (PSA) test. Abnormalities in PSA levels can indicate complications in prostate function, including cancer.

However the PSA assay is known to have poor sensitivity and specificity, between 9% – 33% %, and 91%, respectively. See: Prostate-Specific Antigen – StatPearls – NCBI Bookshelf . The NHS estimates that 3 in 4 men who have a raised PSA will not actually have cancer and that 15% of cancer can be missed with PSA testing alone. As a result, many men may undergo a prostate biopsy unnecessarily. See: What is the most accurate test for prostate cancer? | The Royal Marsden ANGLE’s circulating tumour cell (CTC) based liquid biopsy could potentially offer a unique opportunity to triage men with elevated PSA, avoiding the need for invasive core tissue biopsy for the majority of patients with benign or indolent disease.

Key statistics

2nd

most common cancer in men

1 in 6

men diagnosed in their lifetime*

1.46 million

men diagnosed globally each year

9-33%

sensitivity with current screening tests

5 million

men living with prostate cancer

Professor Yong-Jie Lu - Professor of Molecular Oncology

The Parsortix®system has shown the potential to detect more severe cancer cases, where the patient is likely to die, sooner thereby providing information which may enable clinicians to provide different treatment for their patients, potentially extending the lives of those battling with cancer.”

Dr Yong-Jie Lu

Professor in Molecular Oncology at Barts Cancer Institute

In May 2022, ANGLE formalised a partnership with a major specialist clinical service provider, MidLantic Urology, to initiate ANGLE’s first clinical study in prostate cancer.

The purpose of the study is to evaluate whether ANGLE’s novel liquid biopsy assay, in combination with current standard of care (PSA levels, patient history and physical examination), can reduce the over-detection of indolent prostate cancer whilst identifying aggressive disease. This could improve patient stratification, reducing unnecessary patient harm and hospitalisation from tissue biopsy complications, as well as avoiding over-diagnosis and treatment.

The study, known as ‘DOMINO’, is based on highly successful pilot studies conducted independently by Barts Cancer Institute (Queen Mary University London).

DOMINO has now completed the initial enrolment of 100 men with either an elevated blood PSA or an abnormal rectal exam, who are scheduled to undergo a prostate tissue biopsy. The blood tubes drawn from each patient have been processed using the Parsortix system and the cell harvest stored for future molecular analysis.

In addition to ANGLE sponsored studies there are currently 16 peer-reviewed publications which use the Parsortix technology in prostate cancer from six independent study centres in five countries. Recent highlights from these include:

A study published by the Comprehensive Cancer Center at the Medical University of Vienna used the Parsortix® system to isolate and harvest CTCs from 38 localised and metastatic prostate cancer patients. CTCs were then analysed using a range of molecular techniques which enabled multiple biomarkers to be simultaneously analysed. The study demonstrated the highly effective capture of CTCs using the Parsortix system, with 67% of localised prostate cancer patients positive for CTC biomarker(s) at baseline and 77% positive for CTC biomarker(s) after treatment. The findings indicated a strong correlation between specific CTC biomarkers and clinical parameters, such as tumour grade and stage, suggesting that multi-marker CTC analysis could aid in risk stratification for patients. See: Multi-marker analysis of circulating tumor cells in localized intermediate/high-risk and metastatic prostate cancer – PubMed

Radboud University Medical Center, Nijmegen, The Netherlands, recently published a study into 40 castration resistant metastatic prostate cancer patients in the International Journal of Molecular Sciences. The authors reported that transcriptomic profiling of Parsortix enriched CTCs stratified patient survival, therapy response and highlighted potential novel biomarkers for assay development. See: Transcriptome Profiling of Circulating Tumor Cells to Predict Clinical Outcomes in Metastatic Castration-Resistant Prostate Cancer – PubMed

Barts Cancer Institute published research in the journal Frontiers in Oncology demonstrating that combining CTC counts with prostate specific antigen and alkaline phosphatase levels enabled more accurate prediction of radiological/RECIST response to docetaxel treatment than either serum PSA or serum ALP alone of castration-resistant prostate cancer patients. See: The potential of using circulating tumour cells and their gene expression to predict docetaxel response in metastatic prostate cancer – PubMed

For Research Use Only. Not For Use in Diagnostic Procedures.

*Based on UK data

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