Hope in war on prostate cancer that resists drugs

SCIENTISTS have discovered how some prostate cancers become resistant to therapy – boosting hopes of better treatment for patients.

The disease is the most common cancer in men, affecting 52,000 a year in Britain and killing 12,000 – the equivalent of one every 45 minutes.

One of the most commonly used treatments is hormone therapy, which is crucial in halting the growth of cancer cells.

But some tumours become resistant to the treatment, meaning patients eventually see their disease return and spread.

However two studies have given a team of researchers vital insight into how prostate tumours survive and grow.

In the first, scientists identified a process that helps determine how prostate cells evolve from one type of cell to another, which can seriously affect the response to treatment.

There are two types of cells in the prostate: basal and luminal. Regardless of where the cancer starts, it usually takes on the properties of luminal cells as the disease grows.

Luminal tumours are easier to treat with hormone therapy but over time, and in response to treatment, some tumours become less luminal, making them more resistant.

Researchers saw that when basal cells change into luminal cells, the way they process a molecule called pyruvate also alters.

These changes can influence the ‘genetic instructions’ in the cells that determine how they develop and respond to treatment.

The team discovered that blocking a specific part of cell metabolism and adding lactic acid can alter cell behaviour.

These changes could potentially affect the success of treatments for prostate cancer, said researchers from the University of California, Los Angeles.

Dr Andrew Goldstein, who worked on the study in the journal Nature Cell Biology, added: ‘Identifying metabolic alterations and understanding patterns in cancer cells could be a critical component to developing new treatments.

‘Technological advances are giving us insight into how these tumours break down their nutrients, known as cancer metabolism, to help them grow. And we might be able to harness that biology to make tumours more treatable.’

The second study, by the same team and published in Cell Reports journal, sheds light on how prostate cancer cells react when the androgen receptor pathway, which regulates cell development, is blocked.

This is a common approach to treating advanced cancer. They found that a protein, called MYC, is crucial to how the tumour reacts.

Dr Goldstein said: ‘This teaches us about treatment response and suggests that if we could find the right combination of treatment... we might be able to reduce disease progression and recurrence.’