New study uses genomic sequencing to develop treatments for castration-resistant prostate cancer

A new study at Mayo Clinic is using genomic sequencing to develop customized treatments for men with castration-resistant prostate cancer, a progressive and incurable stage of prostate cancer, which no longer responds to hormone therapies that stop or slow testosterone production.

"Men with castration-resistant prostate cancer have abysmal survival rates, typically living an average of two years once hormone therapies fail," says Manish Kohli, M.D., a Mayo Clinic oncologist and principal investigator of the Prostate Cancer Medically Optimized Genome-Enhanced Therapy (PROMOTE) study. Dr. Kohli says the poor prognosis for men with this cancer highlights the need for studies like PROMOTE, which seek to match new targeted drugs with the genomic characteristics of individual patients' tumors.

Several new therapies have recently been approved by the FDA for use in treating castration-resistant prostate cancer, offering new hope for men with this disease. However, many questions remain over which medications to use in individual cases. In the PROMOTE study, researchers and doctors are using exome sequencing and RNA profiling to identify molecular fingerprints within prostate cancers that can be used to identify the optimal drug for the individual patient.

In addition to identifying individualized treatment plans, PROMOTE will uncover new targets in the cancer genome that investigators and drug companies can use to develop new therapies. These new targets will be identified largely through mouse "avatars," which will carry the individual tumors of PROMOTE study participants. These avatar mice also will help doctors identify and test new drugs against the patients' tumors before introducing the toxic and potentially harmful agents into the patients, themselves.

"The approach we are taking with PROMOTE is exactly what we are working toward across Mayo Clinic through our Center for Individualized Medicine," says Gianrico Farrugia, M.D., director of the Mayo Clinic Center for Individualized Medicine. "We're offering individualized care and tailored treatment options for our patients."

Prostate cancer is the most commonly diagnosed solid organ malignancy in the U.S with more than 238,000 new diagnoses annually and an estimated 29,720 deaths. It is the second leading cause of cancer deaths among American men, according to the Surveillance Epidemiology and End Results Program of the National Cancer Institute.