Prognostic genetic markers in metastatic prostate cancer treatment

Prostate cancer is the second cause of death after lung cancer among malignancies seen in the male population and is the most common urogenital malignancy. The etiology of prostate cancer is multifactorial and the etiological factors are not fully known. In addition, many studies have shown that both family history and genetics play a role in the development of prostate cancer. Genome-related studies have identified more than 100 suspected gene regions that most frequently contribute to the prostate cancer risk. In clinical cohort studies, germline mutations were detected at a rate of 15-17%, regardless of stage. Treatment guidelines and international clinical organizations include testing for germline and somatic mutations (especially BRCA1, BRCA2, ATM, PALB2, FANCA) and genetic prognostic markers are gaining importance in the selection of chemotherapy and hormonotherapy. In our study, 115 patients who were regularly followed up with a diagnosis of metastatic prostate cancer and received maximal androgen blockade therapy were included. The pathology results and tumor tissues of 71 patients with sufficient tissue and tumor amount were examined. The 31 gene expressions which we have identified were analyzed by quantitative real time polymerase chain reaction (qRT-PCR). Gene analysis results, responses to hormonal treatment and time periods for castration resistance development of metastatic prostate cancer patients were compared based on total PSA value. It was determined that the RPS29 gene expression median was higher in cases that developed relapse than in those that did not. In patients without recurrence, RRM2, UBA52 and PMSC1 genes were found to be positively correlated with biochemical relapse time, while PSMA1 gene was found to have a moderate negative correlation. As a result, in our study, it was determined that prostate cancer patients with mutations in the RPS29 gene face a higher risk of recurrence and in patients with RRM2, UBA52 and PMSC1 mutations, the recurrence period may occur in a longer time period or even may nor occur. Key words: Metastatic prostate cancer, RPS29, RRM2, UBA52, PMSC1, PSMA1