Image:False-coloured, high magnification, scanning electron micrograph (SEM) of a three dimensional multi-cellular prostate tumour spheroid (cluster of cells). Credit:Izzat Suffian, David McCarthy & Khuloud T. Al-Jamal. License:CC BY 4.0

Our first news on male cancers in the past year was from a study led by scientists here at The Institute of Cancer Research. They showed that testicular cancer in families is usually caused by the accumulation of minor genetic changes that have only a small effect on their own, but together can add up to a significant risk.

The important study showed that a mixed set of common, single-letter changes to the DNA code, each of which slightly increase a mans risk of testicular cancer, plays the biggest role in causing the disease rather than lifestyle factors, or small numbers of major genetic mutations that each have a big impact on risk.

Study leaderProfessor Clare Turnbull, Team Leader inMolecular and Population Geneticsat the ICR, said:

Our study uncovers the genetic basis for familial cases of the most common type of testicular cancer, and represents an important step forward in our understanding of the disease.

In the short term, our discovery will help in counselling men who might be worried about their risk of developing testicular cancer. In the longer term, it could help inform future screening programmes for testicular cancer that might diagnose it earlier.

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In February we shared news about a new way to plan radiotherapy that could help shape treatment away from sensitive organs near tumours to reduce side-effects.

The technique was developed by physicists at the ICR and our partner hospital,The Royal Marsden, and involves using complex mathematical formulae to spare sensitive organs from radiation damage.

Study leaderProfessor Uwe Oelfke, Head of theJoint Department of Physicsat the ICR and The Royal Marsden, said:

Radiotherapy is a very effective treatment for cancer, but the damaging effect of radiation on healthy tissue can lead to challenging side-effects that can affect a patients quality of life. Treatment margins are necessary to ensure the whole tumour is targeted, but a safe reduction of these margins is key to further improving outcomes for patients.

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In April we revealed that a new panel of genes could identify men at highest risk of aggressive prostate cancer.

The study was the largest of its kind so far, both analysing all known DNA repair genes, and including a comparison with healthy men to determine the effect of gene changes on prostate cancer risk.

Our wide-ranging programme of prostate cancer research is helping men to live longer, improving their quality of life and increasing cure rates.

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In the future, the panel could be developed into a test for use in screening services so that high-risk men could be closely monitored, increasing the chance of catching the disease early.

Professor Ros Eeles, Professor ofOncogeneticsat the ICR, said:

At the moment, men can receive a diagnosis of prostate cancer without really knowing how the disease is likely to affect them, but in future a test could pick out those who are likely to develop aggressive disease and need intensive treatment.

Testing for genes linked with aggressive prostate cancer could be especially helpful for informing treatment decisions in men already diagnosed with the disease.

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During the ASCO 2019 cancer conference, we shared news about how olaparib, a pioneering gene-targeted drug already licensed for breast and ovarian cancer, can also benefit some men with prostate cancer.

The results showed the benefits of olaparib, which is from a family of drugs called PARP inhibitors, for men with prostate cancer and DNA repair defects in their tumours.

Dr Nuria Porta, Principal Statistician on the TOPARP-B trial in theClinical Trials and Statistics Unitat the ICR, said:

Our trial shows that PARP inhibitors could be effective in some men with prostate cancer potentially widening out their use beyond ovarian and breast cancer.

We also found that these drugs could be effective in men with several different DNA repair mutations, and in men with genetic faults in their tumours rather than just the smaller group of men with inherited mutations.

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At Septembers European Society for Medical Oncology (ESMO)Congress, we announced further news about olaparib.

The drug was shown to be more effective than modern targeted hormone treatments at slowing progression and improving survival in some men with advanced prostate cancer, according to the findings of a phase III clinical trial called PROfound.

Professor Johann de Bono, Regius Professor of Cancer Research at the ICR and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, who co-led the PROfound trial, said:

Our clinical trial shows that olaparib, a pill without the side-effects of chemotherapy, is able to target an Achilles heel in cancer cells. Olaparib is able to kill cancer cells with faulty DNA repair genes while sparing normal cells.

This study is a powerful demonstration of the potential of precision medicine to transform the landscape for patients with the commonest of male cancers.

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Last month a new study showed that taking a fingerprint of the mix of bacteria in the gut can indicate how susceptible individual cancer patients are to gut damage as a result of radiotherapy for prostate and gynaecological cancers.

The research is the first to explore the protective effects of the microbiome in prostate cancer patients and at preventing the late effects of radiotherapy.

Professor David Dearnaley, Professor of Uro-Oncology at the ICR and Consultant Clinical Oncologist at The Royal Marsden said:

Our study is the first to show that gut bacteria have an important influence on how susceptible patients are to gastrointestinal side effects from radiotherapy. If microbial treatments such as faecal transplants are found to reduce damage, for example, it could substantially improve patients quality of life.

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Original post:
Science Talk - Men's Health Awareness Month: 12 months of progress into male cancer research at the ICR - The Institute of Cancer Research

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