Dr Townsend on Understanding Prostate Cancer and the Utility of Genomic Sequencing

Jeffrey P. Townsend, PhD, Elihu Professor of Biostatistics, professor, Ecology and Evolutionary Biology, co-leader, Genomics, Genetics, & Epigenetics Research Program, Yale School of Public Health, discusses advancements in the understanding of prostate cancer care through the utility of genomic sequencing.

To begin, Townsend emphasizes that the number of prostate tumor samples that are available from patients who have been screened for whole exome or whole panel sequencing are consistently being utilized and therefore diminished. While there is a substantial repository of sequenced tumors, further analysis is needed to elucidate specific gene mutations and their implications across disease stages, he explains.

With the increasing availability of these samples, researchers are able to conduct stage-specific analyses, revealing nuanced insights into the mutational landscape of prostate cancer, Townsend expands. Furthermore, it is important to underscore the need for continued sample collection and analysis, as it allows for a more comprehensive understanding of disease trajectories, he states

In his research, Townsend shares that he observed that the distinct selective pressures on genes across different risk categories and disease stages vary. While there is a slight increase in the overall mutation rate as the disease progresses, the key finding lies in the differential selection of mutated genes, he reports. Notably, Townsend highlights that the genes targeted for mutations vary significantly depending on disease stage, particularly in metastatic cases.

These findings have implications for precision medicine in prostate cancer treatment, as researchers have the ability to tailor therapies to target specific genetic mutations through gaining a better understanding of the genetic alterations driving disease progression, he elucidates. This personalized approach holds promise for improving treatment efficacy and patient outcomes.

This research underscores the importance of genomic sequencing in elucidating the complex molecular landscape of prostate cancer. By analyzing large cohorts of sequenced tumors, researchers can identify key genetic mutations associated with disease progression and tailor treatments accordingly. This process of sample collection and analysis is crucial for advancing precision medicine in prostate cancer, Townsend concludes.

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Jeffrey P. Townsend, PhD, discusses advancements in the understanding of prostate cancer care through the utility of genomic sequencing. 

Dr Townsend on the Genetic Evolutionary Trajectory of Prostate Cancer 

Jeffrey P. Townsend, PhD, Elihu Professor of Biostatistics and Professor of Ecology and Evolutionary Biology, co-leader, Genomics, Genetics, & Epigenetics Research Program, Yale School of Public Health, elucidates a novel approach to comprehending the genetic evolutionary trajectory of prostate cancer at different stages of the disease.

Research presented at the 2024 AACR Annual Meeting delved into the effects of prostate cancer driver mutations and how the magnitude of these effects vary by stage. Findings presented during the meeting showed that reveals that low-risk, higher-risk, and metastatic prostate tumors exhibit dynamically varied rates along the trajectory of the disease.

Although the common belief is that low-risk prostate cancer follows a different trajectory compared with high-risk prostate cancer, both disease types can lead to metastases; patients with high-risk disease are simply more likely to progress to metastatic disease, Townsend says. To further identify driver mutations at each level of disease, Townsend and colleagues examined tissue from low-risk prostate cancer, high-risk prostate cancer, and metastatic prostate cancer, as well as normal prostate tissue.

By examining which genes are selected in low-risk and high-risk prostate cancer that lead to metastatic disease can help define the trajectory of the disease, Townsend expands. Additionally, identifying these genes could allow for the development of more effective targeted agents for patients at different stages of prostate cancer, he says.

Townsend also explains that the research involved looking at how different genes interact with each other and this effect on epistasis—how selection is increased or decreased based on this interaction. By better understanding how a specific mutation affects the likelihood of other mutations, it is easier the characterize where a specific patient’s prostate cancer falls on the evolutionary trajectory of the disease, he says, such as which mutations may be the likely next step.

In characterizing the molecular and genetic progress of prostate cancer, future generations of therapy could be based on the anticipation of forthcoming mutations, allowing for potential treatments to prevent patients from experiencing disease progression, rather than initiating treatment when progression occurs, Townsend concludes.

Jeffrey P. Townsend, PhD, on a novel approach to comprehending the evolutionary trajectory of prostate cancer through genetic profiling. 

Jeffrey P. Townsend, PhD

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Dr Townsend on Understanding Prostate Cancer and the Utility of Genomic Sequencing

Dr Townsend on the Genetic Evolutionary Trajectory of Prostate Cancer