What is it about?

We have discovered why some prostate cancers are more aggressive, spread to different parts of the body, and ultimately cause death. Recently we developed a test to distinguish aggressive prostate cancers from less threatening forms of the disease, by applying some complex maths known as Latent Process Decomposition, that will help avoid sometimes-damaging unnecessary treatment. This aggressive form of prostate cancer is known as DESNT - which has the worst clinical outcomes for patients. In this study we carry on this work and studied gene expression levels in 1,785 prostate cancer tumour samples. We show how the number of ‘aggressive’ cells in a tumour sample defines how quickly the disease will progress and spread. The more DESNT cells, the quicker the patient is likely to progress. We also revealed three new subtypes of prostate cancer that could be used to stratify patients for different treatments.

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Why is it important?

Prostate cancer is the most common cancer in men in the UK. It usually develops slowly and the majority of cancers will not require treatment in a man’s lifetime. However, doctors struggle to predict which tumours will become aggressive, making it hard to decide on treatment for many men. This means that many thousands of men are treated unnecessarily, increasing the risk of damaging side effects, including impotence from surgery. By determining these subtypes we have a much better chance of correctly assigning patient to the best treatment.


If you have a tumour that is majority DESNT you are more likely to get metastatic disease, in other words it is more likely to spread to other parts of your body. This is a much better indication of aggressive disease. We also identified three more molecular subtypes of prostate cancer that could help doctors decide on different treatment options for patients. This research highlights the importance of using more complex approaches for the analysis of genomic data

Professor Daniel S. Brewer
University of East Anglia

Read the Original

This page is a summary of: A novel stratification framework for predicting outcome in patients with prostate cancer, British Journal of Cancer, March 2020, Springer Science + Business Media,
DOI: 10.1038/s41416-020-0799-5.
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