Gene signature-based screening tool for Castration Resistant Prostate Cancer

Unmet Need

Prostate cancer is the second most common type of cancer diagnosed among adult males, with the first line of treatment being androgen deprivation therapy (ADT). However, up to 20% of patients develop a resistance to ADT, and their disease progresses into Castration Resistant Prostate Cancer (CRPC), which has an average survival rate of two years if it becomes metastatic and spreads to other parts of the body. With the average cost of androgen deprivation therapy at $32,120 and treatments that can last up to three years, there is a need for a method of early detection of high-risk cancer types that are likely to develop resistance to hormone therapy so that providers can determine the best course of treatment for their patients.

Technology

Duke inventors have developed a biomarker for prostate cancers with a high-risk of developing resistance to hormone therapy. Genetic counselors and other providers could use this technology to diagnose patients more effectively and to determine their prognosis. Specifically, the inventors have determined a novel evolutionary gene signature that is present in both CRPC and in some cell clusters in primary prostate cancers that are like CRPC. Providers could use this gene signature to stratify prostate cancer patients as low-risk or high-risk for developing resistance to hormone therapy and determine the best course of treatment for patient outcomes and quality of life. The inventors have demonstrated this through in vitro studies, where they sequenced cells from both primary prostate cancers and CRPCs, identified common genes that are up regulated in CRPC, metastatic prostate cancer, and resistant cell types in primary prostate cancer, and cross referenced this with clinical samples from The Cancer Genome Atlas and Gene Expression Omnibus.

Other Applications

This technology fulfills the very specific use case of identifying CRPC, CPRC-like cells in primary prostate cancer, and metastatic prostate cancer. This gene signature could also potentially be used as the basis for a gene therapy.

Advantages

• Can specifically detect potential CRPC or high-risk primary cancers at an early stage
• Determine more effective courses of treatment for high-risk patients
• Could increase patient quality of life by preventing an unsuccessful course of ADT and lower financial burden