Navigation Links
Study affirms value of epigenetic test for markers of prostate cancer

A multicenter team of researchers report that a commercial test designed to rule out the presence of genetic biomarkers of prostate cancer may be accurate enough to exclude the need for repeat prostate biopsies in many if not most men.

"Often, one biopsy is not enough to definitively rule out prostate cancer," says study researcher Jonathan Epstein, M.D., director of the Division of Surgical Pathology and a professor of pathology, urology and oncology at the Johns Hopkins University School of Medicine. "Our research finds that by looking for the presence or absence of cancer in a different way, we may be able to offer many men peace of mind without putting them through the pain, bleeding and risk of infection that can come with a repeat biopsy."

The new research, called the Detection of Cancer Using Methylated Events in Negative Tissue (DOCUMENT) study, suggests that an initial biopsy complemented with an epigenetic diagnostic test accurately rules out the existence of cancer up to 88 percent of the time. The test, developed by MDxHealth, which paid for the study, was described online in April in The Journal of Urology.

The test specifically captures the presence of chemical modifications to non-nuclear DNA sequences within cells that commonly appear when prostate cancer is present. These so-called epigenetic changes, which add a methyl group to the biochemical makeup of the DNA, alter the way genes function without changing their foundational DNA sequence. The researchers analyzed tissue from biopsies from 320 men with elevated prostate-specific antigen (PSA) levels whose results were negative for prostate cancer. The men were patients at The Johns Hopkins Hospital; the University of California, Los Angeles; the Cleveland Clinic; Eastern Virginia Medical School; and Lahey Hospital & Medical Center.

The epigenetic biomarkers the test detects reflect a process called DNA hypermethylation, in which a methyl group is chemically attached to DNA in this case, to genes called GSTP1, APC and RASSF1. These genes are known to play prominent tumor suppressive roles in key cancer-related pathways. When these genes are hypermethylated, they are commonly silenced, which can lead to a loss of this tumor-suppressing function and the emergence of cancer.

Specifically, the GSTP1 gene acts as a detoxifying agent, preventing genomic damage by carcinogens. Studies find that GSTP1 is methylated in up to 90 percent of prostate cancer cases, making it a strong indicator of the disease.

For the study, pathologists compared methylation levels between the subjects' initial tissue biopsies and later tissue samples taken from each man done within 24 months of the first biopsy. They found that average levels of APC and RASSF1 were about twice as high in the 92 subjects whose second biopsies yielded positive results, as compared to the 228 with two negative biopsies. For GSTP1, the levels were more than eight times higher in the cancerous biopsies.

"It turns out as many as 20 percent of men have prostate cancer, even if their first biopsy results are negative," says Epstein, the Rose-Lee and Keith Reinhard Professor of Urologic Pathology. Approximately 40 percent of men with a negative biopsy go on to receive a second biopsy. Many high-risk men fear sampling errors in their initial biopsy, which often leads to a high rate of follow-up procedures to merely confirm the absence of the disease.

Initial biopsies are typically performed when men receive abnormal results on PSA screenings or digital rectal exams. But an initial biopsy can sometimes miss cancer if none of the biopsy needles pass through the cancer, leading to the false-negative results.

"With prostate biopsies, there is often very little cancer, which makes it difficult to perform molecular prognostic and predictive tests," says Epstein. "The DOCUMENT study overcomes this problem, because it looks at benign tissue, not just the cancer. There is a lot of benign tissue, which is why we think it performs so well."

"Overall, if there is an absence of methylation in all three biomarkers, there is an 88 percent likelihood you don't have cancer," Epstein says. "The test isn't 100 percent of an assurance, but it is a major step forward."

Contact: Stephanie Desmon
Johns Hopkins Medicine

Related medicine news :

1. Technology marketers should take consumer life-cycle into account: New Rotman study
2. Study identifies risk of chemotherapy related hospitalization for eary-stage breast cancer patients
3. Vanderbilt study finds women referred for bladder cancer less often than men
4. New University of Colorado study illuminates how cancer-killing gene may actually work
5. Just look, but dont touch: EMA terms of use for clinical study data are impracticable
6. Study: Some pancreatic cancer treatments may be going after the wrong targets
7. Study shows image fusion-guided biopsy improves accuracy of prostate cancer diagnosis
8. Gambling history is common among homeless people in Toronto, new study
9. More maternal mental health surveillance is needed, suggests new study
10. New study on mobile phones and childrens cognitive development
11. Scientists seek answers with space station thyroid cancer study
Post Your Comments:
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, ... the latter, setting the bar too high can result in disappointment, perhaps even self-loathing. ... toward their goal. , Research from reveals that behind the ...
(Date:6/24/2016)... ... ... Those who have experienced traumatic events may suffer from a complex set of ... or alcohol abuse, as a coping mechanism. To avoid this pain and suffering, Serenity ... event. , Trauma sufferers tend to feel a range of emotions, from depression, guilt, ...
(Date:6/24/2016)... ... ... a crisis. Her son James, eight, was out of control. Prone to extreme mood shifts ... upset him, he couldn’t control his emotions,” remembers Marcy. “If there was a knife ... and say he was going to kill them. If we were driving on the ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... Global law ... magazine’s 2016 Legal Elite. The attorneys chosen by their peers for this recognition are ... , Seven Greenberg Traurig Shareholders received special honors as members of this year’s Legal ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, CA is ... Road To Recovery® program to drive cancer patients to and from their cancer treatments. ... the highest quality of life and ongoing independence. Getting to and from medical ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Calif. , June 24, 2016  American Respiratory Labs (ARL), ... is now able to perform sophisticated lung assessments in patients, homes, ... , Inc. Patients are no longer limited to ... EasyOne PRO ® , ARL patients like Jeanne R. of ... in the comfort of her own home. ...
(Date:6/24/2016)... 2016 According to a new ... Pen Needles, Safety Pen Needles), Needle Length (4mm, 5mm, ... Mode of Purchase (Retail, Non-Retail) - Trends & Global ... the market for the forecast period of 2016 to ... Billion by 2021 from USD 1.65 Billion in 2016, ...
(Date:6/24/2016)... NAMUR , Belgium , ...  (NYSE MKT: VNRX), today announced the appointment of ... Board of Directors as a Non-Executive Director, effective ... the Company,s Audit, Compensation and Nominations and Governance ... Board, Dr. Futcher will provide independent expertise and ...
Breaking Medicine Technology: