An international team of cancer researchers from Denmark, the University of Copenhagen (UCopenhagen), and Germany, the German Cancer Research Center, have used cancer patient data to develop a computer model that can predict the course of disease for prostate cancer (lat. Prostate Carcinoma). The model is currently being implemented at a prostate cancer clinic in Germany. The researchers have also found the enzyme that appears to trigger some of the first mutations in prostate cancer. The team studied the earliest mutational events in prostate cancer to develop a computer model. The researchers collected patient data from close to 300 men who have had their entire cancer genome sequenced to characterise all mutations present in the tumour. Based on the data set, the researchers have developed the computer model which can be used to predict how prostate cancer will develop for a given patient. The computer model is currently being implemented at a clinic in Germany. 

The researchers expect it to take two to three years to have the model fully implemented as an integral part of the clinic's processes. Later, in a not too distant future, the researchers hope that the model can also be introduced at hospitals in other countries, for example, Denmark. The approximately 300 patients from the study all had their entire genome sequenced. With genome sequencing, it becomes possible to tailor the treatment of the individual - also referred to as personalised medicine. The patients whose data the researchers have used have primarily been so-called early-onset patients. This group is defined as men who are diagnosed with prostate cancer before reaching the age of 55 years.

So far, it has not been known precisely what initiates prostate cancer. However, due to the focus on the earliest detected tumours, the researchers uncovered a mutational mechanism involving an enzyme called APOBEC. This enzyme may help trigger the disease - i.e. trigger some of the very first mutations in prostate cancer.

This enzyme mutates the prostate cells at a low but constant rate. Each time the cell divides, APOBEC is likely to cause mutations. If you have early-onset prostate cancer, you may have a couple of mutations caused by APOBEC. Twenty years later, you may have 10-20 mutations. The most common oncogene in prostate cancer involves a certain fusion gene. The APOBEC enzyme may contribute to the formation of this fusion gene

The researchers have also found a putative novel oncogene in prostate cancer - ESRP1 - which is associated with very fast-dividing and highly aggressive prostate cancer. It is located close to an already known oncogene, and the researchers believe this is the reason that it has not been discovered until now. In the study, the researchers show that the oncogene ESRP1 may be used as a possible new biomarker to detect whether a patient will have aggressive prostate cancer, which they validated on a cohort consisting of 12,000 other patients with the same type of cancer.