Clinical Applications of Genomic Analyses in Prostate Cancer

Prostate cancer is a leading cause of cancer-related death globally and is characterised by significant intra- and inter-patient genomic heterogeneity. This heterogeneity manifests as variable disease presentations ranging from indolent cancers for which no treatment is needed to aggressive disease that impacts quality of life and survival. Additional biomarkers that predict clinical course and refine therapeutic decision-making to avoid over- and under-treatment and improve outcomes in men with aggressive disease are urgently needed. Several promising genomic biomarkers have emerged. This thesis firstly summarises the landscape of prostate cancer genomics and its clinical utility in prostate cancer. The second chapter characterises the germline in men with advanced prostate cancer treated at an Australian tertiary centre to identify potential factors that could guide referrals for germline assessment. The third chapter reviews the interactions between two important and therapeutically targetable pathways, androgen receptor and phosphoinositide 3-kinase, in prostate cancer and assesses their therapeutic implications. The fourth chapter of this thesis examines the real-world potential for whole genome sequencing and optical mapping data to inform treatment selection. Finally, cell-free DNA as a predictor of response to novel treatments is explored in Chapter 5. Overall this work assesses the potential for DNA sequencing in prostate cancer to impact patient outcomes.

Grantor dc:publisher

UNSW, Sydney

Year dc:date

2021

Author dc:creator

• Crumbaker, Megan

• Prostate cancer
• Genomics

Statement dc:rights

• open access
• CC BY-NC-ND 3.0
• free_to_read

Licence

• https://purl.org/coar/access_right/c_abf2
• https://creativecommons.org/licenses/by-nc-nd/3.0/au/

Language dc:language

EN

Identifier

https://doi.org/10.26190/unsworks/22513

OAI identifier oai:identifier

oai:unsworks.library.unsw.edu.au:1959.4/70843