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Malone S, Wallis CJD, Lee‐Ying R, Basappa NS, Cagiannos I, Hamilton RJ, Fernandes R, Ferrario C, Gotto GT, Morgan SC, Morash C, Niazi T, Noonan KL, Rendon R, Hotte SJ, Saad F, Zardan A, Osborne B, Chan KFY, Shayegan B. Patterns of care for non‐metastatic castration‐resistant prostate cancer: A population‐based study. BJUI COMPASS 2022; 3:383-391. [PMID: 35950037 PMCID: PMC9349587 DOI: 10.1002/bco2.158] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/28/2022] [Accepted: 04/17/2022] [Indexed: 01/27/2023] Open
Abstract
Objectives To describe patterns of practice of PSA testing and imaging for Ontario men receiving continuous ADT for the treatment of non‐metastatic castration‐resistant prostate cancer (nmCRPC). Patients and Methods This was a retrospective, longitudinal, population‐based study of administrative health data from 2008 to 2019. Men 65 years and older receiving continuous androgen deprivation therapy (ADT) with documented CRPC were included. An administrative proxy definition was applied to capture patients with nmCRPC and excluded those with metastatic disease. Patients were indexed upon progression to CRPC and were followed until death or end of study period to assess frequency of monitoring with PSA tests and conventional imaging. A 2‐year look‐back window was used to assess patterns of care leading up to CRPC as well as baseline covariates. Results At a median follow‐up of 40.1 months, 944 patients with nmCRPC were identified. Their median time from initiation of continuous ADT to CRPC was 26.0 months. 60.7% of patients had their PSA measured twice or fewer in the year prior to index, and 70.7% patients did not receive any imaging in the year following progression to CRPC. Throughout the study period, 921/944 (97.6%) patients with CRPC progressed to high‐risk (HR‐CRPC) with PSA doubling time ≤ 10 months, of which more than half received fewer than three PSA tests in the year prior to developing HR‐CRPC, and 30.9% received no imaging in the subsequent year. Conclusion PSA testing and imaging studies are underutilized in a real‐world setting for the management of nmCRPC, including those at high risk of developing metastatic disease. Infrequent monitoring impedes proper risk stratification, disease staging and detection of treatment failure and/or metastases, thereby delaying the necessary treatment intensification with life‐prolonging therapies. Adherence to guideline recommendations and the importance of timely staging should be reinforced to optimize patient outcomes.
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Affiliation(s)
- Shawn Malone
- The Ottawa Hospital University of Ottawa Ottawa Ontario Canada
| | | | | | - Naveen S. Basappa
- Cross Cancer Institute University of Alberta Edmonton Alberta Canada
| | - Ilias Cagiannos
- The Ottawa Hospital University of Ottawa Ottawa Ontario Canada
| | - Robert J. Hamilton
- Princess Margaret Cancer Centre University of Toronto Toronto Ontario Canada
| | - Ricardo Fernandes
- London Health Sciences Centre Western University London Ontario Canada
| | | | - Geoffrey T. Gotto
- Southern Alberta Institute of Urology University of Calgary Calgary Alberta Canada
| | - Scott C. Morgan
- The Ottawa Hospital University of Ottawa Ottawa Ontario Canada
| | | | - Tamim Niazi
- Jewish General Hospital McGill University Montreal Quebec Canada
| | - Krista L. Noonan
- BC Cancer Agency University of British Columbia Surrey British Columbia Canada
| | - Ricardo Rendon
- Queen Elizabeth II Health Sciences Centre Dalhousie University Halifax Nova Scotia Canada
| | | | - Fred Saad
- Centre Hospitalier de l'Université de Montréal University of Montreal Montreal Quebec Canada
| | | | | | | | - Bobby Shayegan
- St. Joseph's Healthcare McMaster University Hamilton Ontario Canada
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Söderdahl F, Xu LD, Bring J, Häggman M. A Novel Risk Score (P-score) Based on a Three-Gene Signature, for Estimating the Risk of Prostate Cancer-Specific Mortality. Res Rep Urol 2022; 14:203-217. [PMID: 35586706 PMCID: PMC9109804 DOI: 10.2147/rru.s358169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/30/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To develop and validate a risk score (P-score) algorithm which includes previously described three-gene signature and clinicopathological parameters to predict the risk of death from prostate cancer (PCa) in a retrospective cohort. Patients and Methods A total of 591 PCa patients diagnosed between 2003 and 2008 in Stockholm, Sweden, with a median clinical follow-up time of 7.6 years (1–11 years) were included in this study. Expression of a three-gene signature (IGFBP3, F3, VGLL3) was measured in formalin-fixed paraffin-embedded material from diagnostic core needle biopsies (CNB) of these patients. A point-based scoring system based on a Fine-Gray competing risk model was used to establish the P-score based on the three-gene signature combined with PSA value, Gleason score and tumor stage at diagnosis. The endpoint was PCa-specific mortality, while other causes of death were treated as a competing risk. Out of the 591 patients, 315 patients (estimation cohort) were selected to develop the P-score. The P-score was subsequently validated in an independent validation cohort of 276 patients. Results The P-score was established ranging from the integers 0 to 15. Each one-unit increase was associated with a hazard ratio of 1.39 (95% confidence interval: 1.27–1.51, p < 0.001). The P-score was validated and performed better in predicting PCa-specific mortality than both D’Amico (0.76 vs 0.70) and NCCN (0.76 vs 0.71) by using the concordance index for competing risk. Similar improvement patterns are shown by time-dependent area under the curve. As demonstrated by cumulative incidence function, both P-score and gene signature stratified PCa patients into significantly different risk groups. Conclusion We developed the P-score, a risk stratification system for newly diagnosed PCa patients by integrating a three-gene signature measured in CNB tissue. The P-score could provide valuable decision support to distinguish PCa patients with favorable and unfavorable outcomes and hence improve treatment decisions.
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Affiliation(s)
| | - Li-Di Xu
- Prostatype Genomics AB, Stockholm, Sweden
| | | | - Michael Häggman
- Department of Urology, Uppsala University Hospital, Uppsala, Sweden
- Correspondence: Michael Häggman, Department of Urology, Uppsala University Hospital, SE-751 85 Uppsala University Hospital, Uppsala, Sweden, Tel +46 70 520 42 87, Email
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Contrast-Enhanced Ultrasound-Magnetic Resonance Imaging Radiomics Based Model for Predicting the Biochemical Recurrence of Prostate Cancer: A Feasibility Study. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8090529. [PMID: 35529273 PMCID: PMC9071874 DOI: 10.1155/2022/8090529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 11/17/2022]
Abstract
Objective This study was aimed at developing a model for predicting postoperative biochemical recurrence of prostate cancer (PCa) using clinical data-CEUS-MRI radiomics and at verifying its clinical effectiveness. Methods The clinical imaging data of 159 patients pathologically confirmed with PCa and who underwent radical prostatectomy in Xiangyang No. 1 People's Hospital and Jiangsu Hospital of Chinese Medicine from March 2016 to December 2020 were retrospectively analyzed. According to the 2-5-year follow-up results, the patients were divided into the biochemical recurrence (BCR) group (n = 59) and the control group (n = 100). The training set and test set were established in the proportion of 7/3; 4 prediction models were established based on the clinical imaging data. In training set, the area under the curve (AUC) and decision curve analysis (DCA) by R was conducted to compare the efficiency of 4 prediction models, and then, external validation was performed using the test set. Finally, a nomogram tool for predicting BCR was developed. Results Univariate regression analysis confirmed that the SmallAreaHighGrayLevelEmphasis, RunVariance, Contrast, tumor diameter, clinical T stage, lymph node metastasis, distant metastasis, Gleason score, preoperative PSA, treatment method, CEUS-peak intensity (PI), time to peak (TTP), arrival time (AT), and elastography grade were the influencing factors for predicting BCR. In the training set, the AUC of combinatorial model demonstrated the highest efficiency in predicting BCR [AUC: 0.914 (OR 0.0305, 95% CI: 0.854-0.974)] vs. the general clinical data model, the CEUS model, and the MRI radiomics model. The DCA confirmed the largest net benefits of the combinatorial model. The test set validation gave consistent results. The nomogram tool has been well applied clinically. Conclusion The previous clinical and imaging data alone did not perform well for predicting BCR. Our combinatorial model firstly using clinical data-CEUS-MRI radiomics provided an opportunity for clinical screening of BCR and help improve its prognosis.
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Mudhish EA, Siddique AB, Ebrahim HY, Abdelwahed KS, King JA, El Sayed KA. The Tobacco β-Cembrenediol: A Prostate Cancer Recurrence Suppressor Lead and Prospective Scaffold via Modulation of Indoleamine 2,3-Dioxygenase and Tryptophan Dioxygenase. Nutrients 2022; 14:1505. [PMID: 35406118 PMCID: PMC9003379 DOI: 10.3390/nu14071505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer (PC) is the second leading cause of death in men in the US. PC has a high recurrence rate, and limited therapeutic options are available to prevent disease recurrence. The tryptophan-degrading enzymes 2,3-indoleamine dioxygenase (IDO1) and tryptophan dioxygenase (TDO2) are upregulated in invasive PC. (1S,2E,4R,6R,7E,11E)-2,7,11-cembratriene-4,6-diol (β-CBT) and its C-4 epimer α-CBT are the precursors to key flavor ingredients in tobacco leaves. Nearly 40-60% of β- and α-CBT are purposely degraded during commercial tobacco fermentation. Earlier, β-CBT inhibited invasion, reversed calcitonin-stimulated transepithelial resistance decrease, and induced tighter intercellular barriers in PC-3M cells. This study demonstrates the in vitro β-CBT anti-migratory (wound-healing assay) and anti-clonogenicity (colony-formation assay) activities against five diverse human PC cell lines, including the androgen-independent PC-3, PC-3M, and DU-145, the castration-recurrent CWR-R1ca, and the androgen-dependent CWR-22rv1. Meanwhile, β-CBT potently suppressed in vivo locoregional and distant recurrences after the primary tumor surgical excision of PC-3M-Luc cell tumor engrafted in male nude mice. β-CBT treatments suppressed organ and bone metastasis and lacked any major toxicity over the 60-day study course. β-CBT treatments significantly suppressed IDO1, TDO2, and their final metabolite kynurenine levels in PC-3M cells. β-CBT treatments significantly suppressed the tumor recurrence marker PSA and kynurenine levels in treated animals' plasma. β-CBT emerges as a promising PC recurrence suppressive lead.
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Affiliation(s)
- Ethar A. Mudhish
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, 1800 Bienville Drive, Monroe, LA 71201, USA; (E.A.M.); (A.B.S.); (H.Y.E.); (K.S.A.)
| | - Abu Bakar Siddique
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, 1800 Bienville Drive, Monroe, LA 71201, USA; (E.A.M.); (A.B.S.); (H.Y.E.); (K.S.A.)
| | - Hassan Y. Ebrahim
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, 1800 Bienville Drive, Monroe, LA 71201, USA; (E.A.M.); (A.B.S.); (H.Y.E.); (K.S.A.)
| | - Khaldoun S. Abdelwahed
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, 1800 Bienville Drive, Monroe, LA 71201, USA; (E.A.M.); (A.B.S.); (H.Y.E.); (K.S.A.)
| | - Judy Ann King
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA;
| | - Khalid A. El Sayed
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, 1800 Bienville Drive, Monroe, LA 71201, USA; (E.A.M.); (A.B.S.); (H.Y.E.); (K.S.A.)
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Parker AL, Benguigui M, Fornetti J, Goddard E, Lucotti S, Insua-Rodríguez J, Wiegmans AP. Current challenges in metastasis research and future innovation for clinical translation. Clin Exp Metastasis 2022; 39:263-277. [PMID: 35072851 PMCID: PMC8971179 DOI: 10.1007/s10585-021-10144-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/28/2021] [Indexed: 02/06/2023]
Abstract
While immense strides have been made in understanding tumor biology and in developing effective treatments that have substantially improved the prognosis of cancer patients, metastasis remains the major cause of cancer-related death. Improvements in the detection and treatment of primary tumors are contributing to a growing, detailed understanding of the dynamics of metastatic progression. Yet challenges remain in detecting metastatic dissemination prior to the establishment of overt metastases and in predicting which patients are at the highest risk of developing metastatic disease. Further improvements in understanding the mechanisms governing metastasis have great potential to inform the adaptation of existing therapies and the development of novel approaches to more effectively control metastatic disease. This article presents a forward-looking perspective on the challenges that remain in the treatment of metastasis, and the exciting emerging approaches that promise to transform the treatment of metastasis in cancer patients.
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Affiliation(s)
- Amelia L Parker
- Matrix and Metastasis Lab, Kinghorn Cancer Centre, Garvin Institute of Medical Research, Darlinghurst, NSW, 2010, Australia.
- St Vincent's Clinical School, UNSW Sydney, Sydney, 2052, Australia.
| | - Madeleine Benguigui
- Cell Biology and Cancer Science, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 31096, Haifa, Israel
| | - Jaime Fornetti
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake, UT, USA
| | - Erica Goddard
- Public Health Sciences Division/Translational Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Serena Lucotti
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, NY, New York, USA
| | - Jacob Insua-Rodríguez
- Department of Physiology and Biophysics, Department of Biological Chemistry, Chao Family Comprehensive Cancer Centre, University of California, Irvine, CA, USA
| | - Adrian P Wiegmans
- Cancer and Ageing Research Program, Centre for Genomics and Personalised Health, Queensland University of Technology (QUT), Translational Research Institute, Woolloongabba, QLD, 4121, Australia
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Papachristodoulou A, Abate-Shen C. Precision intervention for prostate cancer: Re-evaluating who is at risk. Cancer Lett 2022; 538:215709. [DOI: 10.1016/j.canlet.2022.215709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/30/2022] [Accepted: 04/25/2022] [Indexed: 02/08/2023]
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Zhao Y, Tao Z, Li L, Zheng J, Chen X. Predicting biochemical-recurrence-free survival using a three-metabolic-gene risk score model in prostate cancer patients. BMC Cancer 2022; 22:239. [PMID: 35246070 PMCID: PMC8896158 DOI: 10.1186/s12885-022-09331-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 02/24/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Biochemical recurrence (BCR) after initial treatment, such as radical prostatectomy, is the most frequently adopted prognostic factor for patients who suffer from prostate cancer (PCa). In this study, we aimed to construct a prognostic model consisting of gene expression profiles to predict BCR-free survival. METHODS We analyzed 70 metabolic pathways in 152 normal prostate samples and 494 PCa samples from the UCSC Xena dataset (training set) via gene set enrichment analysis (GSEA) to select BCR-related genes and constructed a BCR-related gene risk score (RS) model. We tested the power of our model using Kaplan-Meier (K-M) plots and receiver operator characteristic (ROC) curves. We performed univariate and multivariate analyses of RS using other clinicopathological features and established a nomogram model, which has stronger prediction ability. We used GSE70770 and DFKZ 2018 datasets to validate the results. Finally, we performed differential expression and quantitative real-time polymerase chain reaction analyses of the UCSC data for further verification of the findings. RESULTS A total of 194 core enriched genes were obtained through GSEA, among which 16 BCR-related genes were selected and a three-gene RS model based on the expression levels of CA14, LRAT, and MGAT5B was constructed. The outcomes of the K-M plots and ROC curves verified the accuracy of the RS model. We identified the Gleason score, pathologic T stage, and RS model as independent predictors through univariate and multivariate Cox analyses and constructed a nomogram model that presented better predictability than the RS model. The outcomes of the validation set were consistent with those of the training set. Finally, the results of differential expression analyses support the effectiveness of our model. CONCLUSION We constructed an RS model based on metabolic genes that could predict the prognosis of PCa patients. The model can be easily used in clinical applications and provide important insights into future research on the underlying mechanism of PCa.
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Affiliation(s)
- Yiqiao Zhao
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, People's Republic of China
| | - Zijia Tao
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, People's Republic of China
| | - Lei Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, People's Republic of China
| | - Jianyi Zheng
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, People's Republic of China
| | - Xiaonan Chen
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, People's Republic of China.
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Is there a diagnostic benefit of late-phase abdomino-pelvic PET/CT after urination as part of whole-body 68 Ga-PSMA-11 PET/CT for restaging patients with biochemical recurrence of prostate cancer after radical prostatectomy? EJNMMI Res 2022; 12:12. [PMID: 35244791 PMCID: PMC8897520 DOI: 10.1186/s13550-022-00885-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/15/2022] [Indexed: 12/31/2022] Open
Abstract
Background To assess the diagnostic value of an additional late-phase PET/CT scan after urination as part of 68 Ga-PSMA-11 PET/CT for the restaging of patients with biochemically recurrent prostate cancer (BCR). Methods This retrospective trial included patients with BCR following radical prostatectomy, who underwent standard whole-body early-phase PET/CT performed 105 ± 45 min and an additional late-phase PET/CT performed 159 ± 13 min after injection of 68 Ga-PSMA-11. Late-phase PET/CT covered a body volume from below the liver to the upper thighs and was conducted after patients had used the bathroom to empty their urinary bladder. Early- and late-phase images were evaluated regarding lesion count, type, localisation, and SUVmax. Reference standard was histopathology and/or follow-up imaging. Results Whole-body early-phase PET/CT detected 93 prostate cancer lesions in 33 patients. Late-phase PET/CT detected two additional lesions in two patients, both local recurrences. In total, there were 57 nodal, 28 bone, and 3 lung metastases, and 7 local recurrences. Between early- and late-phase PET/CT, lymph node metastases showed a significant increase of SUVmax from 14.5 ± 11.6 to 21.5 ± 17.6 (p = 0.00007), translating to a factor of + 1.6. Benign lymph nodes in the respective regions showed a significantly lower increase of SUVmax of 1.4 ± 0.5 to 1.7 ± 0.5 (p = 0.0014, factor of + 1.2). Local recurrences and bone metastases had a SUVmax on late-phase PET/CT that was + 1.7 and + 1.1 times higher than the SUVmax on early-phase PET/CT, respectively. Conclusion In patients with BCR following radical prostatectomy, an additional abdomino-pelvic late-phase 68 Ga-PSMA-11 PET/CT scan performed after emptying the urinary bladder may help to detect local recurrences missed on standard whole-body 68 Ga-PSMA-11 PET/CT. Lymph node metastases show a higher SUVmax and a stronger increase of SUVmax than benign lymph nodes on late-phase PET/CT, hence, biphasic 68 Ga-PSMA-11 PET/CT might help to distinguish between malignant and benign nodes. Bone metastases, and especially local recurrences, also demonstrate a metabolic increase over time.
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Arruda Viani G, Guimaraes Gouveia A, Trigo Leite E, Ynoe Moraes F. Moderate hypofractionation for salvage radiotherapy (HYPO-SRT) in patients with biochemical recurrence after prostatectomy: a cohort study with meta-analysis. Radiother Oncol 2022; 171:7-13. [DOI: 10.1016/j.radonc.2022.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/01/2022] [Accepted: 03/05/2022] [Indexed: 01/23/2023]
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Luo C, He S, Zhang H, He S, Qi H, Wei A. Clinical and Biological Significance of DNA Methylation-Driven Differentially Expressed Genes in Biochemical Recurrence After Radical Prostatectomy. Front Genet 2022; 13:727307. [PMID: 35186021 PMCID: PMC8847683 DOI: 10.3389/fgene.2022.727307] [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: 06/18/2021] [Accepted: 01/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Biochemical recurrence (BCR) after radical prostatectomy indicates poor prognosis in patients with prostate cancer (PCA). DNA methylation (DNAm) is a critical factor in tumorigenesis and has attracted attention as a biomarker for the diagnosis, treatment, and prognosis of PCA. However, the predictive value of DNAm-derived differentially expressed genes (DMGs) in PCA with BCR remains elusive. Methods: We filtered the methylated genes and the differentially expressed genes (DGEs) for more than 1,000 clinical samples from the TCGA cohort using the chAMP and DESeq2 packages of R language, respectively. Next, we integrated the DNAm beta value and gene expression data with the Mithymix package of R language to obtain the DMGs. Then, 1,000 times Cox LASSO regression with 10-fold cross validation was performed to screen signature DMGs and establish a predictive classifier. Univariate and multivariate cox regressive analyses were used to identify the prognostic factors to build a predictive model, and its performance was measured by receiver operating characteristic, calibration curves, and Harrell’s concordance index (C-index). Additionally, a GEO dataset was used to validate the prognostic classifier. Results: One hundred DMGs were mined using the chAMP and Methymix packages of R language. Of these, seven DMGs (CCK, CD38, CYP27A1, EID3, HABP2, LRRC4, and LY6G6D) were identified to build the prognostic classifier (Classifier) through LASSO analysis. Moreover, univariate and multivariate Cox regression analysis determined that the Classifier and pathological T stage (pathological_T) were independent predictors of BCR (hazard ratio (HR 2.2), (95% CI 1.4–3.5), p < 0.0012, and (HR 1.8), (95% CI 1.0–3.2), p < 0.046). A nomogram based on the Classifier was constructed, with high prediction accuracy for BCR-free survival in TCGA and GEO datasets. GSEA enrichment analysis showed that the DMGs were mainly enriched in the metabolism pathways. Conclusion: We identified and validated the nomogram of BCR-free survival for PCA patients, which has the potential to guide treatment decisions for patients at differing risks of BCR. Our study deepens the understanding of DMGs in the pathogenesis of PCA.
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Affiliation(s)
- Chao Luo
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Songzhe He
- Department of Laboratory Medicine, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Haibo Zhang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuhua He
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Huan Qi
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Anyang Wei
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Tryggestad AMA, Axcrona K, Axcrona U, Bigalke I, Brennhovd B, Inderberg EM, Hønnåshagen TK, Skoge LJ, Solum G, Saebøe-Larssen S, Josefsen D, Olaussen RW, Aamdal S, Skotheim RI, Myklebust TÅ, Schendel DJ, Lilleby W, Dueland S, Kvalheim G. Long-term first-in-man Phase I/II study of an adjuvant dendritic cell vaccine in patients with high-risk prostate cancer after radical prostatectomy. Prostate 2022; 82:245-253. [PMID: 34762317 DOI: 10.1002/pros.24267] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Patients with high-risk prostate cancer (PC) can experience biochemical relapse (BCR), despite surgery, and develop noncurative disease. The present study aimed to reduce the risk of BCR with a personalized dendritic cell (DC) vaccine, given as adjuvant therapy, after robot-assisted laparoscopic prostatectomy (RALP). METHODS Twelve weeks after RALP, 20 patients with high-risk PC and undetectable PSA received DC vaccinations for 3 years or until BCR. The primary endpoint was the time to BCR. The immune response was assessed 7 weeks after surgery (baseline) and at one-time point during the vaccination period. RESULTS Among 20 patients, 11 were BCR-free over a median of 96 months (range: 84-99). The median time from the end of vaccinations to the last follow-up was 57 months (range: 45-60). Nine patients developed BCR, either during (n = 4) or after (n = 5) the vaccination period. Among five patients diagnosed with intraductal carcinoma, three experienced early BCR during the vaccination period. All patients that developed BCR remained in stable disease within a median of 99 months (range: 74-99). The baseline immune response was significantly associated with the immune response during the vaccination period (p = 0.015). For patients diagnosed with extraprostatic extension (EPE), time to BCR was longer in vaccine responders than in non-responders (p = 0.09). Among 12 patients with the International Society of Urological Pathology (ISUP) grade 5 PC, five achieved remission after 84 months, and all mounted immune responses. CONCLUSION Patients diagnosed with EPE and ISUP grade 5 PC were at particularly high risk of developing postsurgical BCR. In this subgroup, the vaccine response was related to a reduced BCR incidence. The vaccine was safe, without side effects. This adjuvant first-in-man Phase I/II DC vaccine study showed promising results. DC vaccines after curative surgery should be investigated further in a larger cohort of patients with high-risk PC.
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Affiliation(s)
| | - Karol Axcrona
- Department of Urology, Oslo University Hospital HF, Oslo, Norway
- Department of Urology, Akershus University Hospital HF, Oslo, Norway
| | - Ulrika Axcrona
- Department of Pathology, Oslo University Hospital HF, Oslo, Norway
| | - Iris Bigalke
- Department of Oncology, Oslo University Hospital HF, Oslo, Norway
- BioNTech IMFS GmbH, Idar-Oberstein, Germany
| | - Bjørn Brennhovd
- Department of Urology, Oslo University Hospital HF, Oslo, Norway
| | - Else M Inderberg
- Department of Oncology, Oslo University Hospital HF, Oslo, Norway
| | | | - Lisbeth J Skoge
- Department of Oncology, Oslo University Hospital HF, Oslo, Norway
| | - Guri Solum
- Department of Oncology, Oslo University Hospital HF, Oslo, Norway
| | | | - Dag Josefsen
- Department of Oncology, Oslo University Hospital HF, Oslo, Norway
| | | | - Steinar Aamdal
- Department for Clinical Research, Oslo University Hospital HF, Oslo, Norway
| | - Rolf I Skotheim
- Department of Molecular Oncology, Oslo University Hospital HF, Oslo, Norway
| | - Tor Å Myklebust
- Department of Registration, Cancer Registry Norway, Oslo, Norway
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | | | - Wolfgang Lilleby
- Department of Oncology, Oslo University Hospital HF, Oslo, Norway
| | - Svein Dueland
- Department for Clinical Research, Oslo University Hospital HF, Oslo, Norway
| | - Gunnar Kvalheim
- Department of Oncology, Oslo University Hospital HF, Oslo, Norway
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Porcaro AB, Panunzio A, Tafuri A, Cerrato C, Gallina S, Bianchi A, Rizzetto R, Amigoni N, Gozzo A, Serafin E, Cianflone F, Migliorini F, Vidiri S, Di Filippo G, Novella G, Brunelli M, Shakir A, Pagliarulo V, Cerruto MA, Siracusano S, Antonelli A. The Influence of Endogenous Testosterone Density on Unfavorable Disease and Tumor Load at Final Pathology in Intermediate-Risk Prostate Cancer: Results in 338 Patients Treated with Radical Prostatectomy and Extended Pelvic Lymph Node Dissection. Urol Int 2022; 106:928-939. [PMID: 35081537 DOI: 10.1159/000521260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/21/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the influence of endogenous testosterone density (ETD) on features of aggressive prostate cancer (PCa) in intermediate-risk disease treated with radical prostatectomy and extended pelvic lymph node dissection. MATERIALS AND METHODS Density measurements included the ratio of endogenous testosterone (ET), prostate-specific antigen (PSA), and percentage of biopsy positive cores (BPC) on prostate volume (ETD, PSAD, and BPCD, respectively). The ratio of percentage of cancer invading the gland (tumor load, TL) on prostate weight (TLD) was also calculated. Unfavorable disease (UD) was defined as tumor upgrading (ISUP >3) and/or upstaging (pT >2) and/or lymph node invasion (LNI). Associations of ETD with features of aggressive PCa, including UD and TLD, were evaluated by logistic and linear regression models. RESULTS Evaluated cases were 338. Subjects with upgrading, upstaging, and LNI were 61/338 (18%), 73/338 (21%), and 25/338 (7.4%), respectively. TLD correlated with UD (Pearson's correlation coefficient, r = 0.204; p < 0.0001), PSAD (r = 0.342; p < 0.0001), BPCD (r = 0.364; p < 0.0001), and ETD (r = 0.214; p < 0.0001), which also correlated with BMI (r = -0.223; p < 0.0001), PSAD (r = 0.391; p < 0.0001), and BPCD (r = 0.407; p < 0.0001). TLD was the strongest independent predictor of UD (OR = 2.244; 95% CI = 1.146-4.395; p = 0.018). In the multivariate linear regression model predicting BPCD, ETD was an independent predictor (linear regression coefficient, b = 0.026; 95% CI: 0.016-0.036; p < 0.0001) together with PSAD (b = 1.599; 95% CI: 0.863-2.334; p < 0.0001) and TLD (b = 0.489; 95% CI: 0.274-0.706; p < 0.0001). According to models, TLD increased as ETD increased accordingly, but mean ET levels were significantly lower for patients with UD. CONCLUSIONS As ETD measurements incremented, the risk of large tumors extending beyond the prostate increased accordingly, and patients with lower ET levels were more likely to occult UD. The influence of ETD on PCa biology should be addressed by prospective studies.
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Affiliation(s)
- Antonio Benito Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Andrea Panunzio
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy, .,Department of Urology, Azienda Ospedaliera "Vito Fazzi", Lecce, Italy, .,Department of Neuroscience, Imaging and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy,
| | - Clara Cerrato
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Sebastian Gallina
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alberto Bianchi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Nelia Amigoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandra Gozzo
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Emanuele Serafin
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Francesco Cianflone
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Filippo Migliorini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Stefano Vidiri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giacomo Di Filippo
- Department of General and Hepatobiliary Surgery, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Giovanni Novella
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Aliasger Shakir
- USC Institute of Urology and Catherine and Joseph Aresty, Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | | | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Salvatore Siracusano
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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Ke ZB, You Q, Sun JB, Zhu JM, Li XD, Chen DN, Su L, Zheng QS, Wei Y, Xue XY, Xu N. A Novel Ferroptosis-Based Molecular Signature Associated with Biochemical Recurrence-Free Survival and Tumor Immune Microenvironment of Prostate Cancer. Front Cell Dev Biol 2022; 9:774625. [PMID: 35071228 PMCID: PMC8773967 DOI: 10.3389/fcell.2021.774625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/02/2021] [Indexed: 01/13/2023] Open
Abstract
Objective: To identify ferroptosis-related molecular clusters, and to develop and validate a ferroptosis-based molecular signature for predicting biochemical recurrence-free survival (BCRFS) and tumor immune microenvironment of prostate cancer (PCa). Materials and Methods: The clinical data and transcriptome data of PCa were downloaded from TCGA and GEO database. Ferroptosis-related genes (FRGs) were obtained from FerrDb database. We performed consensus clustering analysis to identify ferroptosis-related molecular subtypes for PCa. Univariate and multivariate Cox regression analysis were used to establish a ferroptosis-based signature for predicting BCRFS. Internal verification, external verification and subgroup survival analysis were then successfully performed. Results: There was a total of 40 differentially expressed FRGs in PCa. We then identified three ferroptosis-related molecular clusters of PCa, which have significantly different immune infiltrating cells, tumor immune microenvironment and PD-L1 expression level. More importantly, a novel ferroptosis-based signature for predicting BCRFS of PCa based on four FRGs (including ASNS, GPT2, NFE2L2, RRM2) was developed. Internal and external verifications were then successfully performed. Patients with high-risk score were associated with significant poor BCRFS compared with those with low-risk score in training cohort, testing cohort and validating cohort, respectively. The area under time-dependent Receiver Operating Characteristic (ROC) curve were 0.755, 0.705 and 0.726 in training cohort, testing cohort and validating cohort, respectively, indicating the great performance of this signature. Independent prognostic analysis indicated that this signature was an independent predictor for BCRFS of PCa. Subgroup analysis revealed that this signature was particularly suitable for younger or stage T III-IV or stage N0 or cluster 1-2 PCa patients. Patients with high-risk score have significantly different tumor immune microenvironment in comparison with those with low-risk score. The results of qRT-PCR successfully verified the mRNA expression levels of ASNS, GPT2, RRM2 and NFE2L2 in DU-145 and RWPE-1 cells while the results of IHC staining exactly verified the relative protein expression levels of ASNS, GPT2, RRM2 and NFE2L2 between PCa and BPH tissues. Conclusions: This study successfully identified three ferroptosis-related molecular clusters. Besides, we developed and validated a novel ferroptosis-based molecular signature, which performed well in predicting BCRFS and tumor immune microenvironment of PCa.
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Affiliation(s)
- Zhi-Bin Ke
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Qi You
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jiang-Bo Sun
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jun-Ming Zhu
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiao-Dong Li
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Dong-Ning Chen
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Li Su
- Department of Radiotherapy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qing-Shui Zheng
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yong Wei
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xue-Yi Xue
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Ning Xu
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Porcaro AB, Tafuri A, Panunzio A, Mazzucato G, Cerrato C, Gallina S, Bianchi A, Rizzetto R, Amigoni N, Serafin E, Cianflone F, Orlando R, Gentile I, Migliorini F, Zecchini Antoniolli S, Di Filippo G, Brunelli M, Pagliarulo V, Cerruto MA, Antonelli A. Endogenous testosterone density is an independent predictor of pelvic lymph node invasion in high-risk prostate cancer: results in 201 consecutive patients treated with radical prostatectomy and extended pelvic lymph node dissection. Int Urol Nephrol 2022; 54:541-550. [PMID: 35044553 PMCID: PMC8831287 DOI: 10.1007/s11255-022-03103-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/29/2021] [Indexed: 11/30/2022]
Abstract
Objective To evaluate the influence of endogenous testosterone density (ETD) on pelvic lymph node invasion (PLNI) in high risk (HR) prostate cancer (PCa) treated with radical prostatectomy (RP) and staged with extended pelvic lymph node dissection (ePLND). Materials and methods ETD was evaluated as the ratio of endogenous testosterone (ET) on prostate volume (PV). HR-PCa was assessed according to the European Association of Urology (EAU) system. The association of ETD and other routinely clinical factors (BPC: percentage of biopsy positive cores; PSA: prostate specific antigen; ISUP: tumor grade system according to the International Society of Urologic Pathology; cT: tumor clinical stage) with the risk of PLNI was assessed by the logistic regression model. Results Overall, 201 out of 805 patients (24.9%) were classified HR and PLNI occurred in 42 subjects (20.9%). On multivariate analysis, PLNI was independently predicted by BPC (OR 1.020; 95% CI 1.006–1.035; p = 0.019), ISUP > 3 (OR 2.621; 95% CI 1.170–5.869; p = 0.019) and ETD (OR 0.932; 95% CI 0.870–0.999; p = 0.045). After categorizing continuous clinical predictors, the risk of PLNI was independently increased by ETD up to the median (OR 2.379; 95% CI 1.134–4.991; p = 0.022), BPC > 50% (OR 3.125; 95% CI 1.520–6.425; p = 0.002) as well as by ISUP > 3 (OR 2.219; 95% CI 1.031–4.776; p = 0.042). Conclusions As ETD measurements decreased, patients were more likely to have PLNI. In HR disease with PLNI, the influence of PCa on ETD should be addressed by higher level studies. Supplementary Information The online version contains supplementary material available at 10.1007/s11255-022-03103-w.
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Affiliation(s)
- Antonio Benito Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
- Department of Urology, Vito Fazzi Hospital, Lecce, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Andrea Panunzio
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giovanni Mazzucato
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Clara Cerrato
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Sebastian Gallina
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alberto Bianchi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Nelia Amigoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Emanuele Serafin
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Francesco Cianflone
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Rossella Orlando
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Ilaria Gentile
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Filippo Migliorini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Giacomo Di Filippo
- Department of General and Hepatobiliary Surgery, Azienda Ospedaliera Universitaria Integrata, University of Verona, Piazzale Stefani 1-37126, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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Ferro M, de Cobelli O, Musi G, del Giudice F, Carrieri G, Busetto GM, Falagario UG, Sciarra A, Maggi M, Crocetto F, Barone B, Caputo VF, Marchioni M, Lucarelli G, Imbimbo C, Mistretta FA, Luzzago S, Vartolomei MD, Cormio L, Autorino R, Tătaru OS. Radiomics in prostate cancer: an up-to-date review. Ther Adv Urol 2022; 14:17562872221109020. [PMID: 35814914 PMCID: PMC9260602 DOI: 10.1177/17562872221109020] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Prostate cancer (PCa) is the most common worldwide diagnosed malignancy in male population. The diagnosis, the identification of aggressive disease, and the post-treatment follow-up needs a more comprehensive and holistic approach. Radiomics is the extraction and interpretation of images phenotypes in a quantitative manner. Radiomics may give an advantage through advancements in imaging modalities and through the potential power of artificial intelligence techniques by translating those features into clinical outcome prediction. This article gives an overview on the current evidence of methodology and reviews the available literature on radiomics in PCa patients, highlighting its potential for personalized treatment and future applications.
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Affiliation(s)
- Matteo Ferro
- Department of Urology, European Institute of Oncology, IRCCS, Milan, Italy, via Ripamonti 435 Milano, Italy
| | - Ottavio de Cobelli
- Department of Urology, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hematology-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Gennaro Musi
- Department of Urology, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hematology-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Francesco del Giudice
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | | | - Alessandro Sciarra
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Martina Maggi
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples ‘Federico II’, Naples, Italy
| | - Biagio Barone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples ‘Federico II’, Naples, Italy
| | - Vincenzo Francesco Caputo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples ‘Federico II’, Naples, Italy
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, G. d’Annunzio, University of Chieti, Chieti, Italy; Urology Unit, ‘SS. Annunziata’ Hospital, Chieti, Italy
- Department of Urology, ASL Abruzzo 2, Chieti, Italy
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples ‘Federico II’, Naples, Italy
| | - Francesco Alessandro Mistretta
- Department of Urology, European Institute of Oncology, IRCCS, Milan, Italy
- Università degli Studi di Milano, Milan, Italy
| | - Stefano Luzzago
- Department of Urology, European Institute of Oncology, IRCCS, Milan, Italy
- Università degli Studi di Milano, Milan, Italy
| | - Mihai Dorin Vartolomei
- Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, Târgu Mures, Romania
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Luigi Cormio
- Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Urology Unit, Bonomo Teaching Hospital, Foggia, Italy
| | | | - Octavian Sabin Tătaru
- Institution Organizing University Doctoral Studies, I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, Târgu Mures, Romania
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MAIA RONALDO, SANTOS GABRIELARANTESDOS, REIS SABRINA, VIANA NAYARAI, PIMENTA RUAN, GUIMARÃES VANESSAR, RECUERO SAULO, ROMÃO POLIANA, LEITE KATIARAMOSMOREIRA, SROUGI MIGUEL, PASSEROTTI CARLOCARMARGO. Podemos usar a expressão de Ki67 para prever a agressividade do câncer de próstata? Rev Col Bras Cir 2022. [DOI: 10.1590/0100-6991e-20223200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Introdução: especialistas precisam biomarcadores que podem discriminar o câncer de próstata indolente de tumores agressivos. Ki67 é um marcador de proliferação, e sua expressão está associada à agressividade de vários tumores. Objetivo: analisar a expressão do Ki67 em amostras de câncer de próstata correlacionando com a agressividade da doença. Métodos: os níveis de mRNA de Ki67 foram determinados utilizando dados de uma coorte de TCGA (Tumor(n)=492 e controle(n)=52). A expressão da proteína foi determinada em 94 biópsias de pacientes por ensaio imuno-histoquímica. Resultados: no mRNA, a superexpressão Ki67 está associada ao tecido canceroso (p<0,0001) e à pior sobrevida livre de doença (p=0,035). A superexpressão proteica está associada ao aumento do escore ISUP (p<0,0001), estágio de câncer (p=0,05), recorrência bioquímica (p=0,0006) e metástase (p<0,0001). Também mostramos uma correlação positiva entre a expressão Ki67 e o escore ISUP (r=0,5112, p<0,0001) e a estratificação de risco de doença (r=0,3388, p=0,0009). A expressão Ki67 é um fator independentemente associado à recorrência bioquímica (p=0,002) e metástase (p<0,0001). Finalmente, os pacientes com alta expressão de Ki67 expression mostram melhor sobrevivência em relação à recorrência bioquímica (p=0,008) e metástase (p=0,056). Os pacientes com alta expressão de Ki67 são 2,62 vezes mais propensos a desenvolver recorrência bioquímica (p=0,036). Conclusão: a superexpressão Ki67 está associada à agressividade do câncer de próstata.
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Affiliation(s)
| | | | - SABRINA REIS
- Universidade de São Paulo, Brazil; Hospital Moriah, Brasil; Universidade do Estado de Minas Gerais, Brazil
| | | | - RUAN PIMENTA
- Universidade de São Paulo, Brazil; D’Or Institute for Research and Education, Brasil
| | | | | | | | | | - MIGUEL SROUGI
- Universidade de São Paulo, Brazil; D’Or Institute for Research and Education, Brasil
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Gühne F, Radke S, Winkens T, Kühnel C, Greiser J, Seifert P, Drescher R, Freesmeyer M. Differences in Distribution and Detection Rate of the [ 68Ga]Ga-PSMA Ligands PSMA-617, -I&T and -11-Inter-Individual Comparison in Patients with Biochemical Relapse of Prostate Cancer. Pharmaceuticals (Basel) 2021; 15:ph15010009. [PMID: 35056066 PMCID: PMC8779232 DOI: 10.3390/ph15010009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 12/04/2022] Open
Abstract
The biochemical relapse of prostate cancer is diagnostically challenging but of high clinical impact for subsequent patient treatment. PET/CT with radiolabeled PSMA ligands outperforms conventional diagnostic methods in the detection of tumor recurrence. Several radiopharmaceuticals were and are available for use. The aim of this study was to investigate whether the routinely applied [68Ga]Ga-PSMA ligands PSMA-617, -I&T and -11 (HBED-CC) differ in physiological and pathological distribution, or in tumor detection rate. A retrospective evaluation of 190 patients (39 patients received PSMA-617, 68 patients PSMA-I&T and 83 patients PSMA-11) showed significant differences in tracer accumulation within all organs examined. The low retention within the compartments blood pool, bone and muscle tissue is a theoretical advantage of PSMA-11. Evaluation of tumor lesion uptake and detection rate did not reveal superiority of one of the three radiopharmaceuticals, neither in the whole population, nor in particularly challenging subgroups like patients with very low PSA levels. We conclude that all three [68Ga]Ga-PSMA ligands are equally feasible in this clinically important scenario, and may replace each other in case of unavailability or production restrictions.
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de Sá Moreira E, Robinson D, Hawthorne S, Zhao L, Hanson M, Kanas G, Turnure M, Davis C, Clark O. Patterns of Care and Outcomes for Non-Metastatic Prostate Cancer in the United States: Results of the CancerMPact ® Survey 2018. Cancer Manag Res 2021; 13:9127-9137. [PMID: 34924773 PMCID: PMC8674664 DOI: 10.2147/cmar.s343321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/27/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose We describe patterns of care and treatment outcomes for non-metastatic PCa (nmPCA), either hormone-sensitive or castration-resistant, in the United States of America (USA) in 2018. Methods A survey (CancerMPact®) recruited physicians nationwide to answer an online questionnaire about how they treated patients with nmPCA. Questions covered aspects of treatment at all disease stages. Board-certified urologists and oncologists with at least five years of clinical practice and who treated at least 30 PCa patients monthly were included. Results The survey included responses from ninety-four physicians with an average of 17.5 years of clinical practice, who had treated a combined average of 4415 patients with nmPCA per month in 2018. Approximately 40% of patients in stage I were managed with either active surveillance or observation/no therapy, decreasing to 20%, 8% and 6% in stages II, III and IV(M0), respectively. Intensity-modulated radiotherapy was favored over other radiotherapy modalities, with rates of use ranging between 60% and 69% depending on disease stage. Leuprolide as monotherapy or in combination with enzalutamide, abiraterone or bicalutamide were the most common systemic treatment options for non-metastatic hormone-sensitive PCa (nmHSPC) patients with the first or second recurrence. Only 16.5% of non-metastatic castration-resistant PCa (nmCRPC) patients did not relapse within five years of initial therapy for nmCRPC. Conclusion While PCa treatment recommendations are rapidly changing due to advances in treatment, we observed great concordance between their most current versions and real-world data treatment patterns reported by US physicians.
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Affiliation(s)
| | | | | | - Linda Zhao
- Health Division, Kantar, New York, NY, USA
| | | | - Gena Kanas
- Health Division, Kantar, New York, NY, USA
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Shih HJ, Chang SC, Hsu CH, Lin YC, Hung CH, Wu SY. Comparison of Clinical Outcomes of Radical Prostatectomy versus IMRT with Long-Term Hormone Therapy for Relatively Young Patients with High- to Very High-Risk Localized Prostate Cancer. Cancers (Basel) 2021; 13:cancers13235986. [PMID: 34885096 PMCID: PMC8656593 DOI: 10.3390/cancers13235986] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/21/2021] [Accepted: 11/24/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary That the definitive optimal treatments for relatively young men (aged ≤ 65 years) with high- or very high-risk localized prostate cancer (HR/VHR-LPC) are radical prostatectomy (RP) or radiation plus antiandrogen therapy (RT-ADT) is controversial. To the best of our knowledge, our study is the first and largest to examine biochemical failure (BF), all-cause death, locoregional recurrence, and distant metastasis in relatively young men with HR/VHR-LPC as defined by National Comprehensive Cancer Network risk strata. After head-to-head propensity score matching was used to balance the potential confounders, a multivariable Cox proportional hazards regression model was used to analyze oncologic outcomes. In relatively young men with HR/VHR-LPC, RP and RT-ADT yielded similar oncologic outcomes and RP reduced the risk of BF compared with RT-ADT. Abstract That intensity-modulated radiotherapy (IMRT) plus antiandrogen therapy (IMRT-ADT) and radical prostatectomy (RP) are the definitive optimal treatments for relatively young patients (aged ≤ 65 years) with high- or very high-risk localized prostate cancer (HR/VHR-LPC), but remains controversial. We conducted a national population-based cohort study by using propensity score matching (PSM) to evaluate the clinical outcomes of RP and IMRT-ADT in relatively young patients with HR/VHR-LPC. Methods: We used the Taiwan Cancer Registry database to evaluate clinical outcomes in relatively young (aged ≤ 65 years) patients with HR/VHR-LPC, as defined by the National Comprehensive Cancer Network risk strata. The patients had received RP or IMRT-ADT (high-dose, ≥72 Gy plus long-term, 1.5–3 years, ADT). Head-to-head PSM was used to balance potential confounders. A Cox proportional hazards regression model was used to analyze oncologic outcomes. Results: High-dose IMRT-ADT had a higher risk of biochemical failure (adjusted hazard ratio [aHR] = 2.03, 95% confidence interval [CI] 1.56–2.65, p < 0.0001) compared with RP; IMRT-ADT did not have an increased risk of all-cause death (aHR = 1.2, 95% CI 0.65–2.24, p = 0.564), locoregional recurrence (aHR = 0.88, 95% CI 0.67–1.06, p = 0.3524), or distant metastasis (aHR = 1.03, 95% CI 0.56–1.9, p = 0.9176) compared with RP. Conclusion: In relatively young patients with HR/VHR-LPC, RP and IMRT-ADT yielded similar oncologic outcomes and RP reduced the risk of biochemical failure compared with IMRT-ADT.
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Affiliation(s)
- Hung-Jen Shih
- Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua 500, Taiwan;
- Department of Recreation and Holistic Wellness, MingDao University, Changhua 500, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Shyh-Chyi Chang
- Department of Urology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan; (S.-C.C.); (C.-H.H.); (Y.-C.L.); (C.-H.H.)
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei 11221, Taiwan
| | - Chia-Hao Hsu
- Department of Urology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan; (S.-C.C.); (C.-H.H.); (Y.-C.L.); (C.-H.H.)
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei 11221, Taiwan
| | - Yi-Chu Lin
- Department of Urology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan; (S.-C.C.); (C.-H.H.); (Y.-C.L.); (C.-H.H.)
| | - Chu-Hsuan Hung
- Department of Urology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan; (S.-C.C.); (C.-H.H.); (Y.-C.L.); (C.-H.H.)
| | - Szu-Yuan Wu
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
- Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242062, Taiwan
- Department of Management, College of Management, Fo Guang University, Yilan 262307, Taiwan
- Centers for Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan
- Correspondence:
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Keizman D, Frenkel M, Peer A, Kushnir I, Rosenbaum E, Sarid D, Leibovitch I, Mano R, Yossepowitch O, Margel D, Wolf I, Geva R, Dresler H, Rouvinov K, Rapoport N, Eliaz I. Modified Citrus Pectin Treatment in Non-Metastatic Biochemically Relapsed Prostate Cancer: Results of a Prospective Phase II Study. Nutrients 2021; 13:nu13124295. [PMID: 34959847 PMCID: PMC8706421 DOI: 10.3390/nu13124295] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022] Open
Abstract
Optimal therapy of biochemically relapsed prostate cancer (BRPC) after local treatment is elusive. An established modified citrus pectin (PectaSol®, P-MCP), a dietary polysaccharide, is an established antagonist of galectin-3, a carbohydrate-binding protein involved in cancer pathogenesis. Based on PSA dynamics, we report on the safety and the primary outcome analysis of a prospective phase II study of P-MCP in non-metastatic BRPC based. Sixty patients were enrolled, and one patient withdrew after a month. Patients (n = 59) were given P-MCP, 4.8 grams X 3/day, for six months. The primary endpoint was the rate without PSA progression and improved PSA doubling time (PSADT). Secondary endpoints were the rate without radiologic progression and toxicity. Patients that did not progress by PSA and radiologically at six months continued for an additional twelve months. After six months, 78% (n = 46) responded to therapy, with a decreased/stable PSA in 58% (n = 34), or improvement of PSADT in 75% (n = 44), and with negative scans, and entered the second twelve months treatment phase. Median PSADT improved significantly (p = 0.003). Disease progression during the first 6 months was noted in only 22% (n = 13), with PSA progression in 17% (n = 10), and PSA and radiologic progression in 5% (n = 3). No patients developed grade 3 or 4 toxicity.
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Affiliation(s)
- Daniel Keizman
- Department of Oncology, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (D.S.); (I.W.); (R.G.)
- Correspondence:
| | - Moshe Frenkel
- Department of Oncology, Rambam Medical Center, Haifa 3109601, Israel; (M.F.); (A.P.)
| | - Avivit Peer
- Department of Oncology, Rambam Medical Center, Haifa 3109601, Israel; (M.F.); (A.P.)
| | - Igal Kushnir
- Department of Oncology, Meir Medical Center and Sackler School of Medicine, Tel-Aviv University, Kfar-Saba 4428164, Israel; (I.K.); (N.R.)
| | - Eli Rosenbaum
- Department of Oncology, Rabin Medical Center, Petah-Tikva 4941492, Israel;
| | - David Sarid
- Department of Oncology, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (D.S.); (I.W.); (R.G.)
| | - Ilan Leibovitch
- Department of Urology, Meir Medical Center, Kfar-Saba 4439246, Israel;
| | - Roy Mano
- Department of Urology, Tel-Aviv Sourasky Medical Center, Tel-Aviv 69978, Israel; (R.M.); (O.Y.)
| | - Ofer Yossepowitch
- Department of Urology, Tel-Aviv Sourasky Medical Center, Tel-Aviv 69978, Israel; (R.M.); (O.Y.)
| | - David Margel
- Department of Urology, Rabin Medical Center, Petah-Tikva 4941492, Israel;
| | - Ido Wolf
- Department of Oncology, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (D.S.); (I.W.); (R.G.)
| | - Ravit Geva
- Department of Oncology, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (D.S.); (I.W.); (R.G.)
| | - Hadas Dresler
- Department of Oncology, Shaare Zedek Medical Center, Jerusalem 9103102, Israel;
| | - Keren Rouvinov
- Department of Oncology, Soroka Medical Center, Beer-Sheva 8428760, Israel;
| | - Noa Rapoport
- Department of Oncology, Meir Medical Center and Sackler School of Medicine, Tel-Aviv University, Kfar-Saba 4428164, Israel; (I.K.); (N.R.)
| | - Isaac Eliaz
- Amitabha Medical Clinic and Healing Center, Santa Rosa, CA 95401, USA;
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71
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Athanasiou A, Tennstedt P, Wittig A, Huber R, Straub O, Schiess R, Steuber T. A novel serum biomarker quintet reveals added prognostic value when combined with standard clinical parameters in prostate cancer patients by predicting biochemical recurrence and adverse pathology. PLoS One 2021; 16:e0259093. [PMID: 34767586 PMCID: PMC8589165 DOI: 10.1371/journal.pone.0259093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022] Open
Abstract
The objective was to determine the prognostic utility of a new biomarker combination in prostate cancer (PCa) patients undergoing Radical Prostatectomy (RP). Serum samples and clinical data of 557 men who underwent RP for PCa with pathological stage (pT) <3 at Martini Clinic (Hamburg, Germany) were used for analysis. Clinical Grade Group and clinical stage was determined using biopsy samples while tumor marker concentrations were measured in serum using immunoassays. The prognostic utility of the proposed marker combination was assessed using Cox proportional hazard regression and Kaplan-Meier analysis. The performance was compared to the Cancer of the Prostate Risk Assessment (CAPRA) score in the overall cohort and in a low-risk patient subset. A multivariable model comprising fibronectin 1, galectin-3-binding protein, lumican, matrix metalloprotease 9, thrombospondin-1 and PSA together with clinical Grade Group (GG) and clinical stage (cT) was created. The proposed model was a significant predictor of biochemical recurrence (BCR) (HR 1.29 per 5 units score, 95%CI 1.20–1.38, p<0.001). The Kaplan-Meier analysis showed that the proposed model had a better prediction for low-risk disease after RP compared to CAPRA (respectively 5.0% vs. 9.1% chance of BCR). In a pre-defined low risk population subset, the risk of BCR using the proposed model was below 5.2% and thus lower when compared to CAPRA = 0–2 (9%), GG<2 (7%) and NCCN = low-risk (6%) subsets. Additionally, the proposed model could significantly (p<0.001) discriminate patients with adverse pathology (AP) events at RP from those without. In conclusion, the proposed model is superior to CAPRA for the prediction of BCR after RP in the overall cohort as well as a in a pre-defined low risk patient population subset. It is also significantly associated with AP at RP.
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Affiliation(s)
| | - Pierre Tennstedt
- Martini-Klinik, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Anja Wittig
- Proteomedix AG, Zurich-Schlieren, Switzerland
| | - Ramy Huber
- Proteomedix AG, Zurich-Schlieren, Switzerland
| | | | - Ralph Schiess
- Proteomedix AG, Zurich-Schlieren, Switzerland
- * E-mail:
| | - Thomas Steuber
- Martini-Klinik, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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Morton M, Omar N, Madi R, Terris M, Powell M. Collision metastasis: Renal cell carcinoma and prostatic adenocarcinoma to a retroperitoneal lymph node. Urol Case Rep 2021; 40:101884. [PMID: 34712581 PMCID: PMC8531555 DOI: 10.1016/j.eucr.2021.101884] [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: 09/18/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
Prostatic adenocarcinoma and renal cell carcinoma (RCC) can coexist. However, the incidence of collision metastasis of both prostatic adenocarcinoma and RCC is a rare phenomenon. A 50-year-old non-smoker male with end stage renal disease and a history of prostate adenocarcinoma was noted to have a left renal mass in the upper pole during CT surveillance. With the use of immunohistochemical stains the collision of two distinct malignancies from two different topographical regions was elucidated in a retroperitoneal lymph node. We report the second known case of collision metastasis of RCC and prostatic adenocarcinoma to a retroperitoneal lymph node. Collision metastasis of renal cell carcinoma and prostatic adenocarcinoma is rare. It is important to keep a high index of suspicion for collision metastasis. Immunohistochemistry can confirm collision metastasis of a suspicious lymph node.
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Affiliation(s)
| | - Nivin Omar
- Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Rabii Madi
- Division of Urology, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Georgia Cancer Center, Augusta, GA, USA
| | - Martha Terris
- Division of Urology, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Georgia Cancer Center, Augusta, GA, USA
| | - Matthew Powell
- Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Corresponding author.
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73
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Li S, Li Z, Mi J, Lu L, Yan Y, Cao Y, Ran L, Yang W. Effects of <italic>Lycium ruthenicum</italic> Murray anthocyanin Pt3G on the proliferation and apoptosis of prostate cancer LNCaP andPC-3 cells. CHINESE SCIENCE BULLETIN-CHINESE 2021. [DOI: 10.1360/tb-2021-0696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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74
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Chen C, Margolis DJ. Prostate-Specific Membrane Antigen (PSMA) PET: A Counterpart to Prostate MRI. Semin Roentgenol 2021; 56:376-383. [PMID: 34688340 DOI: 10.1053/j.ro.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Christine Chen
- Department of Radiology, Weill Cornell Medical College: Weill Cornell Medicine, 1300 York Ave, New York, NY 10065.
| | - Daniel J Margolis
- Department of Radiology, Weill Cornell Medical College: Weill Cornell Medicine, 1300 York Ave, New York, NY 10065
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75
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Patrikidou A, Zilli T, Baciarello G, Terisse S, Hamilou Z, Fizazi K. Should androgen deprivation therapy and other systemic treatments be used in men with prostate cancer and a rising PSA post-local treatments? Ther Adv Med Oncol 2021; 13:17588359211051870. [PMID: 34707693 PMCID: PMC8543684 DOI: 10.1177/17588359211051870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/20/2021] [Indexed: 12/24/2022] Open
Abstract
Biochemical recurrence is an evolving space in prostate cancer, with increasing multidisciplinary involvement. Androgen deprivation therapy has shown proof of its value in complementing salvage radiotherapy in high-risk biochemical relapsing patients; ongoing trials aim to further refine this treatment combination. As systemic treatments, and notably next-generation androgen receptor targeted agents, have moved towards early hormone-sensitive and non-metastatic stages, the prostate specific antigen (PSA)-relapse disease stage will be undoubtedly challenged by future evidence from such ongoing clinical trials. With the use of modern imaging and newer molecular technologies, including integration of tumoral genomic profiling and liquid biopsies in risk stratification, a path towards a precision oncology-focused approach will become a reality to guide in the future decisions for patients with a diagnosis of biochemical recurrence.
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Affiliation(s)
- Anna Patrikidou
- Department of Medical Oncology, Gustave Roussy Institute, Paris Saclay University, 114 rue Edouard Vaillant, Villejuif, 94800, FranceUCL Cancer Institute & University College London Hospital, London, United Kingdom
| | - Thomas Zilli
- Department of Radiation Oncology, Geneva University Hospital and Faculty of Medicine, Geneva University, Geneva, Switzerland
| | | | - Safae Terisse
- Department of Medical Oncology, Saint Louis Hospital, Paris, France
| | - Zineb Hamilou
- Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Karim Fizazi
- Department of Medical Oncology, Gustave Roussy Institute, Paris Saclay University, 114 rue Edouard Vaillant, Villejuif, 94800, France
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Bobrowski A, Metser U, Finelli A, Fleshner N, Berlin A, Perlis N, Kulkarni GS, Chung P, Kuhathaas K, Atenafu EG, Hamilton RJ. Salvage lymph node dissection for prostate-specific membrane antigen (PSMA) positron emission tomography (PET)-identified oligometastatic disease. Can Urol Assoc J 2021; 15:E545-E552. [PMID: 34665714 DOI: 10.5489/cuaj.6988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The availability of prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) imaging, particularly in the setting of rising prostate-specific antigen (PSA) after definitive treatment, has led to oligometastatic prostate cancer being increasingly identified. Despite the enthusiasm surrounding treating oligometastatic disease, it has been relatively understudied. We sought to review our salvage lymphadenectomy experience in the PSMA PET/CT era. METHODS We retrospectively reviewed patients undergoing lymphadenectomy following curative-intent primary therapy with rising PSA who had undergone a PSMA PET/CT identifying oligometastatic disease (defined as ≤5 PSMA-avid lesions) between January 2016 and April 2020. The primary endpoint was complete response, defined as achieving a PSA <0.2 ng/ml without concomitant androgen deprivation therapy (ADT). RESULTS Twenty-two patients were included. Primary curative therapy included radical prostatectomy (86.4%) and brachytherapy (13.6%). Median PSA at salvage surgery was 1.72 ng/ml. Pelvic lymph node dissection was the most performed procedure (72.7%). Median node yield was 10.5, with a median of 1.5 positive nodes on pathology. Eight patients (36.4%) achieved PSA <0.2, with six (27.3%) remaining with PSA <0.2 after a median followup of 23.1 months. Nine (40.9%) had an initial PSA decline, but nadired ≥0.2, and in five (22.7%) the PSA rose immediately after surgery. Overall, ADT was started in seven patients (31.8%) at a median of 10.1 months post-salvage surgery. CONCLUSIONS In our series of salvage dissection for PSMA-PET-detected nodal oligometastases, approximately a third achieved PSA <0.2; yet, it was only durable in 27%. Prospective trials of salvage nodal radiation are ongoing, however, more prospective trials of salvage node dissection are needed.
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Affiliation(s)
- Adam Bobrowski
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ur Metser
- Department of Diagnostic Radiology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Antonio Finelli
- Division of Urology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Neil Fleshner
- Division of Urology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Alejandro Berlin
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Nathan Perlis
- Division of Urology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Girish S Kulkarni
- Division of Urology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Peter Chung
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Kopika Kuhathaas
- Division of Urology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Eshetu G Atenafu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Robert J Hamilton
- Division of Urology, Princess Margaret Cancer Centre, Toronto, ON, Canada
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Tsuzuki S, Nakanishi S, Tamaki M, Oshiro T, Miki J, Yamada H, Shimomura T, Kimura T, Furuta N, Saito S, Egawa S. Initial dose reduction of enzalutamide does not decrease the incidence of adverse events in castration-resistant prostate cancer. PLoS One 2021; 16:e0258160. [PMID: 34597353 PMCID: PMC8486121 DOI: 10.1371/journal.pone.0258160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/19/2021] [Indexed: 11/27/2022] Open
Abstract
Background There was no clear evidence whether the initial dose of enzalutamide affects the incidence of adverse events (AEs), and oncological outcome in patients with castration-resistant prostate cancer (CRPC). Methods The clinical charts of 233 patients with CRPC treated with enzalutamide were reviewed retrospectively. After 1:3 propensity score matching (PSM), 124 patients were divided into a reduced dose group and a standard dose group, and the prostate specific antigen (PSA) response and the incidence of AEs were compared. Results 190 patients with CRPC initiated with standard dose enzalutamide were younger and better performance status compared with 43 patients beginning with reduced dose. After PSM, the baseline characteristics were not different between the standard and the reduced dose group. In the PSM cohort, the PSA response rate was significantly lower in the reduced dose group than in the standard dose group (-66.3% and -87.4%, p = 0.02). The incidence rates of AEs were not statistically different between the groups (22.6% and 34.4%, respectively, p = 0.24). Conclusion Initiating treatment with a reduced dose of enzalutamide did not significantly decrease the incidence rate of AEs, and it showed poorer PSA response rate. There is no clear rationale for treating with a reduced initial dose of enzalutamide to reduce the incidence of AEs.
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Affiliation(s)
- Shunsuke Tsuzuki
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Shotaro Nakanishi
- Department of Urology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Okinawa, Japan
| | - Mitsuyoshi Tamaki
- Department of Urology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Okinawa, Japan
- Department of Urology, Naha City Hospital, Naha, Okinawa, Japan
| | - Takuma Oshiro
- Department of Urology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Okinawa, Japan
- Department of Urology, Naha City Hospital, Naha, Okinawa, Japan
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Hiroki Yamada
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Tatsuya Shimomura
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
- * E-mail:
| | - Nozomu Furuta
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Seiichi Saito
- Department of Urology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Okinawa, Japan
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
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Moteabbed M, Harisinghani M, Paganetti H, Trofimov A, Lu HM, Efstathiou JA. Proton vs. photon radiotherapy for MR-guided dose escalation of intraprostatic lesions. Acta Oncol 2021; 60:1283-1290. [PMID: 34282708 DOI: 10.1080/0284186x.2021.1947523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Dose escalation has been associated with improved biochemical control for prostate cancer. Focusing the high dose on the MRI-defined intraprostatic lesions (IL) could spare the surrounding organs at risk and hence allow further escalation. We compare treatment efficacy between state-of-the-art focally-boosted proton and photon-based radiotherapy, and investigate possible predictive guidelines regarding individualized treatment prescriptions. MATERIAL AND METHODS Ten prostate cancer patients with well-defined ILs were selected. Multiparametric MRI was used to delineate ILs, which were transferred to the planning CT via image registration. Pencil beam scanning proton therapy and volumetric modulated arc therapy treatment plans, were created for each patient. Each modality featured 6 plans: (1) moderately hypofractionated dose: 70 Gy to the prostate in 28 fractions, (2)-(6) plan 1 plus additional simultaneous-integrated-boost to ILs to 75.6, 81.2, 86.6, 98 and 112 Gy in 28 fractions. Equivalent dose to 2 Gy-per-fraction (EqD2) was used to calculate tumor control (TCP) and normal tissue complication probabilities (NTCP) for ILs and organs-at-risk. RESULTS For both modalities, the maximum necessary dose to achieve TCP > 99% was 98 Gy for very high-risk ILs. For lower risk ILs lower doses were sufficient. NTCP was <25% and 35% for protons and photons at the maximum dose escalation, respectively. For the cases and beam characteristics considered, proton therapy was dosimetrically superior when IL was >4 cc or located <2.5 mm from the rectum. CONCLUSION This work demonstrated the potential role for proton therapy in the setting of prostate focal dose escalation. We propose that anatomical characteristic could be used as criteria to identify patients who would benefit from proton treatment.
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Affiliation(s)
- Maryam Moteabbed
- Division of Radiation Biophysics, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Mukesh Harisinghani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Harald Paganetti
- Division of Radiation Biophysics, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alexei Trofimov
- Division of Radiation Biophysics, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Jason A. Efstathiou
- Division of Radiation Biophysics, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Porcaro AB, Tafuri A, Panunzio A, Rizzetto R, Amigoni N, Cerrato C, Shakir A, Gallina S, Bianchi A, Cianflone F, Serafin E, Gozzo A, Di Filippo G, Migliorini F, Novella G, Brunelli M, Cerruto MA, Antonelli A. Endogenous testosterone density predicts unfavorable disease at final pathology in intermediate risk prostate cancer. Int Urol Nephrol 2021; 53:2517-2526. [PMID: 34580803 PMCID: PMC8599400 DOI: 10.1007/s11255-021-02990-9] [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: 07/14/2021] [Accepted: 08/15/2021] [Indexed: 11/23/2022]
Abstract
Objective To test the hypothesis that endogenous testosterone (ET) density could be associated with tumor load (TL) in patients with intermediate risk (IR) prostate cancer (PCa). Materials and methods Endogenous testosterone density (ETD, ratio between ET and prostate volume [PV]), biopsy positive cores density (BPCD, the ratio between the number of positive cores and PV) and prostate-specific antigen density (PSAD, ratio between total PSA and PV) were retrospectively evaluated on a prospectively collected data on 430 patients with IR PCa submitted to radical prostatectomy (RP). Tumor load (TL) was measured as the percentage of prostatic volume occupied by cancer at final pathology. Unfavorable disease (UD) was defined as tumor upgrading (ISUP grading group 4, 5) and/or upstaging (pT3a or 3b) in prostate specimens. Associations were assessed by the logistic regression and linear regression models. Results Overall, UD, which was detected in 122 out of 430 IR patients (28.4%), was predicted by BPCD (odd ratio, OR = 1.356; 95% CI 1.048–1.754; p = 0.020) with a sensitivity 98.4% and overall accuracy 71.9%. On multivariate analysis, BPCD was independently predicted by PSAD (regression coefficient, b = 1.549; 95% CI 0.936–2.162; p < 0.0001), ETD (b = 0.032; 95% CI 0.023–0.040; p < 0.0001) and TL (b = 0.009; 95% CI 0.005–0.014; p < 0.0001). As BPCD increased, ETD and ET levels increased accordingly, but patients with BPCD > 1.0%/mL had significantly lower ET levels. Conclusions As ETD increased, BPCD and TL increased, accordingly; furthermore, patients with lower ET levels were more likely to have occult UD. The influence of tumor load, and unfavorable disease on ET and ETD needs to be addressed by further studies. Supplementary Information The online version contains supplementary material available at 10.1007/s11255-021-02990-9.
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Affiliation(s)
- Antonio Benito Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy.
| | - Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy. .,Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy. .,Department of Urology, Vito Fazzi Hospital, Lecce, Italy.
| | - Andrea Panunzio
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Nelia Amigoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Clara Cerrato
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Aliasger Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Sebastian Gallina
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alberto Bianchi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Francesco Cianflone
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Emanuele Serafin
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alessandra Gozzo
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Giacomo Di Filippo
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy.,USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.,Department of General and Hepatobiliary Surgery, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Filippo Migliorini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Giovanni Novella
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126, Verona, Italy
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80
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Curcean A, Curcean S, Rescigno P, Dafydd DA, Tree A, Reid A, Koh DM, Sohaib A, Tunariu N, Shur J. Imaging features of the evolving patterns of metastatic prostate cancer. Clin Radiol 2021; 77:88-95. [PMID: 34598790 DOI: 10.1016/j.crad.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 09/02/2021] [Indexed: 12/28/2022]
Abstract
The pattern of metastases in prostate cancer (PC) is evolving. Increased use of imaging, newer imaging techniques with higher sensitivity for disease detection and patients receiving multiple lines of novel therapies with increased life expectancy are likely to be contributory. Awareness of metastatic disease patterns improves early diagnosis, accurate staging, and initiation of appropriate therapy, and can inform prognostic information and anticipate potential disease complications. The aim of this review is to document the spectrum of metastases in PC including emerging and unusual patterns, and to highlight the role of novel imaging including prostate-specific membrane antigen (PSMA)-positron-emission tomography (PET) and whole-body magnetic resonance imaging (WB-MRI) to improve diagnostic and response assessment accuracy.
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Affiliation(s)
- A Curcean
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - S Curcean
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - P Rescigno
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - D Ap Dafydd
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - A Tree
- Institute of Cancer Research, Sutton, Surrey, UK; Academic Uro-oncology Unit, The Royal Marsden NHS Foundation Trust, UK
| | - A Reid
- Institute of Cancer Research, Sutton, Surrey, UK; Academic Uro-oncology Unit, The Royal Marsden NHS Foundation Trust, UK
| | - D-M Koh
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - A Sohaib
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - N Tunariu
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - J Shur
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK.
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81
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Proteomic Landscape of Prostate Cancer: The View Provided by Quantitative Proteomics, Integrative Analyses, and Protein Interactomes. Cancers (Basel) 2021; 13:cancers13194829. [PMID: 34638309 PMCID: PMC8507874 DOI: 10.3390/cancers13194829] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/12/2022] Open
Abstract
Prostate cancer is the second most frequent cancer of men worldwide. While the genetic landscapes and heterogeneity of prostate cancer are relatively well-known already, methodological developments now allow for studying basic and dynamic proteomes on a large scale and in a quantitative fashion. This aids in revealing the functional output of cancer genomes. It has become evident that not all aberrations at the genetic and transcriptional level are translated to the proteome. In addition, the proteomic level contains heterogeneity, which increases as the cancer progresses from primary prostate cancer (PCa) to metastatic and castration-resistant prostate cancer (CRPC). While multiple aspects of prostate adenocarcinoma proteomes have been studied, less is known about proteomes of neuroendocrine prostate cancer (NEPC). In this review, we summarize recent developments in prostate cancer proteomics, concentrating on the proteomic landscapes of clinical prostate cancer, cell line and mouse model proteomes interrogating prostate cancer-relevant signaling and alterations, and key prostate cancer regulator interactomes, such as those of the androgen receptor (AR). Compared to genomic and transcriptomic analyses, the view provided by proteomics brings forward changes in prostate cancer metabolism, post-transcriptional RNA regulation, and post-translational protein regulatory pathways, requiring the full attention of studies in the future.
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82
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Chen H, Cai P, Feng Y, Sun Z, Wang Y, Chen Y, Zhang W, Liu N, Zhou Z. In vitro and in vivo comparative study of a novel 68Ga-labeled PSMA-targeted inhibitor and 68Ga-PSMA-11. Sci Rep 2021; 11:19122. [PMID: 34580375 PMCID: PMC8476564 DOI: 10.1038/s41598-021-98555-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 09/07/2021] [Indexed: 12/25/2022] Open
Abstract
68Ga-radiolabeled small molecules that specifically target prostate-specific membrane antigen (PSMA) have been extensively investigated, and some of these tracers have been used in the diagnosis of prostate cancer via 68Ga-positron emission tomography (68Ga-PET). Nevertheless, current 68Ga-labeled radiotracers show only fair detection rates for metastatic prostate cancer lesions, especially those with lower levels of prostate specific antigen (PSA), which often occurs in the biochemical recurrence of prostate cancer. The goal of this study was to design and synthesize a new PSMA-targeted radiotracer, 68Ga-SC691, with high affinity for prostate cancer cells and excellent pharmacokinetics. To this end, structural optimization was carried out on the bifunctional group, target motif, and linker while the high affinity targeting scaffold remained. To explore its potential in the clinic, a comparative study was further performed in vitro and in vivo between 68Ga-SC691 and 68Ga-PSMA-11, a clinically approved tracer for PSMA-positive prostate cancer. SC691 was radiolabeled to provide 68Ga-SC691 in 99% radiolabeling yield under mild conditions. High uptake and a high internalization ratio into LNCaP cells were observed in in vitro studies. In vivo studies showed that 68Ga-SC691 had favorable biodistribution properties and could specifically accumulate on PSMA-positive LNCaP xenografts visualized by micro-PET/CT. This radiotracer showed excellent PET imaging quality and comparable, if not higher, uptake in LNCaP xenografts than 68Ga-PSMA-11.
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Affiliation(s)
- Huanyu Chen
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China.,Academician (Expert) Workstation of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China
| | - Ping Cai
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China.,Department of Pharmaceutics, School of Pharmacy, Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China
| | - Yue Feng
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China.,Academician (Expert) Workstation of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China
| | - Zhanliang Sun
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China.,Academician (Expert) Workstation of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China
| | - Yinwen Wang
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China.,Department of Pharmaceutics, School of Pharmacy, Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China
| | - Yue Chen
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China.,Academician (Expert) Workstation of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China
| | - Wei Zhang
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China.,Academician (Expert) Workstation of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China
| | - Nan Liu
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China. .,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China. .,Academician (Expert) Workstation of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China.
| | - Zhijun Zhou
- The Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China. .,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China. .,Academician (Expert) Workstation of Sichuan Province, Jiangyang District, Luzhou, Sichuan, China. .,Department of Pharmaceutics, School of Pharmacy, Southwest Medical University, Jiangyang District, Luzhou, Sichuan, China.
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83
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Li M, Chen X, Wang X, Wei X, Wang D, Liu X, Xu L, Batu W, Li Y, Guo B, Zhang L. RSL3 enhances the antitumor effect of cisplatin on prostate cancer cells via causing glycolysis dysfunction. Biochem Pharmacol 2021; 192:114741. [PMID: 34428443 DOI: 10.1016/j.bcp.2021.114741] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/17/2022]
Abstract
The resistance to cisplatin (DDP) and dose-related toxicity are the two important obstacles in the chemotherapy of prostate cancer (PCa) patients. The present study demonstrated that cotreatment of DDP and RSL3, a type of small molecular compound which can inactivate glutathione peroxidase 4 (GPX4) and induce ferroptosis, synergistically inhibited the viability and proliferation of PCa cells in vitro and in vivo at low dose. In vitro studies revealed that RSL3 improved that sensitivity of PCa cells to DDP by producing ROS and aggravating the cell cycle arrest and apoptosis caused by DDP. Mechanistically, RSL3 could decrease the ATP and pyruvate content as well as the protein levels of HKII, PFKP, PKM2, which indicated that RSL3 induced glycolysis dysfunction in prostate cancer cells. Rescuing RSL3-induced glycolysis dysfunction by supplement of exterior sodium pyruvate not only inhibited RSL3/DDP-induced changes of apoptosis-related proteins levels, but also mitigated the cell death caused by RSL3/DDP. In vivo studies further confirmed that cotreatment of RSL3 and DDP at low dose significantly inhibited the growth of PCa with no obvious side effects. Taken together, we demonstrated that RSL3 improved the sensitivity of PCa to DDP via causing glycolysis dysfunction. Our findings indicated that DDP-based chemotherapy combined with RSL3 might provide a promising therapy for PCa.
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Affiliation(s)
- Mengxin Li
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Xuyang Chen
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Xuanzhong Wang
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Xiaodong Wei
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Ding Wang
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Xiaorui Liu
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Libo Xu
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Wuren Batu
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Yang Li
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China.
| | - Baofeng Guo
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
| | - Ling Zhang
- Key Laboratory of Pathobiology, Ministry of Education, and Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, China.
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84
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Xing Q, Liu S, Luan J, Wang Y, Ma L. A novel 13 RNA binding proteins (RBPs) signature could predict prostate cancer biochemical recurrence. Pathol Res Pract 2021; 225:153587. [PMID: 34419719 DOI: 10.1016/j.prp.2021.153587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cancer precision medicine requires biomarkers or signatures to predict prognosis and therapeutic benefits. Driven by this, we established a biochemical recurrence (BCR) predictive model for prostate cancer (PCA) patients based on RNA-binding proteins (RBPs). METHODS RNA-sequencing and corresponding clinicopathological data were downloaded from the Cancer Genome Atlas (TCGA) database and the Gene Expression Omnibus (GEO) database. Univariate COX, LASSO and multivariate COX regression analyses were carried out to develop the BCR predictive riskScore model. Survival analysis, ROC curve, independent prognostic analysis, nomogram were also performed to evaluate this signature internally and externally. RESULTS A total of 13 RBPs including TRMT1L, WBP4, MBNL3, SMAD9, NSUN7, ENG9, PIWIL4, PEG10, CSDC2, HELZ2, CELF2, YBX2 and ESRP2 were eventually identified as BCR-related hub biomarkers and utilized to establish a riskScore. Further analysis including external and internal verification indicated that the patients with high riskScores had shorter time to BCR compared to those with low riskScores in both TCGA and GSE116918. The area under the curve (AUC) of the time-dependent receiver operator characteristic curve (ROC) of the predictive model exhibited a good predictive performance. The signature was also proven to be a valuable independent prognostic factor (all P < 0.05). We also established a nomogram based on the 13 RBPs to visualize the relationships between individual predictors and 1-, 3- and 5-year BCR for PCA. CONCLUSIONS Our results successfully screened out 13 RBPs as a robust BCR-predictive signature in PCA by external and internal verification, helping clinician predict patients' cancer progression status and promoting the specific individualized treatment than original clinical parameters.
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Affiliation(s)
- Qianwei Xing
- Department of Urology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Shouyong Liu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Jiaochen Luan
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yi Wang
- Department of Urology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China.
| | - Limin Ma
- Department of Urology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China.
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85
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A circular RNA, circSMARCA5, inhibits prostate cancer proliferative, migrative, and invasive capabilities via the miR-181b-5p/miR-17-3p-TIMP3 axis. Aging (Albany NY) 2021; 13:19908-19919. [PMID: 34390329 PMCID: PMC8386534 DOI: 10.18632/aging.203408] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/30/2021] [Indexed: 12/11/2022]
Abstract
SMARCA5 (circSMARCA5) is involved in the occurrence of different cancers, but its role in prostate cancer carcinogenesis and metastatic transformation remains elusive. Thus, we evaluated the circSMARCA5 functional relevance in prostate cancer and its associated molecular mechanism. First, circSMARCA5 expression and function in this cancer were evaluated. To determine the miR-181b-5p/miR-17-3p target and clarify how circSMARCA5 regulates the miR-181b-5p-TIMP3 and miR-17-3p-TIMP3 axis, RNA immunoprecipitation, biotin-coupled microRNA capture, luciferase reporter, Western blot, and quantitative real-time PCR assays were employed. In primary and metastatic prostate cancer tissues, circSMARCA5 was significantly downregulated compared with normal controls. Functionally, circSMARCA5 exhibited a suppressive effect on prostate cancer cells' metastasis and growth. At the molecular level, circSMARCA5 could affect the tissue inhibitor of metalloproteinases 3 (TIMP3) expression through miR-181b-5p or miR-17-3p interactions. Moreover, lysine acetyltransferase 5 (KAT5) induced circSMARCA5 biogenesis and regulated the miR-181b-5p-TIMP3 and miR-17-3p-TIMP3 axis. These results suggested that targeting circSMARCA5-miR-181b-5p-TIMP3 and circSMARCA5-miR-17-3p-TIMP3 axis might be a novel therapeutic strategy for prostate cancer.
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86
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Monteiro FSM, Schutz FA, Morbeck IAP, Bastos DA, de Padua FV, Costa LAGA, Maia MC, Rinck JA, Zequi SDC, da Trindade KM, Alfer W, Nahas WC, Dos Santos LV, Ferrigno R, da Rosa DAR, Sade JP, Orlandi FJ, de Oliveira FNG, Soares A. Consensus on Treatment and Follow-Up for Biochemical Recurrence in Castration-Sensitive Prostate Cancer: A Report From the First Global Prostate Cancer Consensus Conference for Developing Countries. JCO Glob Oncol 2021; 7:538-544. [PMID: 33856897 PMCID: PMC8162965 DOI: 10.1200/go.20.00508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To present a summary of the treatment and follow-up recommendations for the biochemical recurrence in castration-sensitive prostate cancer (PCa) acquired through a questionnaire administered to 99 PCa experts from developing countries during the Prostate Cancer Consensus Conference for Developing Countries. METHODS A total of 27 questions were identified as related to this topic from more than 300 questions. The clinician's responses were tallied and presented in a percentage format. Topics included the use of imaging for staging biochemical recurrence, treatment recommendations for three different clinical scenarios, the field of radiation recommended, and follow-up. Each question had 5-7 relevant response options, including “abstain” and/or “unqualified to answer,” and investigated not only recommendations but also if a limitation in resources would change the recommendation. RESULTS For most questions, a clear majority (> 50%) of clinicians agreed on a recommended treatment for imaging, treatment scenarios, and follow-up, although only a few topics reached a consensus > 75%. Limited resources did affect several areas of treatment, although in many cases, they reinforced more stringent criteria for treatment such as prostate-specific antigen values > 0.2 ng/mL and STAMPEDE inclusion criteria as a basis for recommending treatment. CONCLUSION A majority of clinicians working in developing countries with limited resources use similar cutoff points and selection criteria to manage patients treated for biochemically recurrent castration-sensitive PCa.
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Affiliation(s)
- Fernando S M Monteiro
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Hospital Santa Lucia, Brasilia, Brazil.,Hospital Universitario de Brasilia, Brasilia, Brazil
| | - Fabio A Schutz
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Beneficencia Portuguesa de São Paulo-BP, São Paulo, Brazil
| | - Igor A P Morbeck
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Hospital Sírio-Libanês, Brasília, Brazil.,Universidade Católica de Brasília, Brasilia, Brazil
| | - Diogo A Bastos
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Hospital Sirio-Libanês, São Paulo, Brazil.,Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Fernando V de Padua
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Hospital Sírio-Libanês, Brasília, Brazil.,Hospital de Base de Brasília, Brasilia, Brazil
| | - Leonardo A G A Costa
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Grupo Oncologia D'Or, Fortaleza, Brazil
| | - Manuel C Maia
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Centro de Oncologia do Paraná, Curitiba, Brazil.,Hospital Universitário Evangélico Mackenzie, Curitiba, Brazil
| | - Jose A Rinck
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,AC Camargo Cancer Center, São Paulo, Brazil
| | | | - Karine M da Trindade
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Oncocentro, Fortaleza, Brazil.,Santa Casa de Misericórdia de Fortaleza, Fortaleza, Brazil
| | | | - William C Nahas
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brazil
| | | | | | - Diogo A R da Rosa
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Grupo Oncoclinicas, Rio de Janeiro, Brazil
| | - Juan P Sade
- Hospital Universitario Austral, Buenos Aires, Argentina
| | | | - Fernando N G de Oliveira
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,CLION-Clínica de Oncologia, Salvador, Brazil
| | - Andrey Soares
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil.,Centro Paulista de Oncologia/Oncoclínicas, São Paulo, Brazil
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Pereira FMT, Silva AGE, Dettino ALA, Cardoso APG, Sasse AD, Kann AG, Dzik C, Herchenhorn D, Jardim DLF, Lopera D, Ayadi M, Salman P, Kopp RAM, De Carvalho RS, Cavallero SRDA, Aguiar S, Souza VC, Uson Junior PLS, Soares A. Consensus on the Treatment and Follow-Up for the Nonmetastatic Castration-Resistant Prostate Cancer: A Report From the First Prostate Cancer Consensus Conference for Developing Countries. JCO Glob Oncol 2021; 7:545-549. [PMID: 33856892 PMCID: PMC8162973 DOI: 10.1200/go.20.00507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To present a summary of the recommendations for the treatment and follow-up for the biochemical recurrence of castration-resistant prostate cancer (PCa) as acquired through a questionnaire administered at the Prostate Cancer Consensus Conference for Developing Countries. METHODS A total of 27 questions were identified as relating to this topic. Responses from the clinician were tallied and are presented in percentage format. Topics included the use of imaging in staging, treatment recommendations across different patient scenarios of life expectancy and prostate-specific antigen (PSA) doubling time, and follow-up for nonmetastatic castration-resistant PCa. RESULTS A consensus agreed that in optimal conditions, positron emission tomography-computed tomography with prostate-specific membrane antigen would be used although in limited resource situations the combined use of CT of the abdomen and pelvic (or pelvic MRI), a bone scan, and a CT of the thorax or chest x-ray was recommended. In cases when PSA levels double in < 10 months, more than 90% of clinicians agreed on the use of apalutamide or enzalutamide, regardless of life expectancy. With a doubling time of more than 10 months, > 54% of experts recommended no treatment independent of life expectancy. More than half of the experts, regardless of resources, recommended follow-up with a physical examination and PSA levels every 3-6 months and imaging only in the case of symptoms. CONCLUSION The voting results and recommendations presented in this document can be used by physicians to support management for biochemical recurrence of castration-resistant PCa in areas of limited resources. Individual clinical decision making should be supported by available data.
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Affiliation(s)
- Felipe Moraes Toledo Pereira
- Hospital São Camilo, Pompeia, São Paulo, Brazil.,Latin American Cooperative Oncology Group-Genitourinary, Porto Alegre, Brazil
| | | | | | - Ana Paula Garcia Cardoso
- Latin American Cooperative Oncology Group-Genitourinary, Porto Alegre, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Ariel Galapo Kann
- Latin American Cooperative Oncology Group-Genitourinary, Porto Alegre, Brazil.,Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.,Centro Paulista de Oncologia-Oncoclínicas, São Paulo, Brazil
| | - Carlos Dzik
- Hospital São Camilo, Pompeia, São Paulo, Brazil.,Latin American Cooperative Oncology Group-Genitourinary, Porto Alegre, Brazil
| | - Daniel Herchenhorn
- Latin American Cooperative Oncology Group-Genitourinary, Porto Alegre, Brazil.,Grupo d'Or de Oncologia, Rio de Janeiro, Brazil
| | | | | | - Mouna Ayadi
- Salah Azaiz Institute, Tunis, Tunisia.,Faculté de médecine, Tunis, Tunisia
| | | | | | | | | | | | - Vinicius Carrera Souza
- Latin American Cooperative Oncology Group-Genitourinary, Porto Alegre, Brazil.,Grupo d'Or de Oncologia, Bahia, Brazil
| | | | - Andrey Soares
- Latin American Cooperative Oncology Group-Genitourinary, Porto Alegre, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil.,Centro Paulista de Oncologia-Oncoclínicas, São Paulo, Brazil
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Meehan J, Gray M, Martínez-Pérez C, Kay C, McLaren D, Turnbull AK. Tissue- and Liquid-Based Biomarkers in Prostate Cancer Precision Medicine. J Pers Med 2021; 11:jpm11070664. [PMID: 34357131 PMCID: PMC8306523 DOI: 10.3390/jpm11070664] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 12/24/2022] Open
Abstract
Worldwide, prostate cancer (PC) is the second-most-frequently diagnosed male cancer and the fifth-most-common cause of all cancer-related deaths. Suspicion of PC in a patient is largely based upon clinical signs and the use of prostate-specific antigen (PSA) levels. Although PSA levels have been criticised for a lack of specificity, leading to PC over-diagnosis, it is still the most commonly used biomarker in PC management. Unfortunately, PC is extremely heterogeneous, and it can be difficult to stratify patients whose tumours are unlikely to progress from those that are aggressive and require treatment intensification. Although PC-specific biomarker research has previously focused on disease diagnosis, there is an unmet clinical need for novel prognostic, predictive and treatment response biomarkers that can be used to provide a precision medicine approach to PC management. In particular, the identification of biomarkers at the time of screening/diagnosis that can provide an indication of disease aggressiveness is perhaps the greatest current unmet clinical need in PC management. Largely through advances in genomic and proteomic techniques, exciting pre-clinical and clinical research is continuing to identify potential tissue, blood and urine-based PC-specific biomarkers that may in the future supplement or replace current standard practices. In this review, we describe how PC-specific biomarker research is progressing, including the evolution of PSA-based tests and those novel assays that have gained clinical approval. We also describe alternative diagnostic biomarkers to PSA, in addition to biomarkers that can predict PC aggressiveness and biomarkers that can predict response to certain therapies. We believe that novel biomarker research has the potential to make significant improvements to the clinical management of this disease in the near future.
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Affiliation(s)
- James Meehan
- Translational Oncology Research Group, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK; (C.M.-P.); (C.K.); (A.K.T.)
- Correspondence:
| | - Mark Gray
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Midlothian EH25 9RG, UK;
| | - Carlos Martínez-Pérez
- Translational Oncology Research Group, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK; (C.M.-P.); (C.K.); (A.K.T.)
- Breast Cancer Now Edinburgh Research Team, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Charlene Kay
- Translational Oncology Research Group, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK; (C.M.-P.); (C.K.); (A.K.T.)
- Breast Cancer Now Edinburgh Research Team, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Duncan McLaren
- Edinburgh Cancer Centre, Western General Hospital, NHS Lothian, Edinburgh EH4 2XU, UK;
| | - Arran K. Turnbull
- Translational Oncology Research Group, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK; (C.M.-P.); (C.K.); (A.K.T.)
- Breast Cancer Now Edinburgh Research Team, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK
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Safety and preliminary immunogenicity of JNJ-64041809, a live-attenuated, double-deleted Listeria monocytogenes-based immunotherapy, in metastatic castration-resistant prostate cancer. Prostate Cancer Prostatic Dis 2021; 25:219-228. [PMID: 34257408 PMCID: PMC9184270 DOI: 10.1038/s41391-021-00402-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/06/2021] [Accepted: 05/27/2021] [Indexed: 12/24/2022]
Abstract
Background The safety and immunogenicity of JNJ-64041809 (JNJ-809), a live-attenuated, double-deleted Listeria monocytogenes (LADD Lm)-based immunotherapy targeting 4 relevant prostate cancer antigens, was evaluated in a phase 1 study in patients with metastatic castration-resistant prostate cancer (mCRPC). Methods Men with progressive mCRPC who had received ≥2 prior approved therapies were enrolled. Primary study objectives were to determine the recommended phase 2 dose (RP2D) and to evaluate the safety and immunogenicity of JNJ-809. Results A total of 26 patients received JNJ-809 (1 × 108 CFU (n = 6); 1 × 109 CFU (n = 20)). No dose-limiting toxicities were reported, and 1 × 109 CFU was selected as the RP2D. The most common adverse events (AEs) reported were chills (92%), pyrexia (81%), and fatigue (62%). The most frequent grade ≥3 AEs were lymphopenia (27%) and hypertension (23%). Serious AEs were reported in 27% of patients including 1 patient with grade 3 intestinal obstruction. JNJ-809 transiently induced peripheral cytokines, including interferon-γ, interleukin-10, and tumor necrosis factor-α. Of the 7 patients evaluable for T cell responses at the 1 × 109 CFU dose, evidence of post-treatment antigenic responses were observed in 6 to the Listeria antigen listeriolysin O and in 5 to ≥1 of the 4 encoded tumor antigens. Best overall response was stable disease in 13/25 response-evaluable patients. The study was terminated early as data collected were considered sufficient to evaluate safety and immunogenicity. Conclusions JNJ-809 has manageable safety consistent with other LADD Lm-based therapies. Limited antigen-specific immune responses were observed, which did not translate into objective clinical responses.
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90
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Jereczek-Fossa BA, Marvaso G, Zaffaroni M, Gugliandolo SG, Zerini D, Corso F, Gandini S, Alongi F, Bossi A, Cornford P, De Bari B, Fonteyne V, Hoskin P, Pieters BR, Tree AC, Arcangeli S, Fuller DB, Franzese C, Hannoun-Levi JM, Janoray G, Kerkmeijer L, Kwok Y, Livi L, Loi M, Miralbell R, Pasquier D, Pinkawa M, Scher N, Scorsetti M, Shelan M, Toledano A, van As N, Vavassori A, Zilli T, Pepa M, Ost P. Salvage stereotactic body radiotherapy (SBRT) for intraprostatic relapse after prostate cancer radiotherapy: An ESTRO ACROP Delphi consensus. Cancer Treat Rev 2021; 98:102206. [PMID: 33965893 DOI: 10.1016/j.ctrv.2021.102206] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Between 30% and 47% of patients treated with definitive radiotherapy (RT) for prostate cancer are at risk of intraprostatic recurrence during follow-up. Re-irradiation with stereotactic body RT (SBRT) is emerging as a feasible and safe therapeutic option. However, no consensus or guidelines exist on this topic. The purpose of this ESTRO ACROP project is to investigate expert opinion on salvage SBRT for intraprostatic relapse after RT. MATERIALS AND METHODS A 40-item questionnaire on salvage SBRT was prepared by an internal committee and reviewed by a panel of leading radiation oncologists plus a urologist expert in prostate cancer. Following the procedure of a Delphi consensus, 3 rounds of questionnaires were sent to selected experts on prostate re-irradiation. RESULTS Among the 33 contacted experts, 18 (54.5%) agreed to participate. At the end of the final round, participants were able to find consensus on 14 out of 40 questions (35% overall) and major agreement on 13 questions (32.5% overall). Specifically, the consensus was reached regarding some selection criteria (no age limit, ECOG 0-1, satisfactory urinary flow), diagnostic procedures (exclusion of metastatic disease, SBRT target defined on the MRI) and therapeutic approach (no need for concomitant ADT, consideration of the first RT dose, validity of Phoenix criteria for salvage SBRT failure). CONCLUSION While awaiting the results of ongoing studies, our ESTRO ACROP Delphi consensus may serve as a practical guidance for salvage SBRT. Future research should address the existing disagreements on this promising approach.
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Affiliation(s)
- Barbara A Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Simone Giovanni Gugliandolo
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy; Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Dario Zerini
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Corso
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Centre for Analysis Decisions and Society (CADS), Human Technopole, Department of Mathematics (DMAT) - MOX Laboratory, Politecnico di Milano, Milan, Italy
| | - Sara Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Filippo Alongi
- Department of Advanced Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy; University of Brescia, Brescia, Italy
| | - Alberto Bossi
- Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France
| | - Philip Cornford
- Liverpool University Hospitals Foundation NHS Trust, Liverpool, UK
| | - Berardino De Bari
- Radiation Oncology, Réseau Hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland; University of Lausanne (UniL), Lausanne, Switzerland
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Bradley R Pieters
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Alison C Tree
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - Stefano Arcangeli
- Department of Radiation Oncology, S. Gerardo Hospital, University of Milan Bicocca, Milan, Italy
| | - Donald B Fuller
- Department of Radiation Oncology, Genesis Health Care Partners, Inc, San Diego, CA, USA
| | - Ciro Franzese
- Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele - Milan, Italy
| | - Jean-Michel Hannoun-Levi
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice, France
| | - Guillaume Janoray
- Department of Radiation-Oncology, Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; University François-Rabelais, Tours, France
| | | | - Young Kwok
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lorenzo Livi
- Radiotherapy Department, University of Florence, Florence, Italy
| | - Mauro Loi
- Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | | | - David Pasquier
- Academic Department of Radiation Oncology, Centre O. Lambret, Lille, France; CRIStAL UMR 9189, Lille University, Lille, France
| | - Michael Pinkawa
- Department of Radiation Oncology, MediClin Robert Janker Klinik, Bonn, Germany
| | - Nathaliel Scher
- Hartmann Radiotherapy Institute, Hartmann Oncology Radiotherapy Group, Levallois-Perret, France; Rafael Institute Center for Predictive Medicine, Levallois-Perret, France
| | - Marta Scorsetti
- Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele - Milan, Italy
| | - Mohamed Shelan
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alain Toledano
- Hartmann Radiotherapy Institute, Hartmann Oncology Radiotherapy Group, Levallois-Perret, France; Rafael Institute Center for Predictive Medicine, Levallois-Perret, France
| | - Nicholas van As
- Department of Clinical Oncology, St Thomas' Hospital, London, UK
| | - Andrea Vavassori
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Thomas Zilli
- Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland; Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Matteo Pepa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Piet Ost
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
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Stewart RJ, Humphris GM, Donaldson J, Cruickshank S. Does Cancer Type Influence the Impact of Recurrence? A Review of the Experience of Patients With Breast or Prostate Cancer Recurrence. Front Psychol 2021; 12:635660. [PMID: 34267696 PMCID: PMC8276075 DOI: 10.3389/fpsyg.2021.635660] [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: 11/30/2020] [Accepted: 06/04/2021] [Indexed: 12/02/2022] Open
Abstract
Objective: Patients will experience a plethora of issues when faced with a recurrence of their cancer. It is unclear if cancer type is a significant factor in how recurrence is experienced by an individual. The aim of the current review is to explore the evidence base and summarise the experiences of patients specifically with a recurrence of breast or prostate cancer (the most common for women and men, respectively) and then provide a comparison of these experiences. These experiences include the physical, psychological and psychosocial issues that arise at this time. Methods: A systematic search was conducted of studies published between January 1994 and April 2019. Due to the mix of research designs used previously in the literature, this review was conducted in an integrative manner; allowing for inclusion of diverse research designs. Results were synthesised narratively, with data categorised according to physical, psychological, and psychosocial indices of quality of life. The review protocol was registered in the international database of prospective systematic reviews in health and social care- (CRD42019137381). Results: Fifteen breast cancer and six prostate cancer articles were identified, each reporting one relevant study. Patients reported several negative issues at the time of a breast or prostate cancer recurrence. Similarities were found between cancer types, with physical problems such as fatigue, psychological issues including anxiety and depressive symptoms, and psychosocial concerns such as issues with healthcare professionals common in both cancers. Certain findings were inconsistent across studies, with some experiences differing between studies rather than due to cancer type. Conclusions: Differences in the experience of recurrent cancer appear to be more heavily influenced by individual factors, rather than cancer type. Findings are confounded by gender; and should be considered preliminary. Effects of recurrence should be studied in samples where cancer type and gender are not confounded. Concerns are raised about available study quality and differing outcome measures in this interpretation. Care and support of the individual at the time of a cancer recurrence is a key focus. Future research suggestions with implications for clinical practise are included. Systematic Review Registration: PROSPERO 2019 CRD42019137381.
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Affiliation(s)
- Ross James Stewart
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | | | - Jayne Donaldson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Susanne Cruickshank
- Royal Marsden National Health Service Foundation Trust, London, United Kingdom
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Evaluation of Quantitative Ga-68 PSMA PET/CT Repeatability of Recurrent Prostate Cancer Lesions Using Both OSEM and Bayesian Penalized Likelihood Reconstruction Algorithms. Diagnostics (Basel) 2021; 11:diagnostics11061100. [PMID: 34208531 PMCID: PMC8233885 DOI: 10.3390/diagnostics11061100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 01/04/2023] Open
Abstract
Rationale: To formally determine the repeatability of Ga-68 PSMA lesion uptake in both relapsing and metastatic tumor. In addition, it was hypothesized that the BPL algorithm Q. Clear has the ability to lower SUV signal variability in the small lesions typically encountered in Ga-68 PSMA PET imaging of prostate cancer. Methods: Patients with biochemical recurrence of prostate cancer were prospectively enrolled in this single center pilot test-retest study and underwent two Ga-68 PSMA PET/CT scans within 7.9 days on average. Lesions were classified as suspected local recurrence, lymph node metastases or bone metastases. Two datasets were generated: one standard PSF + OSEM and one with PSF + BPL reconstruction algorithm. For tumor lesions, SUVmax was determined. Repeatability was formally assessed using Bland–Altman analysis for both BPL and standard reconstruction. Results: A total number of 65 PSMA-positive tumor lesions were found in 23 patients (range 1 to 12 lesions a patient). Overall repeatability in the 65 lesions was −1.5% ± 22.7% (SD) on standard reconstructions and −2.1% ± 29.1% (SD) on BPL reconstructions. Ga-68 PSMA SUVmax had upper and lower limits of agreement of +42.9% and −45.9% for standard reconstructions and +55.0% and −59.1% for BPL reconstructions, respectively (NS). Tumor SUVmax repeatability was dependent on lesion area, with smaller lesions exhibiting poorer repeatability on both standard and BPL reconstructions (F-test, p < 0.0001). Conclusion: A minimum response of 50% seems appropriate in this clinical situation. This is more than the recommended 30% for other radiotracers and clinical situations (PERCIST response criteria). BPL does not seem to lower signal variability in these cases.
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93
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Peripheral androgen blockade in men with castrate-sensitive biochemical recurrent prostate cancer. Med Oncol 2021; 38:80. [PMID: 34089393 DOI: 10.1007/s12032-021-01506-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/27/2021] [Indexed: 01/27/2023]
Abstract
The aim of the study was to evaluate the feasibility of utilizing peripheral androgen blockade in men with biochemical recurrent castrate-sensitive prostate cancer. A registration study to track outcomes of men with biochemical recurrent castrate-sensitive prostate cancer treated with peripheral androgen blockade utilizing concomitant administration of finasteride and bicalutamide. Men were on intermittent peripheral blockade for a median 20.2 months, continuous peripheral blockade for a median 6.8 months, intermittent triple dose peripheral androgen blockade for a median 10.7 months, and continuous triple dose peripheral androgen blockade for 4.4 months before failing therapy. Six men (21%) had additional therapies during treatment that included metastasis-directed therapy (5/37, 14%), systemic Lu-177 (2/37, 5%), and salvage RT (1/37, 3%). The median time to progression, which includes time from initiation through all therapies to the initiation of ADT, was 37.6 months (IQR 20-74.7). From the start of PAB, median time to castrate resistance was 49.8 months (IQR 40.9-NR). After starting ADT, median time to castrate resistance was 8.8 months (IQR 4.6-17.7). Our data support the exploration of PAB as a treatment option in carefully selected patients who present with biochemical recurrence after failure of definitive local therapy for prostate cancer.
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Zaghloul A, Abdelbary A, Fergany A, Aboulkassem H, Fadlalla WM. Robotic Radical Prostatectomy at the Egyptian National Cancer Institute: Overcoming the Challenges in the Initial Case Series. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Robotic prostatectomy is showing progressive worldwide spread owing to potential clinical benefits, but at a higher cost.
AIM: This article describes the challenges and clinical outcomes of the first group of patients undergoing robotic prostatectomy in Egypt.
DESIGN, SETTING, PARTICIPANTS: From 2017 to 2019, the data of all (55) patients undergoing robotic radical prostatectomy at the National Cancer Institute of Egypt were retrospectively analyzed.
OUTCOME EVALUATION: Short-term operative outcomes, complications, technical difficulties, pathologic data, and biochemical recurrence were reported.
RESULTS: Average blood loss was 296 ml; one patient required blood transfusion. One case required open conversion, another required re-docking of the robot. Setup time was significantly improved from an average of 27.7 min in the first 27 cases to an average of 17.3 min in the final 28 cases (p < 0.0001). Complications developed in 27% of our patients. Continence recovery at catheter removal, 1st, 3rd, 6th, and 12th months were 32.7%, 50.9%, 65.5%, 74.5%, and 96%, respectively.
CONCLUSIONS: Results from the first series of robotic radical prostatectomy were encouraging. Technical challenges can be overcome in a short period using a dedicated team supplemented by institutional support. Acceptable complication rate and satisfactory outcomes regarding continence and blood loss were observed.
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Briones J, Khan M, Sidhu AK, Zhang L, Smoragiewicz M, Emmenegger U. Population-Based Study of Docetaxel or Abiraterone Effectiveness and Predictive Markers of Progression Free Survival in Metastatic Castration-Sensitive Prostate Cancer. Front Oncol 2021; 11:658331. [PMID: 34026638 PMCID: PMC8138065 DOI: 10.3389/fonc.2021.658331] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Both Docetaxel (DOC) and Abiraterone (ABI) improve the survival of men with metastatic, castration sensitive prostate cancer (mCSPC). However, the outcome among mCSPC patients is highly variable, while there is a lack of predictive markers of therapeutic benefit. Furthermore, there is limited data on the comparative real-world effectiveness of adding DOC or ABI to androgen deprivation therapy (ADT). METHODS We conducted a retrospective analysis of 121 mCSPC patients treated at Odette Cancer Centre (Toronto, ON, Canada) between Dec 2014 and Mar 2021 (DOC n = 79, ABI n = 42). The primary endpoint studied was progression free survival (PFS), defined as the interval from start of ADT to either (i) biochemical, radiological, or symptomatic progression, (ii) start of first-line systemic therapy for castration-resistant prostate cancer (CRPC), or (iii) death, whichever occurred first. To identify independent predictive factors for PFS in the entire cohort, a Cox proportional hazard model (stepwise selection) was applied. Overall survival (OS) was among secondary endpoints. RESULTS After a median follow-up of 39.6 and 25.1 months in the DOC and ABI cohorts, respectively, 79.7% of men in the DOC and 40.5% in the ABI group experienced a progression event. PFS favored the ABI cohort (p = 0.0038, log-rank test), with 78.0% (95%CI 66.4-91.8%) of ABI versus 67.1% (57.5-78.3%) of DOC patients being free of progression at 12 months. In univariate analysis superior PFS was significantly related to older age at diagnosis of mCSPC, metachronous metastatic presentation, low-volume (CHAARTED), and low-risk (LATITUDE) disease, ≥90% PSA decrease at 3 months (PSA90), and PSA nadir ≤0.2 at 6 months. Age (HR = 0.955), PSA90 (HR = 0.462), and LATITUDE risk stratification (HR = 1.965) remained significantly associated with PFS in multivariable analysis. OS at 12 months was 98.7% (96.3-100%) and 92.7% (85.0-100%) in the DOC and ABI groups (p = 0.97), respectively. CONCLUSIONS In this real-world group of men undergoing treatment intensification with DOC or ABI for mCSPC, we did not find a significant difference in OS, but PFS was favoring ABI. Age at diagnosis of mCSPC, PSA90 at 3 months and LATITUDE risk classification are predictive factors of PFS in men with mCSPC.
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Affiliation(s)
- Juan Briones
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Maira Khan
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Amanjot K. Sidhu
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Liying Zhang
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Martin Smoragiewicz
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Urban Emmenegger
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Biological Sciences Research Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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Ahmadi Bidakhvidi N, Laenen A, Jentjens S, Deroose CM, Van Laere K, De Wever L, Mai C, Berghen C, De Meerleer G, Haustermans K, Joniau S, Everaerts W, Goffin K. Parameters predicting [ 18F]PSMA-1007 scan positivity and type and number of detected lesions in patients with biochemical recurrence of prostate cancer. EJNMMI Res 2021; 11:41. [PMID: 33929626 PMCID: PMC8087750 DOI: 10.1186/s13550-021-00783-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Detection of the site of recurrence using PSMA-PET/CT is important to guide treatment in patients with biochemical recurrence of prostate cancer (PCa). The aim of this study was to evaluate the positivity rate of [18F]PSMA-1007-PET/CT in patients with biochemically recurrent PCa and identify parameters that predict scan positivity as well as the type and number of detected lesions. This monocentric retrospective study included 137 PCa patients with biochemical recurrence who underwent one or more [18F]PSMA-1007-PET/CT scans between August 2018 and June 2019. PET-positive malignant lesions were classified as local recurrence, lymph node (LN), bone or soft tissue lesions. The association between biochemical/paraclinical parameters, as PSA value, PSA doubling time, PSA velocity, Gleason score (GS) and androgen deprivation therapy (ADT), and scan positivity as well as type and number of detected lesions was evaluated using logistic regression analysis (binary outcomes) and Poisson models (count-type outcomes). RESULTS We included 175 [18F]PSMA-1007-PET/CT scans after radical prostatectomy (78%), external beam radiation therapy (8.8%), ADT (7.3%), brachytherapy (5.1%) and high intensity focused ultrasound (0.7%) as primary treatment (median PSA value 1.6 ng/ml). Positivity rate was 80%. PSA value and PSA velocity were significant predictors of scan positivity as well as of the presence of bone and soft tissue lesions and number of bone, LN and soft tissue lesions, both in uni- and/or multivariable analysis. Multivariable analysis also showed prior ADT as predictor of bone and soft tissue lesions, GS as predictor of the number of bone lesions and ongoing ADT as predictor of the number of LN lesions. CONCLUSION [18F]PSMA-1007-PET/CT showed a high positivity rate in patients with biochemically recurrent PCa. PSA value and PSA velocity were significant predictors of scan positivity as well as of the presence and number of bone and soft tissue lesions and the number of LN lesions. Our findings can guide clinicians in optimal patient selection for [18F]PSMA-1007-PET/CT and support further research leading to the development of a prediction nomogram.
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Affiliation(s)
| | - Annouschka Laenen
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, 3000, Leuven, Belgium
| | - Sander Jentjens
- Department of Nuclear Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Christophe M Deroose
- Department of Nuclear Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.,Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, 3000, Leuven, Belgium
| | - Koen Van Laere
- Department of Nuclear Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.,Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, 3000, Leuven, Belgium
| | - Liesbeth De Wever
- Department of Radiology, University Hospitals Leuven, 3000, Leuven, Belgium
| | - Cindy Mai
- Department of Radiology, University Hospitals Leuven, 3000, Leuven, Belgium
| | - Charlien Berghen
- Department of Radiation Oncology, University Hospitals Leuven, 3000, Leuven, Belgium
| | - Gert De Meerleer
- Department of Radiation Oncology, University Hospitals Leuven, 3000, Leuven, Belgium.,Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, 3000, Leuven, Belgium
| | - Karin Haustermans
- Department of Radiation Oncology, University Hospitals Leuven, 3000, Leuven, Belgium.,Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, 3000, Leuven, Belgium
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, 3000, Leuven, Belgium.,Urogenital, Abdominal and Plastic Surgery, Department of Development and Regeneration, KU Leuven, 3000, Leuven, Belgium
| | - Wouter Everaerts
- Department of Urology, University Hospitals Leuven, 3000, Leuven, Belgium.,Urogenital, Abdominal and Plastic Surgery, Department of Development and Regeneration, KU Leuven, 3000, Leuven, Belgium
| | - Karolien Goffin
- Department of Nuclear Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.,Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, 3000, Leuven, Belgium
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97
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Zhang Q, Luan J, Song L, Wei X, Xia J, Song N. Malignant Evaluation and Clinical Prognostic Values of M6A RNA Methylation Regulators in Prostate Cancer. J Cancer 2021; 12:3575-3586. [PMID: 33995635 PMCID: PMC8120168 DOI: 10.7150/jca.55140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/09/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: M6A RNA modification is closely associated with tumor genesis and progression of several malignancies; however, its role in prostate cancer (PCa) remains poorly understood. Materials and methods: Expression data and corresponding clinicopathologic information were available freely from the Cancer Genome Atlas (TCGA) dataset. We compared the expression level of m6A RNA methylation regulators in PCa with different clinicopathologic characteristics and identified subgroups based on their expressions with consensus clustering. To build the signature and assess its prognostic value, several methods were used for the analysis, including univariate Cox regression analysis, Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis, time-dependent receiver operating curve (ROC), and Kaplan-Meier (KM) survival analysis. Results: Most of the m6A RNA methylation regulators were differentially expressed not only between normal and tumor tissue but also among PCa stratified by different clinicopathologic characteristics. There were obvious differences between two clusters, cluster 1 and 2, regarding clinicopathologic features, and the recurrence-free survival (RFS) in cluster 2 was significantly worse than cluster 1. We developed an eleven-gene signature which exhibited a high prognostic value and was able to independently predict RFS. Moreover, a nomogram which integrated clinical information and the gene signature was capable of distinguishing high-risk recurrent patients. Conclusion: These methylation regulators are correlated to clinicopathologic characteristics in PCa and a prognostic model using m6A methylation-related genes is constructed and of high predictive value for recurrence after RP.
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Affiliation(s)
- Qijie Zhang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiaochen Luan
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lebin Song
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiyi Wei
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiadong Xia
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,The Affiliated Kezhou People's Hospital of Nanjing Medical University, Kezhou, Xinjiang, China
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98
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Wang S, Du P, Cao Y, Yang X, Yang Y. Tumor Biological Feature and Its Association with Positive Surgical Margins and Apical Margins after Radical Prostatectomy in Non-Metastasis Prostate Cancer. ACTA ACUST UNITED AC 2021; 28:1528-1536. [PMID: 33924669 PMCID: PMC8167593 DOI: 10.3390/curroncol28020144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/05/2021] [Accepted: 04/11/2021] [Indexed: 11/16/2022]
Abstract
Purpose: We assessed clinical and tumor biological features and evaluated their association with positive surgical margins (PSMs) and positive apical margins (PAMs) variability after radical prostatectomy (RP) in men with non-metastasis prostate cancer (nmPCa) in our institute. Patients and methods: During the period from January 2013 to December 2017, clinical and pathological data were collected in 200 patients with nmPCa undergoing RP in the Urological department of Peking University Cancer Hospital & Institute. Surgical and apical margins were stated negative and positive, separately. A dichotomous logistic regression model was used to assess clinical and tumor biological features including age, total prostate volume (TPV), biopsy positive cores (BPC), D’Amico risk grade, tumor clinical stage, International Society of Urologic Pathology (ISUP) grade, tPSA, f/t and pelvic lymph nodes (PLN) invasion, and their association with PSMs and PAMs was evaluated. Results: Overall, men with nmPCa in this study had a high ISUP grade (58.5% grade 3–5), high risk grade (89.4%) and high clinical T stage (56% cT3-4). PSMs were detected in 106 patients; the rate of PSMs was 53%. Among patients with PSMs, 83% were PAMs; the overall rate of PAMs was 44%. Among patients with PSMs, high risk (OR, 1.439; p = 0.023), cT3a (OR, 1.737; p = 0.045), cT3b (OR, 5.286; p < 0.001), cT4 (OR, 6.12; p < 0.001), ISUP Grade 4 (OR, 2; p = 0.034) and Grade 5 (OR, 6.167; p < 0.001) and PLN invasion (OR, 6; p = 0.019) were strongly associated with PSMs using a dichotomous logistic regression univariable model, and high risk (OR, 6; p = 0.019), cT3a (OR, 5.116; p = 0.048), cT3b (OR, 9.194; p = 0.008), cT4 (OR, 4.58; p = 0.01), ISUP Grade 4 (OR, 7.04; p = 0.035), Grade 5 (OR, 16.514; p = 0.002) and PLN invasion (OR, 5.516; p = 0.03) were independently associated with PSMs by using multivariable analysis. Among patients with PAMs, cT3b (OR, 2.667; p = 0.004), cT4 (OR, 3; p = 0.034) and proportion of BPC (OR, 4.594; p = 0.027) were strongly associated with PAMs by using a dichotomous logistic regression univariable model, and cT3b (OR, 3.899; p = 0.02), cT4 (OR, 2.8; p = 0.041) and proportion of BPC (OR, 5.247; p = 0.04) were independently associated with PSMs by using multivariable analysis. Conclusions: Patients with nmPCa in our institute had high risk, high ISUP grade and high clinical stage. Tumor biological factors were strongly associated with PSMs and PAMs, and PLN invasion was independently associated with PSMs. The risk factors influenced the status of surgical margins, and apical margins were different.
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99
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von Eyben FE, Soydal C, von Eyben R. 68Ga-PSMA PET/CT for Patients with PSA Relapse after Radical Prostatectomy or External Beam Radiotherapy. Diagnostics (Basel) 2021; 11:diagnostics11040622. [PMID: 33808350 PMCID: PMC8066852 DOI: 10.3390/diagnostics11040622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/16/2022] Open
Abstract
The study aimed to summarize clinical characteristics associated with Gallium-68-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (68Ga-PSMA PET/CT) scans as patients were restaged for prostate-specific antigen (PSA) relapse after radical prostatectomy (RP) or external beam radiotherapy (EBRT). Our analyses included multiple cox regression analyses. The study evaluated 95 patients with rising values of PSAs after RP and after EBRT. Sixty 63% of patients had a positive 68Ga-PSMA PET/CT scan. Twelve patients (13%) had a positive site in the prostate bed, 29 patients (30%) had a positive site in the regional lymph nodes, and 19 (20%) had positive sites in distant organs. After four years follow-up, 21 patients (22%) died. Using multiple Cox regression analyses, the number of positive sites on the 68Ga-PSMA PET/CT scan significantly predicted overall survival (OS) (p = 0.0001), whereas risk score and regional locations of the positive sites were not significant in the multiple Cox regression analyses. Our study indicates that the specific findings of 68Ga-PSMA PET/CT scans are important because detailed findings of the scans predict the outcome after salvage treatment of patients with PSA relapse examined with 68Ga-PSMA PET/CT scans.
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Affiliation(s)
| | - Cigdem Soydal
- Department of Nuclear Medicine, Ankara University, 06560 Ankara, Turkey;
| | - Rie von Eyben
- Department of Radiation Oncology, Stanford University, Stanford, CA 94350, USA;
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100
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Fourquet A, Lahmi L, Rusu T, Belkacemi Y, Créhange G, de la Taille A, Fournier G, Cussenot O, Gauthé M. Restaging the Biochemical Recurrence of Prostate Cancer with [ 68Ga]Ga-PSMA-11 PET/CT: Diagnostic Performance and Impact on Patient Disease Management. Cancers (Basel) 2021; 13:cancers13071594. [PMID: 33808301 PMCID: PMC8038030 DOI: 10.3390/cancers13071594] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/21/2021] [Accepted: 03/26/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary We aimed to evaluate the diagnostic performance, impact on patient disease management, and therapy efficacy prediction of [68Ga]Ga-PSMA-11 PET/CT on 294 patients with biochemical recurrence of prostate cancer. We established a composite standard of truth for the imaging based on all clinical data available collected during the follow-up period with a median duration of follow-up of 17 months. Using this methodology, we found that the overall per-patient sensitivity and specificity were both 70%, the patient disease management was changed in 68% of patients, and that [68Ga]Ga-PSMA-11 PET/CT impacted this change in 86% of patients. The treatment carried out on the patient was considered effective in 78% of patients; in 89% of patients when guided by [68Ga]Ga-PSMA-11 PET/CT versus 61% of patients when not guided by [68Ga]Ga-PSMA-11 PET/CT. Abstract Background: Detection rates of [68Ga]Ga-PSMA-11 PET/CT on the restaging of prostate cancer (PCa) patients presenting with biochemical recurrence (BCR) have been well documented, but its performance and impact on patient management have not been evaluated as extensively. Methods: Retrospective analysis of PCa patients presenting with BCR and referred for [68Ga]Ga-PSMA-11 PET/CT. Pathological foci were classified according to six anatomical sites and evaluated with a three-point scale according to the uptake intensity. The impact of [68Ga]Ga-PSMA-11 PET/CT was defined as any change in management that was triggered by [68Ga]Ga-PSMA-11 PET/CT. The existence of a PCa lesion was established according to a composite standard of truth based on all clinical data available collected during the follow-up period. Results: We included 294 patients. The detection rate was 69%. Per-patient sensitivity and specificity were both 70%. Patient disease management was changed in 68% of patients, and [68Ga]Ga-PSMA-11 PET/CT impacted this change in 86% of patients. The treatment carried out on patient was considered effective in 89% of patients when guided by [68Ga]Ga-PSMA-11 PET/CT versus 61% of patients when not guided by [68Ga]Ga-PSMA-11 PET/CT (p < 0.001). Conclusions: [68Ga]Ga-PSMA-11 PET/CT demonstrated high performance in locating PCa recurrence sites and impacted therapeutic management in nearly two out of three patients.
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Affiliation(s)
- Aloÿse Fourquet
- Department of Nuclear Medicine, Hôpital Tenon-AP-HP, Sorbonne Université, 75020 Paris, France; (A.F.); (T.R.)
| | - Lucien Lahmi
- Department of Radiation Oncology, Hôpital Tenon-AP-HP, Sorbonne Université, 75020 Paris, France;
| | - Timofei Rusu
- Department of Nuclear Medicine, Hôpital Tenon-AP-HP, Sorbonne Université, 75020 Paris, France; (A.F.); (T.R.)
| | - Yazid Belkacemi
- Department of Radiation Oncology and Henri Mondor Breast Center, Hôpitaux Universitaires Henri Mondor, Université Paris-Est Créteil (UEPC) et IMRB—INSERM U955 Team 21, 94000 Créteil, France;
| | - Gilles Créhange
- Department of Radiation Oncology, Institut Curie, 75005 Paris, France;
| | - Alexandre de la Taille
- Department of Urology, Hôpitaux Universitaires Henri Mondor, Université Paris-Est Créteil (UEPC), 94000 Créteil, France;
| | - Georges Fournier
- Department of Urology, Hôpital de la Cavale Blanche, Université de Brest, 29200 Brest, France;
| | - Olivier Cussenot
- Department of Urology, Hôpital Tenon-AP-HP, Sorbonne Université, 75020 Paris, France;
| | - Mathieu Gauthé
- Department of Nuclear Medicine, Hôpital Tenon-AP-HP, Sorbonne Université, 75020 Paris, France; (A.F.); (T.R.)
- AP-HP Health Economics Research Unit, INSERM-UMR1153, 75004 Paris, France
- Correspondence: author: ; Tel.: +33-156017842; Fax: +33-156016171
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