We’ve developed a network called Men of African Descent and Carcinoma of the Prostate, or the MADCaP Network. It’s a consortium of about a dozen centres in Sub-Saharan Africa and about a dozen in North America. The goal is to bring together researchers who are asking common questions about prostate cancer aetiology, treatment, prevention, screening and to learn from each other so that we can elevate the quality of the research and the impact on African populations.
What is the MADCap Network?
The network has been very active in creating guidelines, protocols and best practices for doing research. So we’ve created databases and surveys and all kinds of resources for laboratory studies, for biosample collection, storage and processing etc. So we have a baseline set of resources that can be used across Africa to promote cancer research and particularly prostate cancer research.
But beyond that we have spent time studying the genomics of prostate cancer. Prostate cancer is elevated in incidence and mortality among African descent men and we don’t really yet know why that is. In part we can learn from the entire spectrum of the African diaspora in North America and in Africa to understand any underlying biological components to that elevated risk.
What has the MADCaP Network done so far?
The MADCaP Network has begun to characterise common genomic factors that are associated with prostate cancer in African descent populations. We know that prostate cancer is one of the most hereditable of all cancers and yet we have very few modifiable risk factors for prostate cancer. So it has become really important for us to understand what that underlying genomic pattern might be, the genetic architecture of prostate cancer.
So the MADCaP Network has begun to do this by undertaking genome-wide association studies, other kinds of expression analyses in prostate tumours. We have begun to characterise both the inherited and the somatic genome of prostate tumours. We have begun to see some interesting patterns, some of which are very common to what we’ve seen in non-African populations and some that are very different. We have begun to see some evolutionary population genetics patterns that might begin to help us explain the high rates of prostate cancer in African descent men.
What are the fundamental discoveries for prostate cancer in Sub-Saharan Africa?
It’s very important that when we make discoveries about genetics and genomics in a population and in populations like Africa that we then translate that into something that can be used clinically to reduce risk, to act on prevention and treatment. So we have begun to do that by creating a couple of feasibility pilot studies where we are doing genetic testing for high penetrance, high risk alleles. So we have begun to do this by a study of 400 prostate cancer cases and some breast cancer cases in Rwanda to see whether we can develop protocols and practices that can be used to implement genetic testing in an African setting.
This is not only important because we can learn a lot from the African setting in terms of diversity in genetics and things like that but we really feel it’s important for the African populations to have access to the latest state of the art treatment prevention practices that are out there. This is difficult because there are a lot of needs in Africa but if we don’t start working on advanced practice approaches, genetics and genomics approaches, precision approaches, then Africans won’t have access to these tools and it’s really important that we start to develop those and figure out how they can be implemented in a low-resource setting.