How 17 Genes Can Change a Man’s World
Yesterday’s launch of a new test that identifies a unique 17-gene signature indicative of aggressive prostate cancer opens the door to a whole new world for patients.
Sometimes we are so busy looking forward to the future that we fail to see it has arrived. Genomic Health’s introduction of a new test (Oncogene DX) can more accurately predict the aggressiveness of a man’s prostate cancer. If that doesn’t turn the heads of many newly-diagnosed patients, I’m not sure what can. It opens a new era of prostate-specific molecular diagnostics and better predictive bio-markers that will give patients and their physicians more accurate assessment data for choosing the right treatment plan.
This new test (Oncogene DX Prostate Cancer Test) will potentially give tens of thousands of men increased confidence that they can safely forgo aggressive treatment and instead enter a program of active surveillance, where their tumor is monitored over time, deferring surgery or radiation and avoiding the sexual and/or bowel and bladder dysfunction side-effects that can result from those treatments.
To arrive at the 17-gene signature, researchers began with a series of studies conducted at the Cleveland Clinic under the leadership of Dr. Eric Klein. They followed a group of men over time, analyzing the genetics of their tumors. It was through these initial analyses that a group of more than 700 candidate genes was winnowed down to the current subset of 17 used in the predictive signature test now offered by Genomic Health. It has a 95 percent accuracy rate in its ability to predict the future aggressiveness of a tumor even when traditional Gleason scoring points to low-risk prostate cancer at the time of biopsy. The signature was validated in seven separate studies involving more than 1,000 men.
Some patients who have already given their prostate or endured radiation treatment might be tempted to think its too little, to late for them. But I am encouraged that future patients will be given more reliable data about their cancer so they can select treatment plans–or decide not to treat–with greater peace of mind.
More genetic-based tests are on the horizon. Their arrival and subsequent use in the clinic will render the great PSA debate moot sooner than later. And, beyond sparing patients from the trials of unnecessary treatment, the test, which carries a list price of $3,820, may also eliminate billions of dollars in unneeded surgeries or radiation.
For us patients and our families, it’s a comforting idea and a bold new world.