High-risk cancers could be identified sooner after major prostate cancer study

Scientists say they have uncovered genetic “footprints” responsible for 85 per cent of prostate cancers, offering vital insights into why the disease turns fatal in some men.

Describing the findings as “hugely exciting”, experts said the discovery might eventually ensure high-risk cancers are detected sooner, enabling men to receive more personalised treatment options.

For the new study, published in the journal Nature, researchers evaluated tumour tissue samples provided by 959 men.

In total, scientists identified eight distinct genetic “footprints” that explain approximately 85% of prostate cancer cases.

Crucially, four of these “integrated mutational footprints” were associated with aggressive tumours that were more prone to spreading outside of the prostate.

Experts believe these “important new clues” regarding the biological mechanisms driving the illness could pave the way for superior screening tests and earlier identification of high-risk cancers.

“For many years we’ve known that prostate cancer is not a single disease,” said Ros Eeles, professor of oncogenetics at The Institute of Cancer Research (ICR), honorary consultant at The Royal Marsden NHS Foundation Trust, and co-founder of the PPCG.

“Two men may receive the same diagnosis but have cancers that develop and behave very differently, and we have not fully understood the biology behind those differences.

“Some of these findings are helping us understand aggressive disease, while others are revealing entirely new avenues for research.

“Most importantly, this work brings us closer to identifying distinct molecular forms of prostate cancer. Our long-term goal is to help ensure that patients receive the right treatment at the right time, based on the biology of their individual cancer rather than a one-size-fits-all approach.”

The new study, from the Pan Prostate Cancer Group (PPCG) – a global consortium which has now collected molecular data on more than 2,000 prostate cancers, also found other footprints were linked to age and ancestry, including patterns that were more common in black men.

The research team said the next step is to use the findings to develop and test classification systems for prostate cancer tumours using molecular information.

This could in turn help identify aggressive cancers sooner and help guide personalised treatment decisions, they added.

Colin Cooper, professor of cancer genetics at the University of East Anglia and co-founder of the PPCG, said: “The scale of collaboration has helped uncover important new clues about the biological processes that drive prostate cancer and why some forms are more aggressive than others.

“Taken together, these findings are helping us build a much clearer picture of why some cancers remain slow growing while others become life-threatening.

“Ultimately, we hope this knowledge will lead to better tests, earlier identification of high-risk cancers and more personalised care, so that more patients receive the right treatment at the right time.”

Lead author of the new study, Professor Joachim Weischenfeldt – from the University of Copenhagen, added: “We identified eight genetic fingerprints that explain around 85% of prostate cancers.

“Four of these fingerprints were linked to cancers that were more likely to spread, helping us understand why some prostate cancers behave more aggressively than others.

“It is remarkable how much clinical significance these genetic fingerprints appear to have. They can help distinguish between patients who are developing life-threatening cancer and those who are not.

“While further clinical studies are needed before these findings can be used in patient care, they bring us a step closer to understanding the biology that drives aggressive prostate cancer and to delivering more personalised treatment for patients.”

Dr Hayley Luxton, from the charity Prostate Cancer UK – which co-funded the study, said: “At the moment, it’s not obvious which prostate cancers are more likely to spread outside the prostate, which makes it harder for men to receive the best treatment for their individual cancer.

“These findings from the Pan Prostate Cancer Group are hugely exciting and could lead to men getting the personalised treatment they need for their prostate cancer.”