Exploring the Reasons Why Certain Prostate Cancers Are More Aggressive

Paul Boutros, PhD, MBA, discusses the reasons why some patients with prostate cancer have more aggressive disease than others.

Paul Boutros, PhD, MBA, director of the University of California, Los Angeles (UCLA) Jonsson Comprehensive Cancer Center’s Cancer Data Science program and associate director of cancer informatics at the UCLA Institute for Precision Health, discusses the reasons why some patients with prostate cancer have more aggressive disease than others.

Boutros says that aggressive prostate cancer is driven by 5 key processes. The first is genomic instability because tumors that have more mutations are more likely to be deadly. The second process is tumor hypoxia, or the level of oxygen in the tumor. He explains that if there is less oxygen in a tumor, it is more aggressive, and if there is more oxygen and the tumor is more like a normal tissue, the disease will be less aggressive. The third indicator is the presence of an aggressive sub histology called intraductal carcinoma cribriform architecture.

The fourth is whether or not the tumor is visible under a multiparametric MRI, according to Boutros. The last process is the tumors evolution—how clonal, complex, and how branched the tumors evolutionary history is. If you combine these 5 processes, Boutros says that it creates an accurate prediction of which cancers will be more aggressive.