Dr. Boutros on Processes That Predict Lethality in Prostate Cancer

Paul C. Boutros, PhD, MBA, professor in the Departments of Human Genetics and Urology at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA), director of the UCLA Jonsson Comprehensive Cancer Center’s Cancer Data Science program, and associate director of cancer informatics at the UCLA Institute for Precision Health, discusses processes that predict disease lethality in men with prostate cancer.

Aggressive prostate cancer appears to be driven largely by 5 key factors, Boutros explains.

The first is genomic instability, Boutros says. Tumors that harbor more mutations are more likely to be lethal.

Second, hypoxic tumors tend to be more aggressive compared with tumors that receive more oxygen, Boutros says. Non-hypoxic tumors act more like normal tissue and are therefore less lethal versus tumors that receive a low level of oxygen.

Additionally, patients with intraductal carcinoma with cribriform architecture have a more aggressive subhistology of prostate cancer, Boutros says.

A fourth factor is whether the tumor is visible by standard multiparametric MRI, says Boutros.

Finally, estimating the tumor’s evolution, including how clonal, complex, and branched the tumor’s evolutionary history is can provide insight into how lethal a patient’s disease is likely to be, concludes Boutros.