Tumor genomic testing question

[farmanerd]

GenomeDX wants a sample of your tumor to test, but why don't they also want a sample of your normal prostate to compare against?

[Tall_Allen]

No. They are looking for only certain genomic markers on cancer cells that are associated with progression to metastasis.

[farmanerd in reply to Tall_Allen]

Yes they are looking for genomic markers in these areas:

decipherbio.com/

"7 Biologic Pathways

associated with hallmarks of prostate cancer:

1. Proliferation/Cell Death

2. Invasion & Metastasis

3. Androgen Signaling

4. Immune Activity & Response

5. Growth & Differentiation

6. Angiogenesis

7. Metabolism"

But why aren't they comparing MY good to MY bad? Why is the question, not yes or no.

[Tall_Allen in reply to farmanerd]

Because it is only those markers that correlate with metastasis. It doesn't matter if they appear in your healthy tissues (which would be a germline mutation), it is enough that they appear in your cancer.

[farmanerd in reply to Tall_Allen]

"Because it is only those markers that correlate with metastasis."

I find that this statement should have some fuzziness added in if patents and the existence of other genomic tests are considered (Prolaris). Sorry, didn't mean to be discussing only Decipher.

Just adding a link that others may want to look at:

ncbi.nlm.nih.gov/pmc/articl...

I was just abstractly thinking about it like small sections of neighborhoods in a city. If one small area differs badly enough from neighboring areas, does it consume and pull down the rest or does it get renovated into compliance. Would the likelihood or rate of one or the other action have more to do with the smaller local neighborhood differences versus the difference from the 'average' in the whole city of cells? Is cancer associated more with local weather in the organism or climate change throughout the organism?

[Tall_Allen in reply to farmanerd]

There is a whole theory of cancer as a tissue based disease. But Decipher after prostatectomy is much more narrow - it looks only at 22 biomarkers in prostatic cancer cells that have been found to particularly well correlate with eventual metastases after prostatectomy. They decided on those 22 because they had the best explanatory value. It is independent of other risk factors are already captured.

Prolaris and Oncotype Dx have not been validated as tools for deciding whether to have salvage radiation. Their purpose is for men who are sitting on the fence about active surveillance vs primary treatment. Decipher for AS decision support can be done on biopsy samples as well.

I don't know what you mean by "fuzziness."

[j-o-h-n in reply to Tall_Allen]

"fuzziness."

youtube.com/watch?v=0NreVs1...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 05/11/2019 8:04 PM DST