A prostate-specific antigen (PSA) genetic variant discovery by QUT scientists could help to improve current diagnostic tests to distinguish which prostate cancers are aggressive and require stronger treatment, and which may not.
Despite being the first author of the QUT-led, multinational study published in Nature Communications, Dr. Srilakshmi Srinivasan from Brisbane’s Translational Research Institute and QUT’s School of Biomedical Sciences said the researchers observed the function of a particular prostate cancer genetic variation or SNP.
However, in ‘comprehensive lab and mice tests,’ we found that this SNP was associated with a lower prostate cancer risk, but also with a higher risk of an aggressive type of this cancer, Dr. Srinivasan said. “Lower serum PSA levels in carriers of this SNP are also thought to demonstrate a contribution towards the bias in detection during PSA screening, leading to delayed diagnosis and treatment.” The findings provided some clue, said Dr. Srinivasan, into anomalies that are currently detected and treated in the second most common kind of cancer in men worldwide.
“It’s just been used to base the PSA test as a basis of the non-invasive diagnostic, prognostic prostate cancer test and it’s saved lives,” she said. “PSA test cannot distinguish between aggressive and non-aggressive types of cancer, so high PSA in the blood may indicate overdiagnosis and overtreatment in some cases,” said Dave Cann. “This counts as a painful procedure like biopsies which cause men to have a poorer quality of life, eventually they end up spending more money and time on health systems.”
The PSA test can’t tell which cancers will be aggressive and which will be slow-growing, so tumors with low levels of PSA in the blood are often missed by early screening and the result is a highly aggressive disease with high mortality. With the information gleaned from the research, scientists in Professor Jyotsna Batra’s team are now using it to develop tools that could be used by GPs to identify high-risk patients despite low blood PSA levels, based on the knowledge that men with genetic variations in the gene which codes for PSA are predisposed to such aggressive prostate cancer.
Professor Batra said that ‘findings from this study could be useful for the development of a novel and simple point-of-care (POC) device.’ “Our goal is to develop the diagnostic assessments or algorithms needed to respond to individual patient characteristics because treatment has been too broadly applied, and it is an important step forward in an era of personalized treatment.”
“We might be able to predict better prognosis and identify a high-risk group that needs early treatment,” said QUT Distinguished Professor Emeritus Judith Clements, who, together with research co-leader Dr Sofia Kotsimbastis from QUT Medical Research collaborated on the research.
Reference: Srinivasan S, Kryza T, Bock N, et al. A PSA SNP associates with cellular function and clinical outcome in men with prostate cancer. Nat Commun. 2024;15(1):9587. doi:10.1038/s41467-024-52472-6
