Whole-Blood RNA

[Henry Campbell]

Now this sounds interesting ---- I think ??     Is it a bit too accurate ?    

The low end of 7.8 months would have you calling Hospice or jumping off a bridge.  If nothing else it would put you into a deep depression  - me thinks.   

It reminds me of a statement a doctor made to my wife about getting a knee replacement." When the pain you have now, gets unbearable it will be the time" I suspect it will be that way with me and prostate cancer.  So far no pain so I'm not going to think about an end point.  

I suspect in most cases a persons knows when the fight is over and welcomes the end. (this took me into a very proud but sad experience so now I must go)

Henry

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A Whole-Blood RNA Transcript-Based Prognostic Model in Men With Castration-Resistant Prostate Cancer: A Prospective Study

Lancet Oncol. 2012 Nov 1;13(11):1105-1113, RW Ross, MD Galsky, HI Scher, et al

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Investigators developed a six–gene expression model which could stratify patients with castration-resistant prostate cancer into high- and low-risk categories, with median survivals of 7.8 and >35+ months, respectively.

Abstract

Background: Survival for patients with castration-resistant prostate cancer is highly variable. We assessed the effectiveness of a whole-blood RNA transcript-based model as a prognostic biomarker in castration-resistant prostate cancer.

Methods: Peripheral blood was prospectively collected from 62 men with castration-resistant prostate cancer on various treatment regimens who were enrolled in a training set at the Dana-Farber Cancer Institute (Boston, MA, USA) from August, 2006, to June, 2008, and from 140 patients with castration-resistant prostate cancer in a validation set from Memorial Sloan-Kettering Cancer Center (New York, NY, USA) from August, 2006, to February, 2009. A panel of 168 inflammation-related and prostate cancer-related genes was assessed with optimised quantitative PCR to assess biomarkers predictive of survival.

Findings: A six-gene model (consisting of ABL2, SEMA4D, ITGAL, and C1QA, TIMP1, CDKN1A) separated patients with castration-resistant prostate cancer into two risk groups: a low-risk group with a median survival of more than 34.9 months (median survival was not reached) and a high-risk group with a median survival of 7.8 months (95% CI 1.8–13.9; p < 0.0001). The prognostic utility of the six-gene model was validated in an independent cohort. This model was associated with a significantly higher area under the curve compared with a clinicopathological model (0.90 [95% CI 0.78–0.96] vs 0.65 [0.52–0.78]; p = 0.0067).

Interpretation: Transcriptional profiling of whole blood yields crucial prognostic information about men with castration-resistant prostate cancer. The six-gene model suggests possible dysregulation of the immune system, a finding that warrants further study.