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Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Monique J. Roobol, Erasmus University Medical Center, The Netherlands
- Second opponent: Associate Professor, Group Leader, Wytske van Weerden, Erasmus University Medical Center, The Netherlands
- Third member and chair of the evaluation committee: Professor Jan Oldenburg, Faculty of Medicine, University of Oslo
Chair of the Defence
Associate Professor Per Medbøe Thorsby, University of Oslo
Principal Supervisor
Professor II Kristin Austlid Taskén, Faculty of Medicine, University of Oslo
Summary
More than 5000 men are diagnosed with prostate cancer each year in Norway. There is a high frequency of indolent disease and a challenge to identify patients with the aggressive phenotype. This causes a significant proportion of over- and undertreatment.
Prostate-Specific Antigen (PSA) is a blood-based biomarker that has guided clinical management of prostate cancer for years, however, there is still a need for new biomarkers to be able to provide higher certainty on the prognosis and offer more tailored treatment. The aim of this thesis was to identify and validate a new prognostic blood-based biomarker for aggressive prostate cancer, with a vision to contribute to guide treatment decisions.
In this study, Guldvik and colleagues performed sequential analysis of blood samples from more than 1700 treatment-naïve men across seven different cohorts from Norway, Sweden, Denmark and Germany. It was identified a protein named Leucine-rich alpha-2-glycoprotein 1 (LRG1) to be highly elevated in blood from prostate cancer patients with established distant metastasis. Adding information on levels of LRG1 to clinical data increased the accuracy in predicting early death for these patients. In contrast, in patients undergoing curative treatment by surgery or radiotherapy, low levels of LRG1 associated with unfavorable prognosis. This could further be linked to early spread to nearby lymph nodes. It was later found that patients with low LRG1 also demonstrated low levels of immune cells and cytokines related to anti-tumor activity. Incorporating LRG1 into established clinical models for patients undergoing surgery or radiotherapy provided an added net benefit for predicting relapse and progression.
In summary, Guldvik and colleagues have found a prognostic biomarker that could potentially contribute to more personalized treatment schemes in the future.
Additional information
Contact the research support staff.