Biomarkers Offer Promising Insights for Treating Aggressive Prostate Cancer

Recent findings from a Phase 2 clinical trial at UC Davis Comprehensive Cancer Center reveal that genetic and biomarker analysis can provide crucial clues to better understanding and managing aggressive prostate cancer. Men with high-risk prostate cancer often face significant recurrence rates despite undergoing treatment, highlighting the urgent need for more targeted approaches.

The trial focused on using niraparib, a PARP inhibitor, administered before surgery to see if it could reduce tumor recurrence by targeting specific genetic mutations. Eleven men, with a median age of 68 and elevated PSA levels at diagnosis, participated in the study. They exhibited various genetic alterations, including germline mutations in BRCA2, MSH6, CHEK2, and somatic mutations in ATM, SPOP, KMT2C, and KMT2D. These mutations play roles in DNA repair pathways, making them potential targets for personalized therapy.

While the drug did not significantly shrink tumors pre-surgery, the study demonstrated the utility of blood-based genetic monitoring, particularly circulating tumor DNA (ctDNA), in tracking tumor evolution and resistance in real time. This highlights the importance of genetic testing in tailoring treatment strategies for prostate cancer patients.

"This study underscores the complexity of prostate cancer, especially in patients with specific gene mutations," said lead researcher Marc Dall'Era. "Using ctDNA to monitor treatment response and resistance may help identify which patients will benefit most from targeted neoadjuvant therapies."

Ongoing analysis aims to better understand why some prostate cancers resist treatment and how therapies can be refined for individual patients, paving the way for more effective, personalized treatment options.

Source: https://medicalxpress.com/news/2025-06-clinical-trial-biomarkers-clue-aggressive.html