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Fettiplace A, Matis-Mitchell S, Molodetskyi O, Söderbergh M, Oscarsson J, Lin M, Ravikiran S, Billger M, Ambery P. A comprehensive analysis of liver safety across zibotentan oncology trials: knowledge of the past offers new perspectives on the present. Expert Opin Drug Saf 2024; 23:477-486. [PMID: 38469902 DOI: 10.1080/14740338.2024.2328816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Endothelin receptor antagonists (ERAs) are associated with liver injury. We used data from previous oncology clinical trials to determine the liver safety profile of zibotentan, which is currently in clinical development (in combination with dapagliflozin) for chronic kidney disease and cirrhosis. RESEARCH DESIGN AND METHODS Six global, double-blinded, phase 2b and 3 clinical trials from the zibotentan oncology development program were pooled to analyze liver safety. Descriptive statistics, proportion of liver-related adverse events, liver biochemistry parameter elevation, and shifts from baseline were analyzed, with individual case assessment. RESULTS A total of 1532 patients received zibotentan for 285 days (mean), and 1486 patients received placebo for 320 days (mean). The frequency of any hepatic disorder preferred term was similar across zibotentan monotherapy (22/947 patients, 2.3%) and placebo monotherapy arms (30/881 patients, 3.4%). A total of 4 (0.4%) patients receiving zibotentan monotherapy experienced ALT elevations >5× ULN versus 8 (0.9%) receiving placebo. Of the seven patients receiving zibotentan who met criteria for potential Hy's Law, there were no cases of drug-induced liver injury. CONCLUSIONS We found no evidence of zibotentan-related liver biochemistry changes among cancer-treated patients, suggesting that hepatotoxicity of ERAs is molecule-dependent, and allowing exploration of zibotentan for new indications.
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Affiliation(s)
| | | | - Oleksandr Molodetskyi
- Global Patient Safety, Biopharmaceuticals, Chief Medical Office, R&D, AstraZeneca, Gothenburg, Sweden
| | - Malin Söderbergh
- Global Patient Safety, Biopharmaceuticals, Chief Medical Office, R&D, AstraZeneca, Gothenburg, Sweden
| | - Jan Oscarsson
- Late-Stage Clinical Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Min Lin
- Biometrics Late-Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Srivathsa Ravikiran
- Biometrics Late-Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Martin Billger
- Safety Sciences Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Philip Ambery
- Late-Stage Clinical Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
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2
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Nakamura T, Okumura M, Takamune N, Hirotsu T, Sugiura M, Yasunaga J, Nakata H. Conversion of raltegravir carrying a 1,3,4-oxadiazole ring to a hydrolysis product upon pH changes decreases its antiviral activity. PNAS NEXUS 2024; 3:pgad446. [PMID: 38170115 PMCID: PMC10758923 DOI: 10.1093/pnasnexus/pgad446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/14/2023] [Indexed: 01/05/2024]
Abstract
Raltegravir (RAL), a human immunodeficiency virus (HIV)-1 integrase inhibitor, has been administered as part of antiretroviral therapy. Studies in patients with HIV-1 have shown high variability in the pharmacokinetics of RAL, and in healthy volunteers, coadministration of proton-pump inhibitors has been shown to increase the plasma RAL concentrations. Here, we found that RAL containing a 1,3,4-oxadiazole ring is converted to a hydrolysis product (H-RAL) with a cleaved 1,3,4-oxadiazole ring at pH 1.0 and 13.0 conditions in vitro, thereby reducing the anti-HIV activity of the drug. The inclusion of cyclodextrins (beta-cyclodextrin [βCD], random methyl-βCD [RAM-βCD], and hydroxypropyl-βCD [HP-βCD]) can protect RAL from pH-induced changes. The conversion of RAL to H-RAL was detected by using various mass spectrometry analyses. The chromatogram of H-RAL increased in a time-dependent manner similar to another 1,3,4-oxadiazole-containing drug, zibotentan, using high-performance liquid chromatography. Oral bioavailability and target protein interactions of H-RAL were predicted to be lower than those of RAL. Moreover, H-RAL exhibited significantly reduced anti-HIV-1 activity, whereas combinations with βCD, RAM-βCD, and HP-βCD attenuated this effect in cell-based assays. These findings suggest that βCDs can potentially protect against the conversion of RAL to H-RAL under acidic conditions in the stomach, thereby preserving the anti-HIV-1 effect of RAL. Although clinical trials are needed for evaluation, we anticipate that protective devices such as βCDs may improve the pharmacokinetics of RAL, leading to better treatment outcomes, including reduced dosing, long-term anti-HIV-1 activity, and deeper HIV-1 suppression.
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Affiliation(s)
- Tomofumi Nakamura
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Honjyo 1-1-1, Chuo-ku, Kumamoto 860-8556, Japan
- Department of Laboratory Medicine, Kumamoto University Hospital, Honjyo 1-1-1, Chuo-ku, Kumamoto 860-8556, Japan
| | - Mayu Okumura
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Honjyo 1-1-1, Chuo-ku, Kumamoto 860-8556, Japan
| | - Nobutoki Takamune
- Kumamoto Innovative Development Organization, Kumamoto University, Kurokami 2-39-1, Chuo-ku, Kumamoto 860-0862, Japan
| | - Tatsunori Hirotsu
- CyDing Company Limited, Oehonmachi 5-1, Chuo-ku, Kumamoto 862-0973, Japan
| | - Masaharu Sugiura
- Faculty of Pharmaceutical Sciences, Sojo University, Ikeda 4-22-1, Nishi-ku, Kumamoto 860-0082, Japan
| | - Junichiro Yasunaga
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Honjyo 1-1-1, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hirotomo Nakata
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Honjyo 1-1-1, Chuo-ku, Kumamoto 860-8556, Japan
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3
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Zhou M, Boulos JC, Omer EA, Klauck SM, Efferth T. Modes of Action of a Novel c-MYC Inhibiting 1,2,4-Oxadiazole Derivative in Leukemia and Breast Cancer Cells. Molecules 2023; 28:5658. [PMID: 37570631 PMCID: PMC10419799 DOI: 10.3390/molecules28155658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
The c-MYC oncogene regulates multiple cellular activities and is a potent driver of many highly aggressive human cancers, such as leukemia and triple-negative breast cancer. The oxadiazole class of compounds has gained increasing interest for its anticancer activities. The aim of this study was to investigate the molecular modes of action of a 1,2,4-oxadiazole derivative (ZINC15675948) as a c-MYC inhibitor. ZINC15675948 displayed profound cytotoxicity at the nanomolar range in CCRF-CEM leukemia and MDA-MB-231-pcDNA3 breast cancer cells. Multidrug-resistant sublines thereof (i.e., CEM/ADR5000 and MDA-MB-231-BCRP) were moderately cross-resistant to this compound (<10-fold). Molecular docking and microscale thermophoresis revealed a strong binding of ZINC15675948 to c-MYC by interacting close to the c-MYC/MAX interface. A c-MYC reporter assay demonstrated that ZINC15675948 inhibited c-MYC activity. Western blotting and qRT-PCR showed that c-MYC expression was downregulated by ZINC15675948. Applying microarray hybridization and signaling pathway analyses, ZINC15675948 affected signaling routes downstream of c-MYC in both leukemia and breast cancer cells as demonstrated by the induction of DNA damage using single cell gel electrophoresis (alkaline comet assay) and induction of apoptosis using flow cytometry. ZINC15675948 also caused G2/M phase and S phase arrest in CCRF-CEM cells and MDA-MB-231-pcDNA3 cells, respectively, accompanied by the downregulation of CDK1 and p-CDK2 expression using western blotting. Autophagy induction was observed in CCRF-CEM cells but not MDA-MB-231-pcDNA3 cells. Furthermore, microarray-based mRNA expression profiling indicated that ZINC15675948 may target c-MYC-regulated ubiquitination, since the novel ubiquitin ligase (ELL2) was upregulated in the absence of c-MYC expression. We propose that ZINC15675948 is a promising natural product-derived compound targeting c-MYC in c-MYC-driven cancers through DNA damage, cell cycle arrest, and apoptosis.
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Affiliation(s)
- Min Zhou
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University-Mainz, Staudinger Weg 5, 55128 Mainz, Germany
| | - Joelle C. Boulos
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University-Mainz, Staudinger Weg 5, 55128 Mainz, Germany
| | - Ejlal A. Omer
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University-Mainz, Staudinger Weg 5, 55128 Mainz, Germany
| | - Sabine M. Klauck
- Division of Cancer Genome Research, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), National Center for Tumor Disease (NCT), Im Neuenheimer Feld 460, 69120 Heidelberg, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University-Mainz, Staudinger Weg 5, 55128 Mainz, Germany
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4
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Shen F, Huang J, Yang K, Sun C. A Comprehensive Review of Interventional Clinical Trials in Patients with Bone Metastases. Onco Targets Ther 2023; 16:485-495. [PMID: 37408994 PMCID: PMC10318107 DOI: 10.2147/ott.s415399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/21/2023] [Indexed: 07/07/2023] Open
Abstract
Bone metastasis is one of the most important factors associated with poor prognosis for patients with prostate, breast, thyroid, and lung cancer. In the past two decades, 651 clinical trials, including 554 interventional trials, were being registered in ClinicalTrials.gov and pharma.id.informa.com to combat bone metastases from different perspectives. In this review, we comprehensively analyzed, regrouped, and discussed all the interventional trials on bone metastases. Clinical trials were re-grouped into bone-targeting agents, radiotherapy, small molecule targeted therapy, combination therapy, and others, based on the different mechanisms of action including modifying the bone microenvironment and preventing the growth of cancer cells. We also discussed the potential strategies that might improve overall survival and progression-free survival of patients with bone metastases in the future.
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Affiliation(s)
- Fei Shen
- Department of Orthopedics, Suzhou Wuzhong People’s Hospital, Suzhou, People’s Republic of China
| | - Jihe Huang
- Department of Orthopedics, Suzhou Wuzhong People’s Hospital, Suzhou, People’s Republic of China
| | - Kejia Yang
- Department of Orthopedics, Suzhou Wuzhong People’s Hospital, Suzhou, People’s Republic of China
| | - Chunhua Sun
- Department of Orthopedics, Suzhou Wuzhong People’s Hospital, Suzhou, People’s Republic of China
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5
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Kim H, Gu L, Yeo H, Choi U, Lee CR, Yu H, Koo S. Rapid Assembly of Pyrrole-Ligated 1,3,4-Oxadiazoles and Excellent Antibacterial Activity of Iodophenol Substituents. Molecules 2023; 28:molecules28083638. [PMID: 37110872 PMCID: PMC10142073 DOI: 10.3390/molecules28083638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Pyrrole-ligated 1,3,4-oxadiazole is a very important pharmacophore which exhibits broad therapeutic effects such as anti-tuberculosis, anti-epileptic, anti-HIV, anti-cancer, anti-inflammatory, antioxidant, and antibacterial activities. A one-pot Maillard reaction between D-Ribose and an L-amino methyl ester in DMSO with oxalic acid at 2.5 atm and 80 °C expeditiously produced pyrrole-2-carbaldehyde platform chemicals in reasonable yields, which were utilized for the synthesis of pyrrole-ligated 1,3,4-oxadiazoles. Benzohydrazide reacted with the formyl group of the pyrrole platforms to provide the corresponding imine intermediates, which underwent I2-mediated oxidative cyclization to the pyrrole-ligated 1,3,4-oxadiazole skeleton. The structure and activity relationship (SAR) of the target compounds with varying alkyl or aryl substituents of the amino acids and electron-withdrawing or electron-donating substituents on the phenyl ring of benzohydrazide were evaluated for antibacterial activity against Escherichia coli, Staphylococcus aureus, and Acinetobacter baumannii as representative Gram(-) and Gram(+) bacteria. Branched alkyl groups from the amino acid showed better antibacterial activities. Absolutely superior activities were observed for 5f-1 with an iodophenol substituent against A. baumannii (MIC < 2 μg/mL), a bacterial pathogen that displays a high resistance to commonly used antibiotics.
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Affiliation(s)
- Hyein Kim
- Department of Chemistry, Myongji University, Myongji-Ro 116, Cheoin-Gu, Yongin 17058, Gyeonggi-Do, Republic of Korea
| | - Lina Gu
- Department of Chemistry, Myongji University, Myongji-Ro 116, Cheoin-Gu, Yongin 17058, Gyeonggi-Do, Republic of Korea
- School of Pharmacy, East China University of Science and Technology, Meilong Road 130, Shanghai 200237, China
| | - Huisu Yeo
- Department of Chemistry, Myongji University, Myongji-Ro 116, Cheoin-Gu, Yongin 17058, Gyeonggi-Do, Republic of Korea
| | - Umji Choi
- Department of Biological Sciences and Bioinformatics, Myongji University, Myongji-Ro 116, Cheoin-Gu, Yongin 17058, Gyeonggi-Do, Republic of Korea
| | - Chang-Ro Lee
- Department of Biological Sciences and Bioinformatics, Myongji University, Myongji-Ro 116, Cheoin-Gu, Yongin 17058, Gyeonggi-Do, Republic of Korea
| | - Haiyang Yu
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Sangho Koo
- Department of Chemistry, Myongji University, Myongji-Ro 116, Cheoin-Gu, Yongin 17058, Gyeonggi-Do, Republic of Korea
- School of Pharmacy, East China University of Science and Technology, Meilong Road 130, Shanghai 200237, China
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6
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He Y, Xu W, Xiao YT, Huang H, Gu D, Ren S. Targeting signaling pathways in prostate cancer: mechanisms and clinical trials. Signal Transduct Target Ther 2022; 7:198. [PMID: 35750683 PMCID: PMC9232569 DOI: 10.1038/s41392-022-01042-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 12/11/2022] Open
Abstract
Prostate cancer (PCa) affects millions of men globally. Due to advances in understanding genomic landscapes and biological functions, the treatment of PCa continues to improve. Recently, various new classes of agents, which include next-generation androgen receptor (AR) signaling inhibitors (abiraterone, enzalutamide, apalutamide, and darolutamide), bone-targeting agents (radium-223 chloride, zoledronic acid), and poly(ADP-ribose) polymerase (PARP) inhibitors (olaparib, rucaparib, and talazoparib) have been developed to treat PCa. Agents targeting other signaling pathways, including cyclin-dependent kinase (CDK)4/6, Ak strain transforming (AKT), wingless-type protein (WNT), and epigenetic marks, have successively entered clinical trials. Furthermore, prostate-specific membrane antigen (PSMA) targeting agents such as 177Lu-PSMA-617 are promising theranostics that could improve both diagnostic accuracy and therapeutic efficacy. Advanced clinical studies with immune checkpoint inhibitors (ICIs) have shown limited benefits in PCa, whereas subgroups of PCa with mismatch repair (MMR) or CDK12 inactivation may benefit from ICIs treatment. In this review, we summarized the targeted agents of PCa in clinical trials and their underlying mechanisms, and further discussed their limitations and future directions.
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Affiliation(s)
- Yundong He
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China.
| | - Weidong Xu
- Department of Urology, Shanghai Changzheng Hospital, Shanghai, China
| | - Yu-Tian Xiao
- Department of Urology, Shanghai Changzheng Hospital, Shanghai, China.,Department of Urology, Shanghai Changhai Hospital, Shanghai, China
| | - Haojie Huang
- Department of Urology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Di Gu
- Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Shancheng Ren
- Department of Urology, Shanghai Changzheng Hospital, Shanghai, China.
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7
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Desai N, Monapara J, Jethawa A, Khedkar V, Shingate B. Oxadiazole: A highly versatile scaffold in drug discovery. Arch Pharm (Weinheim) 2022; 355:e2200123. [PMID: 35575467 DOI: 10.1002/ardp.202200123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 12/26/2022]
Abstract
As a pharmacologically important heterocycle, oxadiazole paved the way to combat the problem associated with the confluence of many commercially available drugs with different pharmacological profiles. The present review focuses on the potential applications of five-membered heterocyclic oxadiazole derivatives, especially 1,2,4-oxadiazole, 1,2,5-oxadiazole, and 1,3,4-oxadiazole, as therapeutic agents. Designing new hybrid molecules containing the oxadiazole moiety is a better solution for the development of new drug molecules. The designed molecules may accumulate a biological profile better than those of the drugs currently available on the market. The present review will guide the way for researchers in the field of medicinal chemistry to design new biologically active molecules based on the oxadiazole nucleus. Antitubercular, antimalarial, anti-inflammatory, anti-HIV, antibacterial, and anticancer activities of various oxadiazoles have been reviewed extensively here.
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Affiliation(s)
- Nisheeth Desai
- Division of Medicinal Chemistry, Department of Chemistry, Mahatma Gandhi Campus, Maharaja Krishnakumarsinhji Bhavnagar University, Bhavnagar, Gujarat, India
| | - Jahnvi Monapara
- Division of Medicinal Chemistry, Department of Chemistry, Mahatma Gandhi Campus, Maharaja Krishnakumarsinhji Bhavnagar University, Bhavnagar, Gujarat, India
| | - Aratiba Jethawa
- Division of Medicinal Chemistry, Department of Chemistry, Mahatma Gandhi Campus, Maharaja Krishnakumarsinhji Bhavnagar University, Bhavnagar, Gujarat, India
| | - Vijay Khedkar
- School of Pharmacy, Vishwakarma University, Pune, Maharashtra, India
| | - Bapurao Shingate
- Department of Chemistry, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad, Maharashtra, India
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8
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Vlachostergios PJ, Karathanasis A, Papandreou CN, Tzortzis V. Early mRNA Expression of Neuroendocrine Differentiation Signals Predicts Recurrence After Radical Prostatectomy: A Transcriptomic Analysis. World J Oncol 2022; 12:232-239. [PMID: 35059083 PMCID: PMC8734499 DOI: 10.14740/wjon1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/30/2021] [Indexed: 12/04/2022] Open
Abstract
Background Neuroendocrine differentiation (NED) of prostate cancer (PC) is a process that often occurs under evolutionary pressure from pharmacologic blockade of androgen receptor signaling at advanced stages of the disease. Identifying a subset of early PC that has a higher likelihood to evolve into this entity is key for developing therapeutic strategies that could more effectively target this phenotype. This study aimed to assess the prognostic relevance of mRNA expression of major players involved in NED of primary prostate tumors. Methods RNA sequencing data from 122 patients with localized PC were analyzed. Transcript levels of key genes involved in NED, with a focus on endothelin axis and nuclear factor kappa B (NF-κB), were assessed and were correlated with time to prostate specific antigen (PSA) recurrence. Copy number alteration of tumor suppressor genes and gene expression of additional signals hallmarking NED was compared between altered and unaltered groups, including lineage determining transcription factors, transcriptional repressors, cell cycle and epigenetic regulators. Results The presence of altered mRNA expression using a z-score threshold of 2 in NFKB1, RELA, EDN1, EDNRA, and EDNRB genes was associated with a higher Gleason score (P < 0.001) and a shorter time to biochemical recurrence (BCR) (P = 0.029). There was a significant direct correlation between NFKB1 and RELA (P < 0.001), NFKB1 and EDNRA (P < 0.001), NFKB1 and EDNRB (P < 0.001), EDNRA and EDNRB expression (P < 0.001). ASCL1 (q < 0.001), ONECUT2 (q < 0.001), DLL3 (q = 0.019), AURKA (q = 0.013), AURKB (q = 0.014), PLK1 (q < 0.001), and EZH2 (q < 0.001) were enriched in patients with tumors harboring alterations in endothelin axis and NF-κB subunit genes whereas REST was downregulated (q < 0.001). Conclusions This analysis suggests that altered mRNA expression of NF-κB and endothelin axis genes in early PC is not only a harbinger of a more aggressive clinical course but is also associated with aberrant gene expression of several transcription factors, transcriptional repressors, cell cycle and epigenetic regulators that are directly involved in NED, in line with their biological roles. This may have implications for closer follow-up and potential use of targeted therapeutic approaches postoperatively in the adjuvant setting to improve outcomes of these patients.
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Affiliation(s)
- Panagiotis J Vlachostergios
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA
| | - Athanasios Karathanasis
- Department of Urology, University of Thessaly School of Health Sciences Faculty of Medicine, University Hospital of Larissa, Larissa 41100, Greece
| | - Christos N Papandreou
- Department of Medical Oncology, Faculty of Medicine Papageorgiou Hospital, Aristotle University of Thessaloniki, School of Health Sciences, Thessaloniki 54124, Greece
| | - Vassilios Tzortzis
- Department of Urology, University of Thessaly School of Health Sciences Faculty of Medicine, University Hospital of Larissa, Larissa 41100, Greece
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9
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Clézardin P, Coleman R, Puppo M, Ottewell P, Bonnelye E, Paycha F, Confavreux CB, Holen I. Bone metastasis: mechanisms, therapies, and biomarkers. Physiol Rev 2020; 101:797-855. [PMID: 33356915 DOI: 10.1152/physrev.00012.2019] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Skeletal metastases are frequent complications of many cancers, causing bone complications (fractures, bone pain, disability) that negatively affect the patient's quality of life. Here, we first discuss the burden of skeletal complications in cancer bone metastasis. We then describe the pathophysiology of bone metastasis. Bone metastasis is a multistage process: long before the development of clinically detectable metastases, circulating tumor cells settle and enter a dormant state in normal vascular and endosteal niches present in the bone marrow, which provide immediate attachment and shelter, and only become active years later as they proliferate and alter the functions of bone-resorbing (osteoclasts) and bone-forming (osteoblasts) cells, promoting skeletal destruction. The molecular mechanisms involved in mediating each of these steps are described, and we also explain how tumor cells interact with a myriad of interconnected cell populations in the bone marrow, including a rich vascular network, immune cells, adipocytes, and nerves. We discuss metabolic programs that tumor cells could engage with to specifically grow in bone. We also describe the progress and future directions of existing bone-targeted agents and report emerging therapies that have arisen from recent advances in our understanding of the pathophysiology of bone metastases. Finally, we discuss the value of bone turnover biomarkers in detection and monitoring of progression and therapeutic effects in patients with bone metastasis.
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Affiliation(s)
- Philippe Clézardin
- INSERM, Research Unit UMR_S1033, LyOS, Faculty of Medicine Lyon-Est, University of Lyon 1, Lyon, France.,Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Rob Coleman
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Margherita Puppo
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Penelope Ottewell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Edith Bonnelye
- INSERM, Research Unit UMR_S1033, LyOS, Faculty of Medicine Lyon-Est, University of Lyon 1, Lyon, France
| | - Frédéric Paycha
- Service de Médecine Nucléaire, Hôpital Lariboisière, Paris, France
| | - Cyrille B Confavreux
- INSERM, Research Unit UMR_S1033, LyOS, Faculty of Medicine Lyon-Est, University of Lyon 1, Lyon, France.,Service de Rhumatologie Sud, CEMOS-Centre Expert des Métastases Osseuses, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Ingunn Holen
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
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10
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Systemic Management for Nonmetastatic Castration-resistant Prostate Cancer: A Systematic Review and Network Meta-Analysis. Am J Clin Oncol 2020; 43:288-297. [PMID: 31972568 DOI: 10.1097/coc.0000000000000660] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To indirectly compare the efficacy and safety of systemic therapies used for patients with nonmetastatic castration-resistant prostate cancer (nmCRPC). METHODS The relevant randomized controlled trials were retrieved from PubMed and the Cochrane Library. Network meta-analyses were used to compare multiple drugs simultaneously for the outcomes of nmCRPC. Direct evidence in trials and indirect evidence across trials were combined by the network meta-analyses to estimate the treatment efficiency. OUTCOME Eight studies were included in our research. For prostate-specific antigen progression-free survival, the rate of progression was significantly decreased following apalutamide, enzalutamide, bicalutamide+dutasteride, and bicalutamide treatment compared with placebo. Compared with placebo treatment, metastases-free survival was significantly increased in patients who received apalutamide (hazard ratio [HR]: 0.28, 95% confidence interval [CI]: 0.23-0.35), enzalutamide (HR: 0.29, 95% CI: 0.24-0.35), and darolutamide (HR: 0.42, 95% CI: 0.35-0.50). Direct comparison showed significant survival benefits in patients who received second-generation anti-androgen therapy (apalutamide, enzalutamide, and darolutamide: HR: 0.74, 95% CI: 0.61-0.91) compared with patients who received placebo. With respect to metastases-free survival, based on SUCRA analysis, there was 80% and 78% probability that apalutamide and enzalutamide were preferred treatment, while darolutamide was likely to be second-best choice. Compared with placebo, all agents were not associated with significantly higher likelihood of serious adverse events and grade 3 to 4 adverse events. CONCLUSION Our outcomes support equivalent efficacy and similar risk of adverse effects between apalutamide, enzalutamide, and darolutamide, supporting the use of these antiandrogen agents in high-risk of progression nmCRPC.
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11
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Ma X, Yu J. Role of the bone microenvironment in bone metastasis of malignant tumors - therapeutic implications. Cell Oncol (Dordr) 2020; 43:751-761. [PMID: 32623700 DOI: 10.1007/s13402-020-00512-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Bone is one of the most common sites for solid tumor metastasis. Bone metastasis of a malignant tumor seriously affects the quality of life and the overall survival of patients. Evidence has suggested that bone provides a favorable microenvironment that enables disseminated tumor cells to home, proliferate and colonize, leading to the formation of metastases. In the process of bone metastasis the bone microenvironment may be considered as an orchestra that plays a dissonant melody through blending (e.g. cross-talk between osteoclasts, osteoblasts and/or other cells), adding (e.g. a variety of biological factors) or taking away (e.g. blocking a specific pathway) players. CONCLUSIONS Here, we review the normal bone microenvironment, bone microenvironment-related factors that promote bone metastasis, as well as mechanisms underlying bone metastasis. In addition, we elude on directions for clinical bone metastasis management, focusing on potential therapeutic approaches to target bone microenvironment-related factors, including bisphosphonate, denosumab, CXCR4/CXCL12 antagonists and cathepsin K inhibitors.
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Affiliation(s)
- Xiaoting Ma
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, No.95 Yong An Road, Xi Cheng District, Beijing, 100050, China
| | - Jing Yu
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, No.95 Yong An Road, Xi Cheng District, Beijing, 100050, China.
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12
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Enevoldsen FC, Sahana J, Wehland M, Grimm D, Infanger M, Krüger M. Endothelin Receptor Antagonists: Status Quo and Future Perspectives for Targeted Therapy. J Clin Med 2020; 9:jcm9030824. [PMID: 32197449 PMCID: PMC7141375 DOI: 10.3390/jcm9030824] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 02/06/2023] Open
Abstract
The endothelin axis, recognized for its vasoconstrictive action, plays a central role in the pathology of pulmonary arterial hypertension (PAH). Treatment with approved endothelin receptor antagonists (ERAs), such as bosentan, ambrisentan, or macitentan, slow down PAH progression and relieves symptoms. Several findings have indicated that endothelin is further involved in the pathogenesis of certain other diseases, making ERAs potentially beneficial in the treatment of various conditions. In addition to PAH, this review summarizes the use and perspectives of ERAs in cancer, renal disease, fibrotic disorders, systemic scleroderma, vasospasm, and pain management. Bosentan has proven to be effective in systemic sclerosis PAH and in decreasing the development of vasospasm-related digital ulcers. The selective ERA clazosentan has been shown to be effective in preventing cerebral vasospasm and delaying ischemic neurological deficits and new infarcts. Furthermore, in the SONAR (Study Of Diabetic Nephropathy With Atrasentan) trial, the selective ERA atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease. These data suggest atrasentan as a new therapy in the treatment of diabetic nephropathy and possibly other renal diseases. Preclinical studies regarding heart failure, cancer, and fibrotic diseases have demonstrated promising effects, but clinical trials have not yet produced measurable results. Nevertheless, the potential benefits of ERAs may not be fully realized.
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Affiliation(s)
- Frederik C. Enevoldsen
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus C, Denmark; (F.C.E.); (J.S.); (D.G.)
| | - Jayashree Sahana
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus C, Denmark; (F.C.E.); (J.S.); (D.G.)
| | - Markus Wehland
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; (M.W.); (M.I.)
| | - Daniela Grimm
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus C, Denmark; (F.C.E.); (J.S.); (D.G.)
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; (M.W.); (M.I.)
| | - Manfred Infanger
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; (M.W.); (M.I.)
| | - Marcus Krüger
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; (M.W.); (M.I.)
- Correspondence: ; Tel.: +49-391-6721267
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13
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Abstract
Cardiovascular disease is a major contributor to global morbidity and mortality and is the common end point of many chronic diseases. The endothelins comprise three structurally similar peptides of 21 amino acids in length. Endothelin 1 (ET-1) and ET-2 activate two G protein-coupled receptors - endothelin receptor type A (ETA) and endothelin receptor type B (ETB) - with equal affinity, whereas ET-3 has a lower affinity for ETA. ET-1 is the most potent vasoconstrictor in the human cardiovascular system and has remarkably long-lasting actions. ET-1 contributes to vasoconstriction, vascular and cardiac hypertrophy, inflammation, and to the development and progression of cardiovascular disease. Endothelin receptor antagonists have revolutionized the treatment of pulmonary arterial hypertension. Clinical trials continue to explore new applications of endothelin receptor antagonists, particularly in treatment-resistant hypertension, chronic kidney disease and patients receiving antiangiogenic therapies. Translational studies have identified important roles for the endothelin isoforms and new therapeutic targets during development, in fluid-electrolyte homeostasis, and in cardiovascular and neuronal function. Novel pharmacological strategies are emerging in the form of small-molecule epigenetic modulators, biologics (such as monoclonal antibodies for ETB) and possibly signalling pathway-biased agonists and antagonists.
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14
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Abstract
Discovered in 1987 as a potent endothelial cell-derived vasoconstrictor peptide, endothelin-1 (ET-1), the predominant member of the endothelin peptide family, is now recognized as a multifunctional peptide with cytokine-like activity contributing to almost all aspects of physiology and cell function. More than 30 000 scientific articles on endothelin were published over the past 3 decades, leading to the development and subsequent regulatory approval of a new class of therapeutics-the endothelin receptor antagonists (ERAs). This article reviews the history of the discovery of endothelin and its role in genetics, physiology, and disease. Here, we summarize the main clinical trials using ERAs and discuss the role of endothelin in cardiovascular diseases such as arterial hypertension, preecclampsia, coronary atherosclerosis, myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) caused by spontaneous coronary artery dissection (SCAD), Takotsubo syndrome, and heart failure. We also discuss how endothelins contributes to diabetic kidney disease and focal segmental glomerulosclerosis, pulmonary arterial hypertension, as well as cancer, immune disorders, and allograft rejection (which all involve ETA autoantibodies), and neurological diseases. The application of ERAs, dual endothelin receptor/angiotensin receptor antagonists (DARAs), selective ETB agonists, novel biologics such as receptor-targeting antibodies, or immunization against ETA receptors holds the potential to slow the progression or even reverse chronic noncommunicable diseases. Future clinical studies will show whether targeting endothelin receptors can prevent or reduce disability from disease and improve clinical outcome, quality of life, and survival in patients.
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Affiliation(s)
- Matthias Barton
- From Molecular Internal Medicine, University of Zürich, Switzerland (M.B.)
- Andreas Grüntzig Foundation, Zürich, Switzerland (M.B.)
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS) and Life Science Center, Tsukuba Advanced Research Alliance, University of Tsukuba, Japan (M.Y.)
- Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX (M.Y.)
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15
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Moon HH, Clines KL, Cooks MA, Cialek CA, Esvelt MA, Clines GA. Castration Determines the Efficacy of ETAR Blockade in a Mouse Model of Prostate Cancer Bone Metastasis. Endocrinology 2019; 160:1786-1796. [PMID: 31173072 PMCID: PMC6610212 DOI: 10.1210/en.2019-00261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/24/2019] [Indexed: 02/08/2023]
Abstract
Bone metastasis is a painful complication of advanced prostate cancer. Endothelin-1 is a tumor-secreted factor that plays a central role in osteoblast activation and the osteosclerotic response of prostate cancer metastatic to bone. Antagonists that block the activation of the endothelin A receptor (ETAR), located on osteoblasts, reduce osteoblastic bone lesions in animal models of bone metastasis. However, ETAR antagonists demonstrated limited efficacy in clinical trials of men with advanced prostate cancer who also received standard androgen deprivation therapy (ADT). Previous data from our group suggested that, in a mouse model, ETAR antagonists might only be efficacious when androgen signaling in the osteoblast is lowered beyond the ability of standard ADT. This notion was tested in a mouse model of prostate cancer bone metastasis. Castrated and sham-operated male athymic nude mice underwent intracardiac inoculation of the ARCaPM castration-resistant prostate cancer cell line. The mice were then treated with either the ETAR antagonist zibotentan or a vehicle control to generate four experimental groups: vehicle+sham (Veh+Sham), vehicle+castrate (Veh+Castr), zibotentan+sham (Zibo+Sham), and zibotentan+castrate (Zibo+Castr). The mice were monitored radiographically for the development of skeletal lesions. The Zibo+Castr group had significantly longer survival and a single incidental lesion. Mice in the Zibo+Sham group had the shortest survival and the largest number of skeletal lesions. Survival and skeletal lesions of the Veh+Sham and Veh+Castr groups were intermediate compared with the zibotentan-treated groups. We report a complex interaction between ETAR and androgen signaling, whereby ETAR blockade was most efficacious when combined with complete androgen deprivation.
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Affiliation(s)
- Henry H Moon
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Katrina L Clines
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Mark A Cooks
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Charlotte A Cialek
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Marian A Esvelt
- Unit for Laboratory Medicine, University of Michigan, Ann Arbor, Michigan
| | - Gregory A Clines
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
- Veterans Affairs Medical Center, Ann Arbor, Michigan
- Correspondence: Gregory A. Clines, MD, PhD, Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan, Endocrinology Section, Ann Arbor VA Medical Center, 2215 Fuller Road, Research 151, Ann Arbor, Michigan 48105. E-mail:
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16
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Gómez Rivas J, Carrion DM, Alvarez-Maestro M, Cathelineau X, Sanchez-Salas R, Di Lorenzo G, Di Maio M, Paul A, Martinez-Piñeiro L, Sartor O, Saad F, Debruyne F. Bone-targeted therapy in castration-resistant prostate cancer: where do we stand? MINERVA UROL NEFROL 2019; 71:445-456. [PMID: 31353876 DOI: 10.23736/s0393-2249.19.03420-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION In the last years, there have been significant developments in the therapeutic armamentarium of metastatic castration-resistant prostate cancer (mCRPC). New evidence shows that the addition of bone-targeted agents (BTA) to "life-prolonging agents" result in improved clinical benefit. This review aims to give an overview of data for the use of BTAs in a new era of mCRPC where new agents are used in daily practice. EVIDENCE ACQUISITION A non-systematic review of the literature was performed combining the keywords: "castration-resistant prostate cancer" and "bone-targeted therapy". The primary objective was to provide a critical assessment of data for the use of BTAs in mCRPC, and the secondary objective was to assess novel targeted therapy. EVIDENCE SYNTHESIS Zoledronic acid and denosumab have shown to be effective in reducing the risk of SREs in patients with mCRPC. The point at which treatment with bisphosphonates or denosumab should be initiated during PCa evolution has yet to be determined. The EMA has restricted the usage of Ra-223 to patients who have had two previous treatments for mCRPC to the bone or who cannot receive other treatments. Ra-223 should only be used as monotherapy or in combination with ADT for the treatment of mCRPC, symptomatic bone metastases and without visceral metastases. With recent developments in PSMA-targeted radiopharmaceuticals, PSMA RLT agents are now under investigation for the treatment of mCRPC. CONCLUSIONS Reducing skeletal-related morbidity remains a crucial goal of palliative life-extending therapy in mCRPC. New data about dosing schedules and combinations of different treatments will continue to refine the optimal strategy for incorporating BTAs into the new treatment paradigms for PCa. Novel molecules such as PSMA-targeted small molecules promise theranostic agents in the management of PCa patients.
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Affiliation(s)
- Juan Gómez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain - .,Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain -
| | - Diego M Carrion
- Department of Urology, La Paz University Hospital, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Mario Alvarez-Maestro
- Department of Urology, La Paz University Hospital, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | | | | | | | - Massimo Di Maio
- Division of Medical Oncology, Mauriziano Hospital, Turin, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Asit Paul
- Virginia Commonwealth University, Richmond, VA, USA
| | - Luis Martinez-Piñeiro
- Department of Urology, La Paz University Hospital, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Oliver Sartor
- Tulane Cancer Center, Tulane University Medical School, New Orleans, LA, USA
| | - Fred Saad
- Unit of Cancer Prognostics and Health Outcomes, University of Montreal Health Center, Montreal, QC, Canada
| | - Francis Debruyne
- Department of Urology, Andros Men's and Gynos Women's Health Institutes, Arnhem, the Netherlands
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17
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Marandino L, De Luca E, Zichi C, Lombardi P, Reale ML, Pignataro D, Di Stefano RF, Ghisoni E, Mariniello A, Trevisi E, Leone G, Muratori L, La Salvia A, Sonetto C, Buttigliero C, Tucci M, Aglietta M, Novello S, Scagliotti GV, Perrone F, Di Maio M. Quality-of-Life Assessment and Reporting in Prostate Cancer: Systematic Review of Phase 3 Trials Testing Anticancer Drugs Published Between 2012 and 2018. Clin Genitourin Cancer 2019; 17:332-347.e2. [PMID: 31416754 DOI: 10.1016/j.clgc.2019.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/06/2019] [Accepted: 07/15/2019] [Indexed: 01/20/2023]
Abstract
Quality of life (QoL) is not included among the end points in many studies, and QoL results are underreported in many phase 3 oncology trials. We performed a systematic review to describe QoL prevalence and heterogeneity in QoL reporting in recently published prostate cancer phase 3 trials. A PubMed search was performed to identify primary publications of randomized phase 3 trials testing anticancer drugs in prostate cancer, issued between 2012 and 2018. We analyzed QoL inclusion among end points, presence of QoL results, and methodology of QoL analysis. Seventy-two publications were identified (15 early-stage, 20 advanced hormone-sensitive, and 37 castration-resistant prostate cancer [CRPC]). QoL was not listed among study end points in 23 studies (31.9%) (40.0% early stage, 40.0% advanced hormone sensitive, and 24.3% CRPC). QoL results were absent in 15 (30.6%) of 49 primary publications of trials that included QoL among end points. Overall, as a result of absent end point or unpublished results, QoL data were lacking in 38 (52.8%) primary publications (53.3% early stage, 55.0% in advanced hormone sensitive, and 51.4% in CRPC). The most commonly used QoL tools were Functional Assessment of Cancer Therapy-Prostate (FACT-P) (21, 53.8%) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) (14, 35.9%); most common methods of analysis were mean changes or mean scores (28, 71.8%), time to deterioration (14, 35.9%), and proportion of patients with response (10, 25.6%). In conclusion, QoL data are lacking in a not negligible proportion of recently published phase 3 trials in prostate cancer, although the presence of QoL results is better in positive trials, especially in CRPC. The methodology of QoL analysis is heterogeneous for type of instruments, analysis, and presentation of results.
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Affiliation(s)
- Laura Marandino
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Emmanuele De Luca
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy
| | - Clizia Zichi
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy
| | - Pasquale Lombardi
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Maria Lucia Reale
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Daniele Pignataro
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Rosario F Di Stefano
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Eleonora Ghisoni
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Annapaola Mariniello
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Elena Trevisi
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Leonardo Muratori
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Anna La Salvia
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Consuelo Buttigliero
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Marcello Tucci
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Massimo Aglietta
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Giorgio V Scagliotti
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Francesco Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale"-IRCCS, Naples, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy.
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18
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Dewulf J, Vangestel C, Verhoeven Y, van Dam P, Elvas F, Van den Wyngaert T, Clézardin P. Bone metastases in the era of targeted treatments: insights from molecular biology. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2019; 63:98-111. [PMID: 31298015 DOI: 10.23736/s1824-4785.19.03203-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Bone metastases remain a common feature of advanced cancers and are associated with significant morbidity and mortality. Recent research has identified promising novel treatment targets to improve current treatment strategies for bone metastatic disease. This review summarizes the well-known and recently discovered molecular biology pathways in bone that govern normal physiological remodeling or drive the pathophysiological changes observed when bone metastases are present. In the rapidly changing world of targeted cancer treatments, it is important to recognize the specific treatment effects induced in bone by these agents and the potential impact on common imaging strategies. The osteoclastic targets (bisphosphonates, LGR4, RANKL, mTOR, MET-VEGFR, cathepsin K, Src, Dock 5) and the osteoblastic targets (Wnt and endothelin) are discussed, and the emerging field of osteo-immunity is introduced as potential future therapeutic target. Finally, a summary is provided of available trial data for agents that target these pathways and that have been assessed in patients. The ultimate goal of research into novel pathways and targets involved in the tumor-bone microenvironment is to tackle one of the great remaining unmet needs in oncology, that is finding a cure for bone metastatic disease.
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Affiliation(s)
- Jonatan Dewulf
- Molecular Imaging Center Antwerp (MICA), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Christel Vangestel
- Molecular Imaging Center Antwerp (MICA), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.,Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Yannick Verhoeven
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium
| | - Peter van Dam
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Multidisciplinary Oncologic Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium
| | - Filipe Elvas
- Molecular Imaging Center Antwerp (MICA), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Tim Van den Wyngaert
- Molecular Imaging Center Antwerp (MICA), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium - .,Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Philippe Clézardin
- INSERM Laboratory Pathophysiology, Diagnosis and Treatments of Bone Diseases, Lyon, France.,INSERM European Associated Laboratory Cancer and Bone Metastasis, University of Sheffield, Medical School, Sheffield, UK
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19
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Abstract
Bone metastases are the main driver of morbidity and mortality in advanced prostate cancer. Targeting the bone microenvironment, a key player in the pathogenesis of bone metastasis, has become one of the mainstays of therapy in men with advanced prostate cancer. This review will evaluate the data supporting the use of bone-targeted therapy, including (1) bisphosphonates such as zoledronic acid, which directly target osteoclasts, (2) denosumab, a receptor activator of nuclear factor-kappa B (RANK) ligand inhibitor, which targets a key component of bone stromal interaction, and (3) radium-223, an alpha-emitting calcium mimetic, which hones to the metabolically active areas of osteoblastic metastasis and induces double-strand breaks in the DNA. Denosumab has shown enhanced delay in skeletal-related events compared to zoledronic acid in patients with metastatic castration-resistant prostate cancer (mCRPC). Data are mixed with regard to pain control as a primary measure of efficacy. New data call into question dosing frequency, with quarterly dosing strategy potentially achieving similar effect compared to monthly dosing for zoledronic acid. In the case of radium-223, there are data for both pain palliation and improved overall survival in mCRPC. Further studies are needed to optimize timing and combination strategies for bone-targeted therapies. Ongoing studies will explore the impact of combining bone-targeted therapy with investigational therapeutic agents such as immunotherapy, for advanced prostate cancer. Future studies should strive to develop biomarkers of response, in order to improve efficacy and cost-effectiveness of these agents.
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Affiliation(s)
- Tanya B Dorff
- USC Keck School of Medicine, USC Norris Comprehensive Cancer Center, Genitourinary Oncology, Los Angeles, CA 90033, USA
| | - Neeraj Agarwal
- Hunts Man Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USA
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20
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Higano CS. Does nonmetastatic castration-resistant prostate cancer still exist? Nat Rev Clin Oncol 2019; 15:350-351. [PMID: 29686422 DOI: 10.1038/s41571-018-0025-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Celestia S Higano
- Division of Medical Oncology, Department of Medicine, University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA, USA.
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21
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Brown LC, Sonpavde G, Armstrong AJ. Can RECIST response predict success in phase 3 trials in men with metastatic castration-resistant prostate cancer? Prostate Cancer Prostatic Dis 2018; 21:419-430. [PMID: 29858595 DOI: 10.1038/s41391-018-0049-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/11/2018] [Accepted: 03/19/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Intermediate endpoints are needed in early phase studies of men with metastatic castration-resistant prostate cancer (mCRPC) that can reliably predict success in phase 3 trials. Among men with measurable disease, objective response may provide information as to whether a treatment is likely to be successful. METHODS We conducted a systematic review of systemic agents that have proceeded to phase 3 trials in men with mCRPC and examined the relationship between improvements in measurable disease response in phase 2 trials and successful phase 3 trials leading to regulatory approval. Only trials that included men with radiographically measurable disease were included. RESULTS We examined 31 eligible mCRPC phase 3 trials between 1992 and 2017 and 29 of the preceding phase 2 trials for RECIST responses. Measurable tumor responses in phase 2 trials were higher for successful therapies in phase 3 trials in chemotherapy-naive men with mCRPC, but were less correlated with success in trials investigating docetaxel combination regimens or the post chemotherapy mCRPC setting. Many failed agents did not produce higher than expected response rates over control arms; however, several agents such as anti-angiogenic therapies or orteronel produced higher than expected responses without survival benefit. CONCLUSIONS Objective responses in men with mCRPC may be associated with prolonged survival, but this association is mechanism dependent and inconsistent across trials or disease states. These data support considering RECIST response as a supportive but not sole endpoint in phase 2 trials to support launching phase 3 trials.
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Affiliation(s)
- Landon C Brown
- Department of Medicine, School of Medicine, Duke University, Durham, NC, USA
| | | | - Andrew J Armstrong
- Department of Medicine, School of Medicine, Duke University, Durham, NC, USA. .,Duke Cancer Institute and the Duke Prostate and Urologic Cancer Center, Duke University, Durham, NC, USA.
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22
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Wang Y, Zhang H, Shen W, He P, Zhou Z. Effectiveness and tolerability of targeted drugs for the treatment of metastatic castration-resistant prostate cancer: a network meta-analysis of randomized controlled trials. J Cancer Res Clin Oncol 2018; 144:1751-1768. [PMID: 29797220 DOI: 10.1007/s00432-018-2664-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 05/08/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE Castration-resistant prostate cancer (CRPC) refers to prostate cancer that has progressed after initial androgen deprivation therapy (ADT). Over the years, treatment strategies for metastatic CRPC (mCRPC) have undergone considerable changes. We performed a network meta-analysis to assess the effectiveness and tolerability of targeted agents for mCRPC. METHODS We search databases including MEDLINE, EMBASE, and the Cochrane Library through Sep 5, 2017. The major effectiveness outcomes were progression-free survival (PFS) and overall survival (OS). The tolerability outcome was severe adverse events (AEs) of grade ≥ 3. RESULTS Twenty-six articles assessing a total of 20,314 patients were included in this study. A random-effect analysis showed that targeted agents could significant prolong PFS in mCRPC patients (I2 = 94.3%; hazard ratio (HR): 0.74; 95% confidence interval (CI): 0.65-0.84; p < 0.001). In addition, the surface under the cumulative ranking curve (SUCRA) ranking from the network analysis showed that enzalutamide was the most effective in improving the PFS of mCRPC patients (100%), followed by abiraterone (90.1%) and tasquinimod (84.2%). Additionally, targeted agents could clearly prolong OS in mCRPC patients (I2 = 71.6%; HR: 0.91; 95% CI: 0.85-0.97; p < 0.001). Furthermore, based on SUCRA ranking, enzalutamide was the most effective in improving the OS of mCRPC patients (97.2%), followed by abiraterone (91.1%) and zibotentan (65.8%). Intetumumab was associated with the lowest incidence of severe AEs (94.9%), followed by atrasentan (85.1%) and placebo (79.3%). CONCLUSION In patients with mCRPC, enzalutamide, abiraterone and tasquinimod can prolong PFS, and enzalutamide and abiraterone can prolong OS. Additionally, enzalutamide and abiraterone can improve both PFS and OS with a low risk of causing severe AEs.
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Affiliation(s)
- Yongquan Wang
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Heng Zhang
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Wenhao Shen
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Peng He
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Zhansong Zhou
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
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Ghatalia P, Pond GR, Templeton AJ, Sonpavde G. Effect of Single-agent Daily Prednisone on Outcomes and Toxicities in Metastatic Castration-resistant Prostate Cancer: Pooled Analysis of Prospective Studies. Clin Genitourin Cancer 2017; 16:e277-e287. [PMID: 29352714 DOI: 10.1016/j.clgc.2017.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 12/06/2017] [Accepted: 12/15/2017] [Indexed: 11/19/2022]
Abstract
The clinical effect of prednisone in metastatic castration-resistant prostate cancer (mCRPC) is unknown. We performed a pooled analysis of control arms of randomized controlled trials that had or had not administered single-agent prednisone. Randomized controlled trials with a control arm that included single-agent placebo (or no anticancer therapy) or single-agent prednisone (with or without placebo) were eligible for analysis. Patients receiving prednisone combined with other agents in the control arm were excluded. The trial characteristics, baseline demographic data, overall survival (OS), progression-free survival (PFS), prostate-specific antigen (PSA) response, Response Evaluation Criteria In Solid Tumors response, and toxicities were recorded. The effect of prednisone was investigated for significance in bivariate models, adjusting for age, pre- and post-docetaxel status, Eastern Cooperative Oncology Group performance status, and trial publication year. Eighteen trials were included; 9 had control arms that contained prednisone (n = 2831) and 9 did not (n = 2784). No significant differences were identified for OS or toxicities of any grade. A significantly greater PSA response rate (18.8% vs. 2.5%; P = .023) and a trend toward more frequent grade ≥ 3 fluid retention (1.0% vs. 0.4%; P = .097) was seen in the prednisone group. Prednisone was also significantly associated with PFS after adjusting for docetaxel status. Single-agent prednisone for mCRPC did not improve OS but was associated with a greater PSA response rate and PFS. Overall and grade ≥ 3 toxicities were not significantly different with prednisone. With the exception of concurrent use with abiraterone or for palliative purposes, the routine use of prednisone for mCRPC appears unnecessary.
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24
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Sonpavde G, Madan A, Baker MK, May JE, Naik G, Bae S. Prevalence of Measurable Disease in Metastatic Castration-resistant Prostate Cancer. Clin Genitourin Cancer 2017; 15:534-539. [PMID: 28526418 DOI: 10.1016/j.clgc.2017.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 04/11/2017] [Accepted: 04/14/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Because of the low historical prevalence of measurable disease in metastatic castration-resistant prostate cancer (mCRPC), phase II trials have used prostate-specific antigen (PSA) and bone scan changes as primary end points. Frequent whole-body imaging and improved computed tomography technology currently identify measurable disease more frequently, warranting consideration of objective response as a major end point. PATIENTS AND METHODS Data from reported phase III trials of mCRPC were analyzed. The proportion of patients with measurable disease, setting (pre-docetaxel [D], D-based, post-D), year of starting accrual, PSA, and the requirement for symptoms were collected. The χ2 test was used to evaluate the association of variables with measurable disease rate. RESULTS Twenty phase III trials totaling 19,276 men with mCRPC were evaluable. Three trials (n = 1289) started accruing before 2000 and 17 trials (n = 17,987) accrued after 2000. The proportion of measurable disease rate for all trials was 47.5%. The measurable disease rate was significantly higher (P < .001) in trials that accrued after 2000 versus before 2000 (48.7% vs. 31.1%; P < .001), D-based (51.8%) or post-D patients (48.9%) compared with pre-D patients (38.6%) and in trials allowing symptomatic versus asymptomatic/minimally symptomatic patients (50.1% vs. 40.0%). CONCLUSION The proportion of men with measurable disease was significantly higher in phase III trials of mCRPC that accrued after 2000, in D-based or post-D patients and in trials that allowed symptomatic patients. Because of the association of objective measurable changes with survival, Response Evaluation Criteria in Solid Tumors changes might warrant consideration as a major end point in phase II trials to obtain a firm signal of efficacy before launching phase III trials.
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Affiliation(s)
- Guru Sonpavde
- University of Alabama, Birmingham, School of Medicine, Birmingham, AL.
| | - Ankit Madan
- University of Alabama, Birmingham, School of Medicine, Birmingham, AL
| | - Mary K Baker
- University of Alabama, Birmingham, School of Medicine, Birmingham, AL
| | - Jori E May
- University of Alabama, Birmingham, School of Medicine, Birmingham, AL
| | - Gurudatta Naik
- University of Alabama, Birmingham, School of Medicine, Birmingham, AL
| | - Sejong Bae
- University of Alabama, Birmingham, School of Medicine, Birmingham, AL
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25
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Pan Y, Hu C, Chen PH, Gu YH, Qiao QY, Pan LH, Zhou DC, Gu HF, Fu SK, Jin HM. Association of oral endothelin receptor antagonists with risks of cardiovascular events and mortality: meta-analysis of randomized controlled trials. Eur J Clin Pharmacol 2016; 73:267-278. [PMID: 27957707 DOI: 10.1007/s00228-016-2171-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 11/30/2016] [Indexed: 10/24/2022]
Abstract
BACKGROUND Endothelin receptor antagonists (ERAs) are widely used in a variety of disorders, including pulmonary artery hypertension, systemic sclerosis, diabetic and kidney diseases, and several tumors. However, reported adverse events, especially increased risks of cardiovascular disease (CVD) morbidity and mortality, have cast doubt on their potential clinical application. Therefore, we conducted this meta-analysis to confirm whether ERAs increased CVD risk and mortality. METHODS We systematically searched PubMed (1966-2015), EMBASE (1974-2015), ClinicalTrials.gov, and the Cochrane Controlled Clinical Trials Register Database for randomized controlled trials published between Jan 1, 1990 and Mar 18, 2015. Inclusion criteria included a study duration of more than 3 weeks, the use of a randomized control group receiving an oral ERA or placebo, and the availability of outcome data for cardiovascular events and all-cause death. RESULTS A total of 33 trials met the inclusion criteria. There were 8098 cases in the ERA group and 5074 cases in the placebo group. Compared with the control group, the risk ratio (RR) for all-cause death in the ERA group was 0.983 [95% confidence interval (CI), 0.883 to 1.094, P = 0.754]. The summary RR for cardiovascular events was 1.651 in the ERA group (95% CI, 1.164 to 2.34, P = 0.005). The pooled results showed that ERAs treatment could lead to more edema, anemia, and abnormal transaminase levels. Also, there was an increased proportion of discontinued therapy in the ERA treatment because of side effects (RR = 1.322, 95% CI, 1.036 to 1.686, P = 0.025). There were no significant differences in the experienced episodes of headache and dyspnea between the active therapy and control groups. CONCLUSIONS ERAs therapy is not significantly associated with increased all-cause death, but there are more cardiovascular events and edema or fluid retention, anemia, and liver enzymes disorder. Large clinical randomized controlled studies are needed to further confirm the safety of the clinical application of ERAs.
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Affiliation(s)
- Yu Pan
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Chun Hu
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Pei Hua Chen
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yan Hong Gu
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai, 201399, China
| | - Qing Yan Qiao
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai, 201399, China
| | - Li Hua Pan
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai, 201399, China
| | - Dong Chi Zhou
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai, 201399, China
| | - Hui Fang Gu
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai, 201399, China
| | - Shun Kun Fu
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai, 201399, China
| | - Hui Min Jin
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai, 201399, China.
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26
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Assessment of quality of life in advanced, metastatic prostate cancer: an overview of randomized phase III trials. Qual Life Res 2016; 26:813-822. [DOI: 10.1007/s11136-016-1429-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2016] [Indexed: 11/12/2022]
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27
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Tsuzuki S, Park SH, Eber MR, Peters CM, Shiozawa Y. Skeletal complications in cancer patients with bone metastases. Int J Urol 2016; 23:825-832. [PMID: 27488133 DOI: 10.1111/iju.13170] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 06/07/2016] [Indexed: 12/13/2022]
Abstract
As a result of significant improvements in current therapies, the life expectancy of cancer patients with bone metastases has dramatically improved. Unfortunately, these patients often experience skeletal complications that significantly impair their quality of life. The major skeletal complications associated with bone metastases include: cancer-induced bone pain, hypercalcemia, pathological bone fractures, metastatic epidural spinal cord compression and cancer cachexia. Once cancer cells invade the bone, they perturb the normal physiology of the marrow microenvironment, resulting in bone destruction, which is believed to be a direct cause of skeletal complications. However, full understanding of the mechanisms responsible for these complications remains unknown. In the present review, we discuss the complications associated with bone metastases along with matched conventional therapeutic strategies. A better understanding of this topic is crucial, as targeting skeletal complications can improve both the morbidity and mortality of patients suffering from bone metastases.
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Affiliation(s)
- Shunsuke Tsuzuki
- Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sun Hee Park
- Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Matthew R Eber
- Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Christopher M Peters
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Yusuke Shiozawa
- Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
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28
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Aubert JD, Juillerat-Jeanneret L. Endothelin-Receptor Antagonists beyond Pulmonary Arterial Hypertension: Cancer and Fibrosis. J Med Chem 2016; 59:8168-88. [PMID: 27266371 DOI: 10.1021/acs.jmedchem.5b01781] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The endothelin axis and in particular the two endothelin receptors, ETA and ETB, are targets for therapeutic intervention in human diseases. Endothelin-receptor antagonists are in clinical use to treat pulmonary arterial hypertension and have been under clinical investigation for the treatment of several other diseases, such as systemic hypertension, cancer, vasospasm, and fibrogenic diseases. In this Perspective, we review the molecules that have been evaluated in human clinical trials for the treatment of pulmonary arterial hypertension, as well as other cardiovascular diseases, cancer, and fibrosis. We will also discuss the therapeutic consequences of receptor selectivity with regard to ETA-selective, ETB-selective, or dual ETA/ETB antagonists. We will also consider which chemical characteristics are relevant to clinical use and the properties of molecules necessary for efficacy in treating diseases against which known molecules displayed suboptimal efficacy.
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Affiliation(s)
- John-David Aubert
- Pneumology Division and Transplantation Center, Centre Hospitalier Universitaire Vaudois (CHUV) , CH1011 Lausanne, Switzerland
| | - Lucienne Juillerat-Jeanneret
- University Institute of Pathology and Transplantation Center, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne (UNIL), CH1011 Lausanne, Switzerland
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29
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Davenport AP, Hyndman KA, Dhaun N, Southan C, Kohan DE, Pollock JS, Pollock DM, Webb DJ, Maguire JJ. Endothelin. Pharmacol Rev 2016; 68:357-418. [PMID: 26956245 PMCID: PMC4815360 DOI: 10.1124/pr.115.011833] [Citation(s) in RCA: 502] [Impact Index Per Article: 62.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The endothelins comprise three structurally similar 21-amino acid peptides. Endothelin-1 and -2 activate two G-protein coupled receptors, ETA and ETB, with equal affinity, whereas endothelin-3 has a lower affinity for the ETA subtype. Genes encoding the peptides are present only among vertebrates. The ligand-receptor signaling pathway is a vertebrate innovation and may reflect the evolution of endothelin-1 as the most potent vasoconstrictor in the human cardiovascular system with remarkably long lasting action. Highly selective peptide ETA and ETB antagonists and ETB agonists together with radiolabeled analogs have accurately delineated endothelin pharmacology in humans and animal models, although surprisingly no ETA agonist has been discovered. ET antagonists (bosentan, ambrisentan) have revolutionized the treatment of pulmonary arterial hypertension, with the next generation of antagonists exhibiting improved efficacy (macitentan). Clinical trials continue to explore new applications, particularly in renal failure and for reducing proteinuria in diabetic nephropathy. Translational studies suggest a potential benefit of ETB agonists in chemotherapy and neuroprotection. However, demonstrating clinical efficacy of combined inhibitors of the endothelin converting enzyme and neutral endopeptidase has proved elusive. Over 28 genetic modifications have been made to the ET system in mice through global or cell-specific knockouts, knock ins, or alterations in gene expression of endothelin ligands or their target receptors. These studies have identified key roles for the endothelin isoforms and new therapeutic targets in development, fluid-electrolyte homeostasis, and cardiovascular and neuronal function. For the future, novel pharmacological strategies are emerging via small molecule epigenetic modulators, biologicals such as ETB monoclonal antibodies and the potential of signaling pathway biased agonists and antagonists.
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Affiliation(s)
- Anthony P Davenport
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
| | - Kelly A Hyndman
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
| | - Neeraj Dhaun
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
| | - Christopher Southan
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
| | - Donald E Kohan
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
| | - Jennifer S Pollock
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
| | - David M Pollock
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
| | - David J Webb
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
| | - Janet J Maguire
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (A.P.D., J.J.M.); IUPHAR/BPS Guide to PHARMACOLOGY, Centre for Integrative Physiology, University of Edinburgh, Hugh Robson Building, Edinburgh, United Kingdom (C.S.); Division of Nephrology, University of Utah Health Sciences Center, Salt Lake City, Utah (D.E.K.); Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (K.A.H., J.S.P., D.M.P.); and Department of Renal Medicine, Royal Infirmary of Edinburgh (N.D.) and University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute (D.J.W.N.D.), Edinburgh, Scotland, United Kingdom
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30
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Vignani F, Bertaglia V, Buttigliero C, Tucci M, Scagliotti GV, Di Maio M. Skeletal metastases and impact of anticancer and bone-targeted agents in patients with castration-resistant prostate cancer. Cancer Treat Rev 2016; 44:61-73. [PMID: 26907461 DOI: 10.1016/j.ctrv.2016.02.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 02/03/2016] [Accepted: 02/05/2016] [Indexed: 12/27/2022]
Abstract
Incidence of bone metastases is very high in advanced prostate cancer patients. Bone metastases likely have a significant impact on functional status and quality of life, not only related to pain, but also to the relevant risk of skeletal-related events. A better understanding of mechanisms associated with bone metastatic disease secondary to prostate cancer and more specifically to the cross-talk between tumor cells and bone microenvironment in metastatic progression represented the background for the development of new effective bone-targeted therapies. Furthermore, a better knowledge of biological mechanisms driving disease progression led to significant advances in the treatment of castration-resistant prostate cancer, with the development and approval of new effective drugs. Aim of this review is to outline the physiopathology of bone metastases in prostate cancer and summarize the main results of clinical trials conducted with different drugs to control morbidity induced by skeletal metastases and bone disease progression. For each agent, therapeutic effect on bone metastases has been measured in terms of pain control and/or incidence of skeletal-related events, usually defined as a composite endpoint, including the need for local treatment (radiation therapy or surgery), spinal cord compression, pathological bone fractures. In details, data obtained with chemotherapy (mitoxantrone, docetaxel, cabazitaxel), new generation hormonal agents (abiraterone, enzalutamide), radium-223, bone-targeted agents (zoledronic acid, denosumab) and with several experimental agents (cabozantinib, dasatinib, anti-endothelin and other agents) in patients with castration-resistant prostate cancer are reviewed.
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Affiliation(s)
- Francesca Vignani
- Division of Medical Oncology, Department of Oncology, University of Turin at San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Valentina Bertaglia
- Division of Medical Oncology, Department of Oncology, University of Turin at San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Consuelo Buttigliero
- Division of Medical Oncology, Department of Oncology, University of Turin at San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Marcello Tucci
- Division of Medical Oncology, Department of Oncology, University of Turin at San Luigi Gonzaga Hospital, Orbassano, Turin, Italy.
| | - Giorgio V Scagliotti
- Division of Medical Oncology, Department of Oncology, University of Turin at San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Massimo Di Maio
- Division of Medical Oncology, Department of Oncology, University of Turin at San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
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31
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Hussain M, DiPaola RS. Clinical research in metastatic prostate cancer: a focus on impact and value. Am Soc Clin Oncol Educ Book 2016:17-21. [PMID: 25993136 DOI: 10.14694/edbook_am.2015.35.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
KEY POINTS Several therapies targeting the androgen receptor and other pathways have improved survival and quality of life for patients with metastatic prostate cancer. Many costly therapeutic clinical trial efforts have failed to improve outcomes. Prostate cancer is a complex disease. Its biologic heterogeneity warrants that future clinical trials be carefully designed to achieve higher levels of clinical impact by attention to targeting more critical pathways; integrating improved diagnostics; well-designed and powered clinical trials using multi-targeted strategies; and optimized timing of therapy.
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Affiliation(s)
- Maha Hussain
- From the University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Robert S DiPaola
- From the University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
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Hiraga T. Targeted Agents in Preclinical and Early Clinical Development for the Treatment of Cancer Bone Metastases. Expert Opin Investig Drugs 2016; 25:319-34. [DOI: 10.1517/13543784.2016.1142972] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
In the context of breast cancer, the importance of the skeleton in the regulation of primary tumour development and as a site for subsequent metastasis is well characterized. Our understanding of the contributions made by the host bone and bone marrow cells increasingly demonstrates the extent of the interaction between tumour cells and normal host cells. As a result, the need to develop and utilize therapies that can impede the growth and/or function of tumour cells while sparing normal host bone and bone marrow cells is immense and expanding. The need for these new treatments is, however, superimposed on the orthopaedic management of patients' quality of life, where pain control and continued locomotion are paramount. Indeed, the majority of the anticancer therapies used to date often result in direct or indirect damage to bone. Thus, although the bone microenvironment regulates tumour cell growth in bone, cells within the bone marrow niche also mediate many of the orthopaedic consequences of tumour progression as well as resistance to the antitumour effects of existing therapies. In this Review, we highlight the effects of existing cancer treatments on bone and the bone marrow microenvironment as well as the mechanisms mediating these effects and the current utility of modern orthopaedic interventions.
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Affiliation(s)
- Issam Makhoul
- Department of Medicine, Division of Haematology/Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Corey O Montgomery
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Dana Gaddy
- Department of Physiology and Biophysics, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Larry J Suva
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
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Massari F, Modena A, Ciccarese C, Pilotto S, Maines F, Bracarda S, Sperduti I, Giannarelli D, Carlini P, Santini D, Tortora G, Porta C, Bria E. Addressing the expected survival benefit for clinical trial design in metastatic castration-resistant prostate cancer: Sensitivity analysis of randomized trials. Crit Rev Oncol Hematol 2015; 98:254-63. [PMID: 26638863 DOI: 10.1016/j.critrevonc.2015.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/25/2015] [Accepted: 11/12/2015] [Indexed: 11/28/2022] Open
Abstract
We performed a sensitivity analysis, cumulating all randomized clinical trials (RCTs) in which patients with metastatic castration-resistant prostate cancer (mCRPC) received systemic therapy, to evaluate if the comparison of RCTs may drive to biased survival estimations. An overall survival (OS) significant difference according to therapeutic strategy was more likely be determined in RCTs evaluating hormonal drugs versus those studies testing immunotherapy, chemotherapy or other strategies. With regard to control arm, an OS significant effect was found for placebo-controlled trials versus studies comparing experimental treatment with active therapies. Finally, regarding to docetaxel (DOC) timing, the OS benefit was more likely to be proved in Post-DOC setting in comparison with DOC and Pre-DOC. These data suggest that clinical trial design should take into account new benchmarks such as the type of treatment strategy, the choice of the comparator and the phase of the disease in relation to the administration of standard chemotherapy.
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Affiliation(s)
- Francesco Massari
- Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Alessandra Modena
- Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Chiara Ciccarese
- Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Sara Pilotto
- Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | | | - Sergio Bracarda
- Medical Oncology, Ospedale San Donato, Istituto Toscano Tumori, Arezzo, Italy.
| | | | | | - Paolo Carlini
- Medical Oncology, Regina Elena National Cancer Institute, Roma, Italy.
| | - Daniele Santini
- Medical Oncology, Policlinico Universitario Campus Bio-Medico, Roma, Italy.
| | - Giampaolo Tortora
- Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Camillo Porta
- Medical Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Emilio Bria
- Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
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Hathaway AR, Baker MK, Sonpavde G. Emerging agents for the therapy of advanced prostate cancer. Future Oncol 2015; 11:2775-87. [DOI: 10.2217/fon.15.224] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Since 2010, multiple advances have been made in the field of metastatic castration-resistant prostate cancer including regulatory approvals for five new agents including androgen pathway inhibitors (enzalutamide, abiraterone acetate), immunotherapy (sipuleucel-T), cytotoxic chemotherapy (cabazitaxel) and radiopharmaceuticals (radium-223) that have improved overall survival in this patient population. Despite these advances, each therapy has only extended median survival by 3–5 months and data suggest substantial cross-resistance among them. Given these modest increments, there is a major role for the vigorous investigation of new drugs and predictive biomarkers to select suitable patients who will benefit from them. This review describes emerging promising agents and their ongoing clinical development.
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Affiliation(s)
- Amanda R Hathaway
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL, USA
| | - Mary Katherine Baker
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL, USA
| | - Guru Sonpavde
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL, USA
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Schmid S, Omlin A, Blum D, Strasser F, Gillessen S, Rothermundt C. Assessment of anticancer-treatment outcome in patients with metastatic castration-resistant prostate cancer-going beyond PSA and imaging, a systematic literature review. Ann Oncol 2015. [PMID: 26216388 DOI: 10.1093/annonc/mdv326] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In the past years, there has been significant progress in anticancer drug development for patients with metastatic castration-resistant prostate cancer (CRPC). However, the current instruments to assess clinical treatment response have limitations and may not sufficiently reflect patient benefit. Our objective was to systematically identify tools to evaluate both patient benefit and clinical anticancer-treatment response as basis for an international consensus process and development of a specific pragmatic instrument for men with CRPC. METHODS PubMed, Embase and CINAHL were searched to identify currently available tools to assess anticancer-treatment benefit, other than standard imaging procedures and prostate-specific antigen measurements, namely quality of life (QoL), detailed pain assessment, physical function and objective measures of other complex cancer-related syndromes in patients with CRPC. Additionally, all CRPC phase III trials published in the last 5 years were reviewed as well as studies using physical function tools in a general cancer population. The PRIMSA statement was followed for the systematic review process. RESULTS The search generated 1096 hits, 185 full-text papers were screened and finally 73 publications were included. Additional 89 publications were included by hand-search. We identified a total of 98 tools used in CRPC trials and grouped these into three categories: 22 tools assessing QoL domains and subgroups, 47 tools for pain assessment and 29 tools for objective measures, mainly physical function and assessment of skeletal disease burden. CONCLUSION A wide variety of assessment tools and also efforts to standardize and harmonize patient-reported outcomes and pain assessment were identified. However, the specific needs of the increasing CRPC population living longer with their incurable cancer are insufficiently captured and objective physical outcome measures are under-represented. In the age of new anticancer drug targets and principles, new methods to monitor patient relevant outcomes of antineoplastic therapy are of utmost importance.
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Affiliation(s)
- S Schmid
- Division of Oncology and Haematology, Division of Oncology and Palliative Centre, Cantonal Hospital St Gallen, St Gallen,Switzerland
| | - A Omlin
- Division of Oncology and Haematology, Division of Oncology and Palliative Centre, Cantonal Hospital St Gallen, St Gallen,Switzerland
| | - D Blum
- Division of Oncological Palliative Medicine, Division of Oncology and Palliative Centre, Cantonal Hospital St Gallen, St Gallen,Switzerland
| | - F Strasser
- Division of Oncology and Haematology, Division of Oncology and Palliative Centre, Cantonal Hospital St Gallen, St Gallen,Switzerland Division of Oncological Palliative Medicine, Division of Oncology and Palliative Centre, Cantonal Hospital St Gallen, St Gallen,Switzerland
| | - S Gillessen
- Division of Oncology and Haematology, Division of Oncology and Palliative Centre, Cantonal Hospital St Gallen, St Gallen,Switzerland
| | - C Rothermundt
- Division of Oncology and Haematology, Division of Oncology and Palliative Centre, Cantonal Hospital St Gallen, St Gallen,Switzerland
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Qi P, Chen M, Zhang LX, Song RX, He ZH, Wang ZP. A Meta-Analysis and Indirect Comparison of Endothelin A Receptor Antagonist for Castration-Resistant Prostate Cancer. PLoS One 2015; 10:e0133803. [PMID: 26192308 PMCID: PMC4508042 DOI: 10.1371/journal.pone.0133803] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/30/2015] [Indexed: 01/08/2023] Open
Abstract
Background Endothelin A (ET-A) receptor antagonists including zibotentan and atrasentan, have been suggested as a treatment for castration-resistant prostate cancer (CRPC). Our aim was to conduct a meta-analysis and indirect comparison to assess the efficacy and safety of ET-A receptor antagonists for treatment of CRPC. Methods We systematically searched PubMed, EMBASE, the Cochrane Library, and Web of Science from inception to November 2014 to identify randomized controlled trials (RCTs) which assessed ET-A receptor antagonists for treatment of CRPC. Meta-analysis was conducted by STATA version 12.0 software. Results Eight RCTs were identified, involving 6,065 patients. The results of direct comparison showed that compared with placebo, there was no statistically significant difference in the improvement of progression-free survival (PFS), overall survival (OS), time to disease progression (TTP), and total adverse events (AEs) with ET-A receptor antagonist treatment for CRPC. The results of ET-A receptor antagonists plus docetaxel versus docetaxel alone were similar. The indirect comparisons showed that there were no significant differences between zibotentan plus docetaxel versus atrasentan plus docetaxel when compared with docetaxel alone or zibotentan versus atrasenta compared with placebo in the improvement of PFS, OS, TTP, and total adverse events. Conclusions There were no significant benefits for ET-A receptor antagonists with or without docetaxel in the improvement of PFS, OS, TTP, and overall AEs. And there were no significant differences between zibotentan and atrasentan. Single-agent docetaxel should remain as one of the standard treatments.
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Affiliation(s)
- Ping Qi
- Institute of Urology, The Second Hospital of Lanzhou University, Lanzhou 730030, China
- Department of Clinical Laboratory, The Second Hospital of Lanzhou University, Lanzhou 730030, China
| | - Ming Chen
- Department of Urology, GanSu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
| | - Li-xiu Zhang
- Institute of Urology, The Second Hospital of Lanzhou University, Lanzhou 730030, China
| | - Rui-xia Song
- Institute of Urology, The Second Hospital of Lanzhou University, Lanzhou 730030, China
- Key Laboratory of Urological Diseases in Gansu Province, Lanzhou 730030, China
| | - Zhen-hua He
- Institute of Urology, The Second Hospital of Lanzhou University, Lanzhou 730030, China
- Department of Neurosurgery, The Second Hospital of Lanzhou University, Lanzhou 730030, China
| | - Zhi-ping Wang
- Institute of Urology, The Second Hospital of Lanzhou University, Lanzhou 730030, China
- Key Laboratory of Urological Diseases in Gansu Province, Lanzhou 730030, China
- * E-mail:
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Carducci MA, Manola J, Nair SG, Liu G, Rousey S, Dutcher JP, Wilding G. Atrasentan in Patients With Advanced Renal Cell Carcinoma: A Phase 2 Trial of the ECOG-ACRIN Cancer Research Group (E6800). Clin Genitourin Cancer 2015; 13:531-539.e1. [PMID: 26272427 DOI: 10.1016/j.clgc.2015.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/08/2015] [Accepted: 07/11/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Atrasentan, an oral endothelin receptor A antagonist, demonstrated phase 1 activity in patients with renal cell carcinoma (RCC). A phase 2 study was undertaken in patients with measurable or bone-only metastatic RCC in the pre-VEGF/TKI era. METHODS AND MATERIALS Patients were stratified by disease status and prior immunotherapy. Eligible patients had no prior chemotherapy, 0 to 1 prior immunotherapies, and an Eastern Cooperative Oncology Group performance status of 0 to 2. Patients received atrasentan 10 mg per day until progression. The primary end point was progression-free (PF) rate at 6 months. Rates of 25% among patients treated with prior immunotherapy and 45% among patients with no prior immunotherapy were considered promising. A 2-stage design was used for cohorts without prior immunotherapy. RESULTS From 2003 to 2005, 98 patients were registered. Median treatment duration was 9.9 weeks (range, 0.3-107 weeks). Toxicities were mild; 71% of patients reported no grade 3 or higher treatment-related events. Grade 4 events included neutropenia (n = 3), dyspnea (n = 2), thrombosis (n = 1), and arrhythmia (n = 1). Two grade 5 events (dyspnea and constitutional) were possibly treatment related. Six-month PF rates (90% confidence interval) were 14% (6-25), 0% (0-39), 8% (1-23), and 22% (8-44), respectively, for patients with prior immunotherapy/measurable disease (n = 44), prior immunotherapy/bone metastases (n = 6), no prior immunotherapy/measurable disease (n = 25), and no prior immunotherapy/bone metastases (n = 18). Median PF survival was 2.3 months (95% confidence interval, 2.0-3.5 months). CONCLUSION Although well tolerated, atrasentan did not yield 6-month PF rates supporting its use as first-line monotherapy in patients with advanced RCC.
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Affiliation(s)
| | - Judith Manola
- Department of Biostatistics & Computational Biology, Dana-Farber Cancer Institute, Boston, MA.
| | - Suresh G Nair
- Hematology/Oncology Associates, Lehigh Valley Hospital-Cedar Crest, Allentown, PA
| | - Glenn Liu
- University of Wisconsin Carbone Cancer Center, Wisconsin Institute for Medical Research, Madison, WI
| | | | - Janice P Dutcher
- Our Lady of Mercy Cancer Center, New York Medical College, Bronx, NY
| | - George Wilding
- University of Wisconsin Carbone Cancer Center, Madison, WI
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Rachner TD, Jakob F, Hofbauer LC. Cancer-targeted therapies and radiopharmaceuticals. BONEKEY REPORTS 2015; 4:707. [PMID: 26131359 DOI: 10.1038/bonekey.2015.76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 04/16/2015] [Indexed: 12/26/2022]
Abstract
The treatment of bone metastases remains a clinical challenge. Although a number of well-established agents, namely bisphosphonates and denosumab, are available to reduce the occurrence of skeletal-related events, additional cancer-targeted therapies are required to improve patients' prognosis and quality of life. This review focuses on novel targets and agents that are under clinical evaluation for the treatment of malignant bone diseases such as activin A, src and endothelin-1 inhibition or agents that are clinically approved and may positively influence bone, such as the mTOR inhibitor everolimus. In addition, the potential of alpharadin, a novel radiopharmaceutical approved for the treatment of prostatic bone disease, is discussed.
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Affiliation(s)
- Tilman D Rachner
- Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine III, Dresden University Medical Center , Dresden, Germany
| | - Franz Jakob
- Orthopedic Center for Musculoskeletal Research, University Hospital Wuerzburg , Wuerzburg, Germany
| | - Lorenz C Hofbauer
- Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine III, Dresden University Medical Center , Dresden, Germany ; Center for Regenerative Therapies, Dresden Technical University , Dresden, Germany
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Wyatt AW, Gleave ME. Targeting the adaptive molecular landscape of castration-resistant prostate cancer. EMBO Mol Med 2015; 7:878-94. [PMID: 25896606 PMCID: PMC4520654 DOI: 10.15252/emmm.201303701] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 03/12/2015] [Accepted: 03/26/2015] [Indexed: 12/19/2022] Open
Abstract
Castration and androgen receptor (AR) pathway inhibitors induce profound and sustained responses in advanced prostate cancer. However, the inevitable recurrence is associated with reactivation of the AR and progression to a more aggressive phenotype termed castration-resistant prostate cancer (CRPC). AR reactivation can occur directly through genomic modification of the AR gene, or indirectly via co-factor and co-chaperone deregulation. This mechanistic heterogeneity is further complicated by the stress-driven induction of a myriad of overlapping cellular survival pathways. In this review, we describe the heterogeneous and evolvable molecular landscape of CRPC and explore recent successes and failures of therapeutic strategies designed to target AR reactivation and adaptive survival pathways. We also discuss exciting areas of burgeoning anti-tumour research, and their potential to improve the survival and management of patients with CRPC.
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Affiliation(s)
- Alexander W Wyatt
- Vancouver Prostate Centre & Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Martin E Gleave
- Vancouver Prostate Centre & Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
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Pantano F, Iuliani M, Zoccoli A, Fioramonti M, De Lisi D, Fioroni I, Ribelli G, Santoni M, Vincenzi B, Tonini G, Santini D. Emerging drugs for the treatment of bone metastasis. Expert Opin Emerg Drugs 2015; 20:637-51. [PMID: 26113304 DOI: 10.1517/14728214.2015.1062876] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Bone metastases are virtually incurable resulting in significant disease morbidity, reduced quality of life and mortality. Bone provides a unique microenvironment whose local interactions with tumor cells offer novel targets for therapeutic interventions. Increased understanding of the pathogenesis of bone disease has led to the discovery and clinical utility of bone-targeted agents other than bisphosphonates and denosumab, currently, the standard of care in this setting. AREAS COVERED In this review, we present the recent advances in molecular targeted therapies focusing on therapies that inhibit bone resorption and/or stimulate bone formation and novel anti-tumoral agents that exerts significant effects on skeletal metastases, nowadays available in clinical practice or in phase of development. EXPERT OPINION New emergent bone target therapies radium-223, mTOR inhibitors, anti-androgens have demonstrated the ability to increase overall survival in bone metastatic patients, other compounds, such as ET-1 and SRC inhibitors, up to now failed to clearly confirm in clinical trials their promising preclinical data.
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Affiliation(s)
- Francesco Pantano
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Michele Iuliani
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Alice Zoccoli
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Marco Fioramonti
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Delia De Lisi
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Iacopo Fioroni
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Giulia Ribelli
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Matteo Santoni
- b 2 Università Politecnica delle Marche, AOU Ospedali Riuniti, Medical Oncology Department , Ancona, Italy
| | - Bruno Vincenzi
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Giuseppe Tonini
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
| | - Daniele Santini
- a 1 Campus Bio-Medico University of Rome, Medical Oncology Department , Via Alvaro del Portillo 200, 00128 Rome, Italy +39 062 254 191 17 ; +39 062 254 119 33;
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Abstract
Bone metastases develop in most patients with metastatic castration-resistant prostate cancer (mCRPC). They affect the structural integrity of bone, manifesting as pain and skeletal-related events (SREs), and are the primary cause of patient disability, reduced quality of life (QOL) and death. Understanding the pathophysiology of bone metastases resulted in the development of agents that improve clinical outcome, suggesting that managing both the systemic disease and associated bone events is important. Historically, the treatment of CRPC bone metastases with early radiopharmaceuticals and external beam radiation therapy was largely supportive; however, now, zoledronic acid and denosumab are integral to the therapeutic strategy for mCRPC. These agents substantially reduce skeletal morbidity and improve patient QOL. Radium-223 dichloride is the first bone-targeting agent to show improved survival and reduced pain and symptomatic skeletal events in patients with mCRPC without visceral disease. Five other systemic agents are currently approved for use in mCRPC based on their ability to improve survival. These include the cytotoxic drugs docetaxel and cabazitaxel, the hormone-based therapies, abiraterone and enzalutamide, and the immunotherapeutic vaccine sipuleucel-T. Abiraterone and enzalutamide are able to reduce SREs and improve survival in this setting. Novel agents targeting tumour and bone cells are under clinical development.
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Vlachostergios PJ, Papandreou CN. Targeting neuroendocrine prostate cancer: molecular and clinical perspectives. Front Oncol 2015; 5:6. [PMID: 25699233 PMCID: PMC4313607 DOI: 10.3389/fonc.2015.00006] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 01/09/2015] [Indexed: 11/18/2022] Open
Abstract
Neuroendocrine prostate carcinoma, either co-present with the local adenocarcinoma disease or as a result of transdifferentiation later in time, was described as one major process of emerging resistance to androgen deprivation therapies, and at the clinical level it is consistent with the development of rapidly progressive visceral disease, often in the absence of elevated serum prostate-specific antigen level. Until present, platinum-based chemotherapy has been the only treatment modality, able to produce a fair amount of responses but of short duration. Recently, several efforts for molecular characterization of this lethal phenotype have resulted in identification of novel signaling factors involved in microenvironment interactions, mitosis, and neural reprograming as potential therapeutic targets. Ongoing clinical testing of specific inhibitors of these targets, for example, Aurora kinase A inhibitors, in carefully selected patients and exploitation of expression changes of the target before and after manipulation is anticipated to increase the existing data and facilitate therapeutic decision making at this late stage of the disease when hormonal manipulations, even with the newest androgen-directed therapies are no longer feasible.
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Affiliation(s)
| | - Christos N Papandreou
- Department of Medical Oncology, Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece
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Todenhöfer T, Stenzl A, Hofbauer LC, Rachner TD. Targeting bone metabolism in patients with advanced prostate cancer: current options and controversies. Int J Endocrinol 2015; 2015:838202. [PMID: 25802521 PMCID: PMC4329828 DOI: 10.1155/2015/838202] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 01/03/2015] [Indexed: 12/21/2022] Open
Abstract
Maintaining bone health remains a clinical challenge in patients with prostate cancer (PC) who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL), antiresorptive agents have been shown to improve bone mineral density (BMD) and to reduce the risk of fractures. For patients with bone metastases, both zoledronic acid and denosumab delay skeletal related events (SREs) in the castration resistant stage of disease. Novel agents targeting the Wnt inhibitors dickkopf-1 and sclerostin are currently under investigation for the treatment of osteoporosis and malignant bone disease. New antineoplastic drugs such as abiraterone, enzalutamide, and Radium-223 are capable of further delaying SREs in patients with advanced PC. The benefit of antiresorptive treatment for patients with castration sensitive PC appears to be limited. Recent trials on the use of zoledronic acid for the prevention of bone metastases failed to be successful, whereas denosumab delayed the occurrence of bone metastases by a median of 4.1 months. Currently, the use of antiresorptive drugs to prevent bone metastases still remains a field of controversies and further trials are needed to identify patient subgroups that may profit from early therapy.
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Affiliation(s)
- Tilman Todenhöfer
- Department of Urology, University Hospital, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany
- Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver, BC, Canada V6H 3Z6
| | - Arnulf Stenzl
- Department of Urology, University Hospital, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany
| | - Lorenz C. Hofbauer
- Department of Medicine III, Technische Universität Dresden Medical Center, Fetscherstraße 74, 01307 Dresden, Germany
| | - Tilman D. Rachner
- Department of Medicine III, Technische Universität Dresden Medical Center, Fetscherstraße 74, 01307 Dresden, Germany
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Abstract
Due to the propensity of relapse and resistance with prolonged androgen deprivation therapy (ADT), there is a growing interest in developing non-hormonal therapeutic approaches as alternative treatment modalities for hormone refractory prostate cancer (HRPC). Although the standard treatment for HRPC consists of a combination of ADT with taxanes and anthracyclines, the clinical use of chemotherapeutics is limited by systemic toxicity stemming from nondiscriminatory drug exposure to normal tissues. In order to improve the tumor selectivity of chemotherapeutics, various targeted prodrug approaches have been explored. Antibody-directed enzyme prodrug therapy (ADEPT) and gene-directed enzyme prodrug therapy (GDEPT) strategies leverage tumor-specific antigens and transcription factors for the specific delivery of cytotoxic anticancer agents using various prodrug-activating enzymes. In prostate cancer, overexpression of tumor-specific proteases such as prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) is being exploited for selective activation of anticancer prodrugs designed to be activated through proteolysis by these prostate cancer-specific enzymes. PSMA- and PSA-activated prodrugs typically comprise an engineered high-specificity protease peptide substrate coupled to a potent cytotoxic agent via a linker for rapid release of cytotoxic species in the vicinity of prostate cancer cells following proteolytic cleavage. Over the past two decades, various such prodrugs have been developed and they were effective at inhibiting prostate tumor growth in rodent models; several of these prodrug approaches have been advanced to clinical trials and may be developed into effective therapies for HRPC.
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Affiliation(s)
- Herve Aloysius
- Department of Medicinal Chemistry, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854
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Fang J, Xu Q. Differences of osteoblastic bone metastases and osteolytic bone metastases in clinical features and molecular characteristics. Clin Transl Oncol 2014; 17:173-9. [DOI: 10.1007/s12094-014-1247-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/30/2014] [Indexed: 12/12/2022]
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Basch E, Loblaw DA, Oliver TK, Carducci M, Chen RC, Frame JN, Garrels K, Hotte S, Kattan MW, Raghavan D, Saad F, Taplin ME, Walker-Dilks C, Williams J, Winquist E, Bennett CL, Wootton T, Rumble RB, Dusetzina SB, Virgo KS. Systemic therapy in men with metastatic castration-resistant prostate cancer:American Society of Clinical Oncology and Cancer Care Ontario clinical practice guideline. J Clin Oncol 2014; 32:3436-48. [PMID: 25199761 PMCID: PMC4876355 DOI: 10.1200/jco.2013.54.8404] [Citation(s) in RCA: 179] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To provide treatment recommendations for men with metastatic castration-resistant prostate cancer (CRPC). METHODS The American Society of Clinical Oncology and Cancer Care Ontario convened an expert panel to develop evidence-based recommendations informed by a systematic review of the literature. RESULTS When added to androgen deprivation, therapies demonstrating improved survival, improved quality of life (QOL), and favorable benefit-harm balance include abiraterone acetate/prednisone, enzalutamide, and radium-223 ((223)Ra; for men with predominantly bone metastases). Improved survival and QOL with moderate toxicity risk are associated with docetaxel/prednisone. For asymptomatic/minimally symptomatic men, improved survival with unclear QOL impact and low toxicity are associated with sipuleucel-T. For men who previously received docetaxel, improved survival, unclear QOL impact, and moderate to high toxicity risk are associated with cabazitaxel/prednisone. Modest QOL benefit (without survival benefit) and high toxicity risk are associated with mitoxantrone/prednisone after docetaxel. No benefit and excess toxicity are observed with bevacizumab, estramustine, and sunitinib. RECOMMENDATIONS Continue androgen deprivation (pharmaceutical or surgical) indefinitely. Abiraterone acetate/prednisone, enzalutamide, or (223)Ra should be offered; docetaxel/prednisone should also be offered, accompanied by discussion of toxicity risk. Sipuleucel-T may be offered to asymptomatic/minimally symptomatic men. For men who have experienced progression with docetaxel, cabazitaxel may be offered, accompanied by discussion of toxicity risk. Mitoxantrone may be offered, accompanied by discussion of limited clinical benefit and toxicity risk. Ketoconazole or antiandrogens (eg, bicalutamide, flutamide, nilutamide) may be offered, accompanied by discussion of limited known clinical benefit. Bevacizumab, estramustine, and sunitinib should not be offered. There is insufficient evidence to evaluate optimal sequences or combinations of therapies. Palliative care should be offered to all patients.
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Affiliation(s)
- Ethan Basch
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - D Andrew Loblaw
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Thomas K Oliver
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Michael Carducci
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Ronald C Chen
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - James N Frame
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Kristina Garrels
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Sebastien Hotte
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Michael W Kattan
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Derek Raghavan
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Fred Saad
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Mary-Ellen Taplin
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Cindy Walker-Dilks
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - James Williams
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Eric Winquist
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Charles L Bennett
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Ted Wootton
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - R Bryan Rumble
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Stacie B Dusetzina
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Katherine S Virgo
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
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Kowalczyk A, Kleniewska P, Kolodziejczyk M, Skibska B, Goraca A. The role of endothelin-1 and endothelin receptor antagonists in inflammatory response and sepsis. Arch Immunol Ther Exp (Warsz) 2014; 63:41-52. [PMID: 25288367 PMCID: PMC4289534 DOI: 10.1007/s00005-014-0310-1] [Citation(s) in RCA: 171] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 07/18/2014] [Indexed: 12/12/2022]
Abstract
Endothelin-1 (ET-1) is a potent endogenous vasoconstrictor, mainly secreted by endothelial cells. It acts through two types of receptors: ETA and ETB. Apart from a vasoconstrictive action, ET-1 causes fibrosis of the vascular cells and stimulates production of reactive oxygen species. It is claimed that ET-1 induces proinflammatory mechanisms, increasing superoxide anion production and cytokine secretion. A recent study has shown that ET-1 is involved in the activation of transcription factors such as NF-κB and expression of proinflammatory cytokines including TNF-α, IL-1, and IL-6. It has been also indicated that during endotoxaemia, the plasma level of ET-1 is increased in various animal species. Some authors indicate a clear correlation between endothelin plasma level and morbidity/mortality rate in septic patients. These pathological effects of ET-1 may be abrogated at least partly by endothelin receptor blockade. ET-1 receptor antagonists may be useful for prevention of various vascular diseases. This review summarises the current knowledge regarding endothelin receptor antagonists and the role of ET-1 in sepsis and inflammation.
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Affiliation(s)
- Agata Kowalczyk
- Chair of Experimental and Clinical Physiology, Department of Cardiovascular Physiology, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland,
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Sfoungaristos S, Frank SJ, Duvdevani M, Gofrit ON, Yutkin V, Katz R, Pode D, Perimenis P. Contemporary pharmacotherapy for the prevention of skeletal complications in patients with prostate cancer. Expert Opin Pharmacother 2014; 15:2513-24. [PMID: 25234584 DOI: 10.1517/14656566.2014.960390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Bones represent the most common metastatic sites in prostate cancer (PCa) patients, and in addition with androgen deprivation therapy, they represent the causative reasons of bone mineral density loss and the onset of skeletal-related events. AREAS COVERED An extensive search of PubMed/Medline was performed to identify randomized, Phase II/III controlled trials reporting results regarding the prevention of skeletal morbidity in patients with PCa. EXPERT OPINION Preventing bone health is an imperative issue for preserving quality of life and elongate survival and, thus, a concerted effort should be made to monitor skeletal changes and to apply treatment for preventing bone loss. Although several agents have received approval for routine use, it is of paramount importance to identify the appropriate patients who would mostly be benefited by the use of these agents with attention to documenting the toxicity and economic implications. Additionally, it remains to be justified the frequency of administration in order to balance the efficacy and the potential complications.
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Affiliation(s)
- Stavros Sfoungaristos
- Hadassah University Hospital, the Hebrew University , Jerusalem, 91120 , Israel +972508946695 ;
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Wozney JL, Antonarakis ES. Growth factor and signaling pathways and their relevance to prostate cancer therapeutics. Cancer Metastasis Rev 2014; 33:581-94. [PMID: 24402967 PMCID: PMC4090293 DOI: 10.1007/s10555-013-9475-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Treatments that target the androgen axis represent an effective strategy for patients with advanced prostate cancer, but the disease remains incurable and new therapeutic approaches are necessary. Significant advances have recently occurred in our understanding of the growth factor and signaling pathways that are active in prostate cancer. In conjunction with this, many new targeted therapies with sound preclinical rationale have entered clinical development and are being tested in men with castration-resistant prostate cancer. Some of the most relevant pathways currently being exploited for therapeutic gain are HGF/c-Met signaling, the PI3K/AKT/mTOR pathway, Hedgehog signaling, the endothelin axis, Src kinase signaling, the IGF pathway, and angiogenesis. Here, we summarize the biological basis for the use of selected targeted agents and the results from available clinical trials of these drugs in men with prostate cancer.
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Affiliation(s)
- Jocelyn L. Wozney
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Emmanuel S. Antonarakis
- Prostate Cancer Research Program, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, CRB1-1 M45, 1650 Orleans St., Baltimore, MD 21231, USA
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