Introduction
The IGSP focuses on improving prostate cancer treatment through better knowledge of tumor biology. The aim is to match genetic and genomic changes in prostate cancer to the tumor's behavior. Our goal is to be able to give doctors information about a tumor to predict whether it will respond to a particular treatment. Our research may help scientists understand why some tumors resist treatment, making it possible to develop new prostate cancer treatments. Our hope is that in the future, doctors can use genomic information to help them choose the best treatment for an individual patient, leading to personalized (individualized) prostate cancer treatment.

We know from initial results that changes found in the genes of prostate cancers are connected to treatment response. Our current clinical trials are collecting more genetic and genomic information. The data will help us figure out how to use details of a prostate tumor's genetics to improve treatment outcomes.

About Prostate Cancer
Prostate cancer is the most common non-skin cancer in men. It's the second highest cause of cancer deaths in American men. About 230,000 men are diagnosed with prostate cancer each year. Annually, 27,000 men die from the disease.

It is important to detect cancer early, as later stage cancers tend to resist treatment. Also, later stage cancer has more likely begun spreading throughout the body, a process called metastasis. Since the early 1990s, a diagnostic tool called prostate specific antigen (PSA) screening, has helped doctors detect prostate cancer earlier. Yet, one in ten patients have metastatic cancer at their first doctor’s visit. Many patients are cured following initial treatment. However, the cancer recurs in about a third of cases.

Risk assessment of a localized (non-metastatic) prostate cancer is based on serum PSA levels, degree to which cells are abnormal, and how far along the disease has progressed. Curing high-risk localized prostate cancer usually takes more than one kind of therapy. Such combination or multi-modality therapy may involve surgery and radiation, as well as chemotherapy. For prostate cancer that has spread outside of the prostate (metastasized), hormone therapy is the most effective option. Metastatic prostate cancer that grows despite hormone therapy is called hormone-refractory, androgen-independent, or castration-resistant. Unfortunately, such cancers can not be cured.

Docetaxel, a chemotherapy agent, is the only treatment shown to improve survival in men with hormone-refractory prostate cancer. Some types of prostate cancer do not respond to docetaxel. We do not know what makes tumors resistant. Understanding the basis for this drug resistance would help scientists develop new drugs that could be used to treat docetaxel-resistant tumors.

Prostate cancer is generally treated using a "shot-gun" approach — doctors try what they think will work best, based on existing knowledge. We know that tumors vary in their origin and behavior, but we cannot predict which patients will respond to which type of treatment. Our research hopes to change this. Instead, each patient's tumor is looked at individually to characterize its unique features. This makes a highly directed approach to treatment possible. With more detailed information about the tumor we can target specific tumor machinery, using a much more accurate "rifle shot" to attack the tumor.

Genes, Cells, & Cancer
The human body is built from millions of cells. Inside each cell is DNA, the inherited genetic material that programs cell growth and development. DNA is organized into genes. Each gene contains the information for a specific task carried out by the cell. Genes represent the "blueprint" for all processes of the human body. The collection of all our genes is called the genome. Scientists estimate that the human genome contains 20,000 to 25,000 genes. Although each cell contains a full set of genes, not all of the genes are active at the same time. Some genes are turned 'on' and others are turned 'off' at different times. When genes are turned 'on' they are copied into RNA. We can measure the amount of RNA in a group of cells (such as a tumor) to assess which genes are turned 'on' (expressed) or 'off' (not expressed).

Large groups of proteins, RNA, and other molecules work together in a complex network to keep cells healthy. Healthy cells work together in the tissues that are part of a healthy human body. Genes may become damaged over time. Damaged genes can result in RNA or proteins that no longer work the way they should. For example, the genes that stop a cell from reproducing might be damaged. A cell that reproduces out of control may result in a tumor.