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Febbo's team genetically profiled more than 100 samples of prostate cancer. A genetic signature separates which men with hormone-resistant advanced cancer still have a very active androgen receptor and which don't -- something else, perhaps a gene named Src, is fueling their cancer, he reported this month in the Journal of Clinical Oncology.
Next month, Duke and other hospitals that are part of the Defense Department's Prostate Cancer Consortium will begin recruiting 60 such patients and custom-profile their cancer to decide treatment. Those with highly active androgen receptors will get nilutamide, a receptor blocker. Those whose androgen receptors aren't the problem will receive an experimental treatment, the leukemia drug dasatanib that's known to target prostate-related factors.
Also under way: Testing whether there's a genetic signature that says which men will respond best to a different drug, docetaxel. It's proven to increase survival in hormone-resistant advanced prostate cancer but only in a fraction of patients.
Separately, doctors are closely watching studies of an experimental drug named abiraterone that's supposed to target mutated androgen receptors.
It's way too soon to predict if any of these approaches will pan out. But the genetics rationale appeals to Tim Atkeson, a Denver lawyer whose prostate cancer already had spread to his bones when he was diagnosed at the unusually young age of 49.
Atkeson read up on studies presented at leading cancer meetings and, while systematically working through treatments for the hormone-resistant, he contacted Febbo about volunteering for the gene-guided study. At the very least, he hopes to spur science in case his sons or brothers ever face the same disease.
"I keep my fingers crossed that perhaps I'll be one of the lucky ones," says Atkeson, now 51.
Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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