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Roberts EK, Luo L, Mondul AM, Banerjee M, Veenstra CM, Mariotto AB, Schipper MJ, He K, Taylor JMG, Brouwer AF. Time-varying associations of patient and tumor characteristics with cancer survival: an analysis of SEER data across 14 cancer sites, 2004-2017. Cancer Causes Control 2024:10.1007/s10552-024-01888-y. [PMID: 38811511 DOI: 10.1007/s10552-024-01888-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 05/13/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Surveillance, Epidemiology, and End Results (SEER) cancer registries provides information about survival duration and cause of death for cancer patients. Baseline demographic and tumor characteristics such as age, sex, race, year of diagnosis, and tumor stage can inform the expected survival time of patients, but their associations with survival may not be constant over the post-diagnosis period. METHODS Using SEER data, we examined if there were time-varying associations of patient and tumor characteristics on survival, and we assessed how these relationships differed across 14 cancer sites. Standard Cox proportional hazards models were extended to allow for time-varying associations and incorporated into a competing-risks framework, separately modeling cancer-specific and other-cause deaths. For each cancer site and for each of the five factors, we estimated the relative hazard ratio and absolute hazard over time in the presence of competing risks. RESULTS Our comprehensive consideration of patient and tumor characteristics when estimating time-varying hazards showed that the associations of age, tumor stage at diagnosis, and race/ethnicity with risk of death (cancer-specific and other-cause) change over time for many cancers; characteristics of sex and year of diagnosis exhibit some time-varying patterns as well. Stage at diagnosis had the largest associations with survival. CONCLUSION These findings suggest that proportional hazards assumptions are often violated when examining patient characteristics on cancer survival post-diagnosis. We discuss several interesting results where the relative hazards are time-varying and suggest possible interpretations. Based on the time-varying associations of several important covariates on survival after cancer diagnosis using a pan-cancer approach, the likelihood of the proportional hazards assumption being met or corresponding interpretation should be considered in survival analyses, as flawed inference may have implications for cancer care and policy.
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Affiliation(s)
- Emily K Roberts
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA.
| | - Lingfeng Luo
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mousumi Banerjee
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Christine M Veenstra
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Angela B Mariotto
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
| | - Matthew J Schipper
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kevin He
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeremy M G Taylor
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrew F Brouwer
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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Nguyen CB, Kobe C, Kumbier KE, Bauman J, Burns JA, Tsao PA, Sparks JB, Skolarus TA, Caram ME. Determinants of Bone-Modifying Agent Prescribing for Metastatic Castration-Resistant Prostate Cancer in a National Health Care Delivery System. JCO Oncol Pract 2024; 20:59-68. [PMID: 38085028 PMCID: PMC10827294 DOI: 10.1200/op.23.00258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/07/2023] [Accepted: 09/27/2023] [Indexed: 01/13/2024] Open
Abstract
PURPOSE Despite guidelines recommending bone-modifying agents (BMAs) to decrease skeletal-related events (SREs) in men with metastatic castration-resistant prostate cancer (mCRPC), BMAs are underutilized. In this retrospective cohort study, we report the factors associated with BMA use in a national health care delivery system. METHODS We used the Veterans Affairs Corporate Data Warehouse to identify men with mCRPC between 2010 and 2017. BMA prescribing frequency was evaluated, and the association between patient- and disease-specific factors with BMA use was assessed using multivariable logistic regression. RESULTS Among 3,980 men identified with mCRPC (mean age 73.5 years, 29% Black), 47% received a BMA; median time to BMA from start of mCRPC treatment was 102 days. Factors associated with BMA use included previous BMA use (adjusted odds ratio [aOR], 7.81 [95% CI, 6.48 to 9.47]), diagnosis code for bone metastases (aOR, 1.26 [95% CI, 1.08 to 1.46]), and concomitant corticosteroid use (aOR, 1.53 [95% CI, 1.29 to 1.82]). Decreased BMA use was associated with advancing age (aOR, 0.85 per 10 years [95% CI, 0.78 to 0.92]), Charlson comorbidity index ≥2 (aOR, 0.76 [95% CI, 0.63 to 0.93]), Black race (aOR, 0.83 [95% CI, 0.70 to 0.98]), and decreased estimated glomerular filtration rate (eGFR; aOR, 0.19 [95% CI, 0.11 to 0.32] for eGFR 0-29 mL/minutes; aOR, 0.76 [95% CI, 0.64 to 0.91] for 30-59 mL/minutes). CONCLUSION Patients who are older, Black, or have more comorbidities are less likely to receive guideline concordant care to prevent SREs. These observations highlight the unique challenges of caring for patients with mCRPC and the need for future studies to increase BMA use in these populations.
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Affiliation(s)
- Charles B. Nguyen
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Christopher Kobe
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Kyle E. Kumbier
- VA Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Jordan Bauman
- Division of Geriatric & Palliative Medicine, Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Jennifer A. Burns
- VA Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Phoebe A. Tsao
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
- VA Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Jordan B. Sparks
- VA Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Ted A. Skolarus
- VA Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
- Department of Surgery, Section of Urology, University of Chicago Pritzker School of Medicine, Chicago, IL
| | - Megan E.V. Caram
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
- VA Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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3
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Khan AA, Al-Mahrouqi N, Al-Yahyaee A, Al-Sayegh H, Al-Harthy M, Al-Zadjali S. Deciphering Urogenital Cancers through Proteomic Biomarkers: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 16:22. [PMID: 38201450 PMCID: PMC10778028 DOI: 10.3390/cancers16010022] [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: 08/30/2023] [Revised: 11/20/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024] Open
Abstract
Urogenital cancers, which include prostate, bladder, and kidney malignancies, exert a substantial impact on global cancer-related morbidity and mortality. Proteomic biomarkers, emerging as valuable tools, aim to enhance early detection, prognostic accuracy, and the development of personalized therapeutic strategies. This study undertook a comprehensive systematic review and meta-analysis of the existing literature investigating the role and potential of proteomic biomarkers in plasma, tissue, and urine samples in urogenital cancers. Our extensive search across several databases identified 1879 differentially expressed proteins from 37 studies, signifying their potential as unique biomarkers for these cancers. A meta-analysis of the significantly differentially expressed proteins was executed, accentuating the findings through visually intuitive volcano plots. A functional enrichment analysis unveiled their significant involvement in diverse biological processes, including signal transduction, immune response, cell communication, and cell growth. A pathway analysis highlighted the participation of key pathways such as the nectin adhesion pathway, TRAIL signaling pathway, and integrin signaling pathways. These findings not only pave the way for future investigations into early detection and targeted therapeutic approaches but also underscore the fundamental role of proteomics in advancing our understanding of the molecular mechanisms underpinning urogenital cancer pathogenesis. Ultimately, these findings hold remarkable potential to significantly enhance patient care and improve clinical outcomes.
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Affiliation(s)
- Aafaque Ahmad Khan
- Research Laboratories, Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat 123, Oman; (N.A.-M.); (A.A.-Y.); (H.A.-S.); (S.A.-Z.)
| | - Nahad Al-Mahrouqi
- Research Laboratories, Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat 123, Oman; (N.A.-M.); (A.A.-Y.); (H.A.-S.); (S.A.-Z.)
| | - Aida Al-Yahyaee
- Research Laboratories, Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat 123, Oman; (N.A.-M.); (A.A.-Y.); (H.A.-S.); (S.A.-Z.)
| | - Hasan Al-Sayegh
- Research Laboratories, Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat 123, Oman; (N.A.-M.); (A.A.-Y.); (H.A.-S.); (S.A.-Z.)
| | - Munjid Al-Harthy
- Medical Oncology Department, Urogenital Cancers Program, Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat 123, Oman;
| | - Shoaib Al-Zadjali
- Research Laboratories, Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat 123, Oman; (N.A.-M.); (A.A.-Y.); (H.A.-S.); (S.A.-Z.)
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4
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Botelho F, Lopes R, Pina F, Silva C, Pacheco-Figueiredo L, Lunet N. Prostate cancer treatment in Portugal: a nationwide analysis. Sci Rep 2023; 13:19362. [PMID: 37938598 PMCID: PMC10632360 DOI: 10.1038/s41598-023-46591-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023] Open
Abstract
Different treatment options exist for localized prostate cancer. Treatments performed in high-volume hospitals are associated with better results. Our objective was to describe time trends in prostate cancer treatments in Portugal and case volume per hospital. We used the national database of diagnosis-related group of the Portuguese Central Administration of the Health System to describe the number of radical prostatectomy (RP), brachytherapy (BT) and external radiotherapy (eRT) treatments performed in all National Health System hospitals. There was a rapid increase in the annual number of RP until 2006 and then a deceleration; BT treatments augmented significantly until 2011. The utilization of eRT also increased, surpassing RP after 2010. From the 46 hospitals performing RP, only eight had a case-volume > 50 treatments/year, and from the nine hospitals performing BT, only four accomplished > 15 treatments/year. In the 11 hospitals with eRT, nine performed > 50/year. Regarding RP, there was negative correlation between the hospital volume and length of stay (r = - 0.303; p = 0.041). In the Portuguese National Health Service there was a steep increase in the number of prostate cancer treatments, and there is an ample margin for concentration of RP and BT treatments, for improvement of the hospitals case volume.
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Affiliation(s)
- Francisco Botelho
- Serviço de Urologia do Centro Hospitalar Universitário S. João, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal.
- Instituto de Investigação em Ciências da Vida e Saúde - ICVS/3B's Laboratório Associado, Escola de Medicina, Universidade do Minho, Braga, Portugal.
| | - Rui Lopes
- Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Francisco Pina
- Serviço de Urologia do Centro Hospitalar Universitário S. João, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal
- Departamento de Urologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Carlos Silva
- Serviço de Urologia do Centro Hospitalar Universitário S. João, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal
- Departamento de Urologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Luís Pacheco-Figueiredo
- Serviço de Urologia do Centro Hospitalar Universitário S. João, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal
- Instituto de Investigação em Ciências da Vida e Saúde - ICVS/3B's Laboratório Associado, Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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5
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Garg S, Sachdeva A, Peeters M, McClements J. Point-of-Care Prostate Specific Antigen Testing: Examining Translational Progress toward Clinical Implementation. ACS Sens 2023; 8:3643-3658. [PMID: 37830899 PMCID: PMC10616866 DOI: 10.1021/acssensors.3c01402] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023]
Abstract
Prostate cancer (PCa) is the second most common male cancer and is attributable to over 375,000 deaths annually. Prostate specific antigen (PSA) is a key biomarker for PCa and therefore measuring patient PSA levels is an important aspect of the diagnostic pathway. Automated immunoassays are currently utilized for PSA analysis, but they require a laboratory setting with specialized equipment and trained personnel. This results in high diagnostic costs, extended therapeutic turnaround times, and restrictions on testing capabilities in resource-limited settings. Consequently, there is a strong drive to develop point-of-care (PoC) PSA tests that can offer accurate, low-cost, and rapid results at the time and place of the patient. However, many emerging PoC tests experience a trade-off between accuracy, affordability, and accessibility which distinctly limits their translational potential. This review comprehensively assesses the translational advantages and limitations of emerging laboratory-level and commercial PoC tests for PSA determination. Electrochemical and optical PSA sensors from 2013 to 2023 are systematically examined. Furthermore, we suggest how the translational potential of emerging tests can be optimized to achieve clinical implementation and thus improve PCa diagnosis globally.
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Affiliation(s)
- Saweta Garg
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
- Department
of Chemical Engineering and Analytical Science, School of Engineering, University of Manchester, Manchester M20 4BX, U.K.
| | - Ashwin Sachdeva
- Division
of Cancer Sciences, University of Manchester, Wilmslow Road, Manchester M20 4BX, U.K.
- Department
of Urology, The Christie NHS Foundation
Trust, Manchester M20 4BX, U.K.
| | - Marloes Peeters
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
| | - Jake McClements
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
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6
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Maddeboina K, Jonnalagadda SK, Morsy A, Duan L, Chhonker YS, Murry DJ, Penning TM, Trippier PC. Aldo-Keto Reductase 1C3 Inhibitor Prodrug Improves Pharmacokinetic Profile and Demonstrates In Vivo Efficacy in a Prostate Cancer Xenograft Model. J Med Chem 2023; 66:9894-9915. [PMID: 37428858 DOI: 10.1021/acs.jmedchem.3c00732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Aldo-keto reductase 1C3 (AKR1C3) is overexpressed in castration-resistant prostate cancer where it acts to drive proliferation and aggressiveness by producing androgens. The reductive action of the enzyme leads to chemoresistance development against various clinical antineoplastics across a range of cancers. Herein, we report the continued optimization of selective AKR1C3 inhibitors and the identification of 5r, a potent AKR1C3 inhibitor (IC50 = 51 nM) with >1216-fold selectivity for AKR1C3 over closely related isoforms. Due to the cognizance of the poor pharmacokinetics associated with free carboxylic acids, a methyl ester prodrug strategy was pursued. The prodrug 4r was converted to free acid 5r in vitro in mouse plasma and in vivo. The in vivo pharmacokinetic evaluation revealed an increase in systemic exposure and increased the maximum 5r concentration compared to direct administration of the free acid. The prodrug 4r demonstrated a dose-dependent effect to reduce the tumor volume of 22Rv1 prostate cancer xenografts without observed toxicity.
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Affiliation(s)
- Krishnaiah Maddeboina
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
| | - Sravan K Jonnalagadda
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
| | - Ahmed Morsy
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
| | - Ling Duan
- Center of Excellence in Environmental Toxicology, Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Yashpal S Chhonker
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
| | - Daryl J Murry
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
- Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
| | - Trevor M Penning
- Center of Excellence in Environmental Toxicology, Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Paul C Trippier
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
- Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
- UNMC Center for Drug Discovery, University of Nebraska Medical Center, Omaha, Nebraska 68106, United States
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7
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Lin S, Lin D, Li Y, Zhong L, Zhou W, Wu Y, Xie C, Luo S, Huang X, Xu X, Weng X. Disease burden of prostate cancer from 2014 to 2019 in the United States: estimation from the Global Burden of Disease Study 2019 and Medical Expenditure Panel Survey. Epidemiol Health 2023; 45:e2023038. [PMID: 36996867 PMCID: PMC10586921 DOI: 10.4178/epih.e2023038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/27/2023] [Indexed: 04/01/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.
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Affiliation(s)
- Shen Lin
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Pharmacy, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Dong Lin
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Pharmacy, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yiyuan Li
- Department of Pharmacy, Shishi General Hospital, Quanzhou, China
| | - Lixian Zhong
- College of Pharmacy, Texas A&M University, College Station, TX, USA
| | - Wei Zhou
- Journal Center of The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yajing Wu
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Pharmacy, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Chen Xie
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Pharmacy, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Shaohong Luo
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Pharmacy, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiaoting Huang
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Pharmacy, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiongwei Xu
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Pharmacy, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiuhua Weng
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Pharmacy, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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8
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Analysis of Frailty Syndrome in Men with Metastatic Prostate Cancer: A Scoping Review. J Pers Med 2023; 13:jpm13020319. [PMID: 36836553 PMCID: PMC9964735 DOI: 10.3390/jpm13020319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/01/2023] [Accepted: 02/11/2023] [Indexed: 02/15/2023] Open
Abstract
Most patients with metastatic prostate cancer (mPCa) are older. In addition, current geriatric oncology guidelines suggest that all cancer patients aged over 70 years should undergo a comprehensive geriatric assessment (CGA), with the identification of frailty syndrome being crucial for clinical decisions. Frailty can be associated with lower quality of life (QoL) and interfere with the feasibility or side effects of oncology treatments. METHODS We performed a systematic literature search to evaluate frailty syndrome and associated alterations related to CGA impairment by searching in different academic databases (PubMed, Embase, and Scopus). The identified articles were reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Of the 165 articles consulted, 7 met our inclusion criteria. Analysis of data related to frailty syndrome in patients with mPCa showed a prevalence between 30-70% depending on the tool used. Additionally, frailty was associated with other CGA assessments and QoL evaluation outcomes. In general terms, CGA scores for patients with mPCa were lower than those for patients without metastasis. Furthermore, functional QoL appeared to be worse for patients with metastasis, and global QoL (burden) was more strongly associated with frailty. CONCLUSION Frailty syndrome was related to a poorer QoL in patients with mPCa and its evaluation should be considered in clinical decision-making and when choosing the most appropriate active treatment, if any, to increase survival.
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Foster S, Carvallo M, Wenske M, Lee J. Damaged Masculinity: How Honor Endorsement Can Influence Prostate Cancer Screening Decision-Making and Prostate Cancer Mortality Rates. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023; 49:296-308. [PMID: 34964413 DOI: 10.1177/01461672211065293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Prior research has established factors that contribute to the likelihood that men seek out prostate cancer screenings. The current study addresses how endorsing the ideology found in cultures of honor may serve as a barrier to prostate cancer screenings. Two studies were conducted which analyzed the impact of stigma on men's decisions to seek out prostate cancer screenings (Study 1) as well as how prostate cancer deaths may be higher in the culture of honor regions due to men's reticence to seek out screenings (Study 2). Results suggest that older, honor-endorsing men are less likely to have ever sought out a prostate cancer screening due to screening stigma and that an honor-oriented region (southern and western United States) displays higher rates of prostate cancer death than a non-honor-oriented region (northern United States). These findings suggest that honor may be a cultural framework to consider when practitioners address patients' screening-related concerns.
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Affiliation(s)
| | | | | | - Jongwon Lee
- The University of New Mexico, Albuquerque, USA
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10
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AKT1 regulates UHRF1 protein stability and promotes the resistance to abiraterone in prostate cancer. Oncogenesis 2023; 12:1. [PMID: 36593255 PMCID: PMC9807647 DOI: 10.1038/s41389-022-00446-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023] Open
Abstract
Oncogenic activation of PI3K/AKT signaling pathway, together with epigenetic aberrations are the characters of castration-resistant prostate cancer (CRPC). UHRF1 as a key epigenetic regulator, plays a critical role in prostate cancer (PCa) development, and its expression is positively correlated with the degree of malignancy. In this present study we investigated the potential regulatory mechanism of AKT1 on UHRF1, and further validated the in vitro and in vivo anticancer efficacy of AKT phosphorylation inhibitor MK2206 in combination with abiraterone. Both UHRF1 and p-AKT aberrantly overexpressed in the abiraterone-resistant PCa cells. Further studies revealed that AKT1 protein interacts with UHRF1, and AKT1 directly phosphorylates UHRF1 via the site Thr-210. MK2206 induced UHRF1 protein degradation by inhibiting AKT1-induced UHRF1 phosphorylation, and then reduced the interaction between UHRF1 and deubiquitinase USP7, while promoted the interaction between UHRF1 and E3 ubiquitin protein ligase BTRC. MK2206 significantly promoted the sensitivity of abiraterone-refractory PCa cells and xenografts to abiraterone by decreasing UHRF1 protein level, and reversed the phenotype of NEPC, evently induced cellular senescence and cell apoptosis. Altogether, our present study for the first time revealed a novel molecular mechanism of abiraterone resistance through PI3K/AKT-UHRF1 pathway, and provided a novel therapeutic modality by targeting PI3K/AKT1 to promote the drug sensitivity of abiraterone in PCa patients.
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11
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Figueroa-Valverde L, Rosas-Nexticapa M, Alvarez-Ramirez M, Lopez-Ramos M, Mateu-Armand V, Lopez-Gutierrez T. Statistical Data (1978-2020) on Prostate Cancer in the Southern Population of Mexico. CLINICAL CANCER INVESTIGATION JOURNAL 2023. [DOI: 10.51847/lkyjt987fn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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12
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Robsahm TE, Tsuruda KM, Hektoen HH, Storås AH, Cook MB, Hurwitz LM, Langseth H. Applying recommended definition of aggressive prostate cancer: a validation study using high-quality data from the Cancer Registry of Norway. Acta Oncol 2023; 62:8-14. [PMID: 36762472 PMCID: PMC10301241 DOI: 10.1080/0284186x.2023.2175331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND The Prostate Cancer Cohort Consortium (PC3) Working Group proposed a definition for aggressive prostate cancer (PC) for aetiologic epidemiologic research. We aimed to validate this definition as well as a second approach utilising only information on stage at diagnosis. METHODS First primary PCs diagnosed 2004 - 2009 in the population-based Janus Serum Bank (JSB) cohort were identified by linkage to the population-based Cancer Registry of Norway (CRN) (n = 3568). The CRN and Norwegian Prostate Cancer Registry provided clinicopathological data for these cases. Approach 1 classified PC as aggressive if it was clinically T4, or N1, or M1, or had a Gleason score ≥8 at diagnosis (as proposed). Approach 2 classified PC as aggressive if CRN stage at diagnosis was 'regional spread' or 'distant metastases'. Both approaches were validated by calculating the sensitivity and positive predictive value (PPV) against PC-death within 10 years of diagnosis. RESULTS Overall, 555 died from PC within 10 years. Approach 1 classified 24.7% of cases as aggressive and 13.6% were unclassified due to missing information. Approach 2 classified 19.6% as aggressive and 29% were unclassified. Sensitivity was highest for Approach 1 (0.76, 95% CI: 0.72 - 0.80 vs 0.69, 95% CI: 0.64 - 0.73), while PPVs were similar for both approaches (0.43, 95% CI: 0.40 - 0.46 and 0.40, 95% CI: 0.36 - 0.44). We observed similarly high sensitivity and higher PPVs than those reported by the PC3 Working Group. CONCLUSIONS The proposed definition of aggressive PC was applicable and valid in the JSB cohort. Stage at diagnosis can be useful if data on cTNM or Gleason score is unavailable.
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Affiliation(s)
- TE Robsahm
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - KM Tsuruda
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - HH Hektoen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Cancer Genetics, Institute for Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - AH Storås
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - MB Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - LM Hurwitz
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - H Langseth
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
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13
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Pagadala MS, Linscott JA, Talwar JV, Seibert TM, Rose B, Lynch J, Panizzon M, Hauger R, Hansen MH, Sammon JD, Hayn MH, Kader K, Carter H, Ryan ST. PRState: Incorporating genetic ancestry in prostate cancer risk scores for men of African ancestry. BMC Cancer 2022; 22:1289. [PMID: 36494783 PMCID: PMC9733391 DOI: 10.1186/s12885-022-10258-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/30/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Prostate cancer (PrCa) is one of the most genetically driven solid cancers with heritability estimates as high as 57%. Men of African ancestry are at an increased risk of PrCa; however, current polygenic risk score (PRS) models are based on European ancestry groups and may not be broadly applicable. The objective of this study was to construct an African ancestry-specific PrCa PRS (PRState) and evaluate its performance. METHODS African ancestry group of 4,533 individuals in ELLIPSE consortium was used for discovery of African ancestry-specific PrCa SNPs. PRState was constructed as weighted sum of genotypes and effect sizes from genome-wide association study (GWAS) of PrCa in African ancestry group. Performance was evaluated using ROC-AUC analysis. RESULTS We identified African ancestry-specific PrCa risk loci on chromosomes 3, 8, and 11 and constructed a polygenic risk score (PRS) from 10 African ancestry-specific PrCa risk SNPs, achieving an AUC of 0.61 [0.60-0.63] and 0.65 [0.64-0.67], when combined with age and family history. Performance dropped significantly when using ancestry-mismatched PRS models but remained comparable when using trans-ancestry models. Importantly, we validated the PRState score in the Million Veteran Program (MVP), demonstrating improved prediction of PrCa and metastatic PrCa in individuals of African ancestry. CONCLUSIONS African ancestry-specific PRState improves PrCa prediction in African ancestry groups in ELLIPSE consortium and MVP. This study underscores the need for inclusion of individuals of African ancestry in gene variant discovery to optimize PRSs and identifies African ancestry-specific variants for use in future studies.
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Affiliation(s)
- Meghana S Pagadala
- Department of Medicine, Division of Medical Genetics, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
- Medical Scientist Training Program, University of California San Diego, La Jolla, CA, USA.
- Biomedical Science Program, University of California, San Diego, La Jolla, CA, USA.
| | | | - James V Talwar
- Bioinformatics and Systems Biology Program, University of California, San Diego, La Jolla, CA, USA
| | - Tyler M Seibert
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, La Jolla, CA, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Brent Rose
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, La Jolla, CA, USA
- Department of Urology, University of California San Diego, La Jolla, CA, USA
| | - Julie Lynch
- VA Salt Lake City Healthcare System, Salt Lake City, UT, USA
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Matthew Panizzon
- VA San Diego Healthcare System, La Jolla, CA, USA
- Center for Behavioral Genetics of Aging, University of California San Diego, La Jolla, CA, USA
| | - Richard Hauger
- VA San Diego Healthcare System, La Jolla, CA, USA
- Center for Behavioral Genetics of Aging, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health (CESAMH), San Diego Healthcare System, San Diego, CA, USA
| | - Moritz H Hansen
- Division of Urology, Maine Medical Center, Portland, ME, USA
| | - Jesse D Sammon
- Division of Urology, Maine Medical Center, Portland, ME, USA
| | - Matthew H Hayn
- Division of Urology, Maine Medical Center, Portland, ME, USA
| | - Karim Kader
- Department of Urology, University of California San Diego, La Jolla, CA, USA
| | - Hannah Carter
- Department of Medicine, Division of Medical Genetics, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Stephen T Ryan
- Division of Urology, Maine Medical Center, Portland, ME, USA
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14
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Welliver C, Feinstein L, Ward JB, Kirkali Z, Martinez-Miller EE, Matlaga BR, McVary K. Poor clinical guideline adherence and inappropriate testing for incident lower urinary tract symptoms associated with benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 2022; 25:269-273. [PMID: 34545201 PMCID: PMC8934314 DOI: 10.1038/s41391-021-00435-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/01/2021] [Accepted: 07/23/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The American Urological Association makes recommendations for evaluation and testing for lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) to help primary care providers and specialists identify LUTS/BPH and harmful related conditions including urinary retention and prostate or bladder cancer. Our understanding of provider adherence to these Guidelines is limited to single-site or nonrepresentative settings. METHODS We analyzed two insurance claims databases: the Optum® de-identified Clinformatics® Data Mart database for privately insured males aged 40-64 years (N ≈ 1,650,900 annually) and the Medicare 5% Sample for males aged ≥65 years (N ≈ 546,000 annually). We calculated the annual prevalence of LUTS/BPH and comorbid bladder cancer and bladder stones from 2004 to 2013. We additionally examined LUTS/BPH incidence and adherence to testing guidelines in a cohort of men newly diagnosed with LUTS/BPH in 2009. RESULTS While LUTS/BPH prevalence and incidence increased with increasing age, evaluation testing became less common. Urinalysis was the most common testing type but was performed in <60% of incident patients. Serum prostate-specific antigen (PSA) was the second most common test across age groups (range: 15-34%). Prevalence of comorbid bladder cancer (range: 0-4%), but not bladder stones (range: 1-2%), increased with increasing age. CONCLUSIONS Although older men were at greater risk of LUTS/BPH than younger men, they were less likely to undergo testing at diagnosis. Recommended testing with urinalysis was poor despite higher prevalence of bladder cancer in older men and a standard recommendation for urinalysis since 1994. Providers should be more cognizant of AUA Guidelines when assessing LUTS/BPH patients.
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Affiliation(s)
| | - Lydia Feinstein
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA. .,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Julia B. Ward
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Erline E. Martinez-Miller
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC,Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Brian R. Matlaga
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kevin McVary
- Loyola University Medical Center, Center for Male Health, Maywood, IL
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15
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Son HS, Kim JH. Lower Urinary Tract Symptoms are common after Artificial Urinary Sphincter implantation. Urology 2022; 165:343-350. [DOI: 10.1016/j.urology.2022.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
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16
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LI J, HU S, LI H, JIANG J, WANG J. Clinical prognosis and gene expression profiles of prostate cancer patients with bone and lymphatic metastases. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.57221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | | | - Huafu LI
- Sun Yat-Sen University, China; Sun Yat-Sen University, China
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17
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Long Non-Coding RNAs at the Chromosomal Risk Loci Identified by Prostate and Breast Cancer GWAS. Genes (Basel) 2021; 12:genes12122028. [PMID: 34946977 PMCID: PMC8701176 DOI: 10.3390/genes12122028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/20/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) are emerging as key players in a variety of cellular processes. Deregulation of the lncRNAs has been implicated in prostate and breast cancers. Recently, germline genetic variations associated with cancer risk have been correlated with lncRNA expression and/or function. In addition, single nucleotide polymorphisms (SNPs) at well-characterized cancer-associated lncRNAs have been analyzed for their association with cancer risk. These SNPs may occur within the lncRNA transcripts or spanning regions that may alter the structure, function, and expression of these lncRNA molecules and contribute to cancer progression and may have potential as therapeutic targets for cancer treatment. Additionally, some of these lncRNA have a tissue-specific expression profile, suggesting them as biomarkers for specific cancers. In this review, we highlight some of the cancer risk-associated SNPs that modulated lncRNAs with a potential role in prostate and breast cancers and speculate on how these lncRNAs may contribute to cancer development.
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18
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Haroon M, Tahir M, Nawaz H, Majeed MI, Al-Saadi AA. Surface-enhanced Raman scattering (SERS) spectroscopy for prostate cancer diagnosis: A review. Photodiagnosis Photodyn Ther 2021; 37:102690. [PMID: 34921990 DOI: 10.1016/j.pdpdt.2021.102690] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/28/2021] [Accepted: 12/13/2021] [Indexed: 12/13/2022]
Abstract
The present review focuses on the diagnosis of prostate cancer using surface enhanced Raman scattering (SERS) spectroscopy. On the basis of literature search, SERS-based analysis for prostate cancer detection of different sample types is reported in the present study. Prostate cancer is responsible for nearly one-tenth of all cell cancer deaths among men. Significant efforts have been dedicated to establish precise and sensitive monitoring techniques to detect prostate cancer biomarkers in different types of body samples. Among the various spectro-analytical techniques investigated to achieve this objective, SERS spectroscopy has been proven as a promising approach that provides noticeable enhancements of the Raman sensitivity when the target biomolecules interact with a nanostructured surface. The purpose of this review is to give a brief overview of the SERS-basedapproach and other spectro-analytical strategies being used for the detection and quantification of prostate cancer biomarkers. The revolutionary development of SERS methods for the diagnosis of prostate cancer has been discussed in more details based on the reported literature. It has been noticed that the SERS-based immunoassay presents reliable results for the prostate cancer quantification. The EC-SERS, which integrates electrochemistry with the SERS model, could also offer a potential ultrasensitive strategy, although its application in prostate cancer analysis has been still limited.
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Affiliation(s)
- Muhammad Haroon
- Department of Chemistry, King Fahd University of Petroleum and Minerals, Dhahran 31261, Saudi Arabia
| | - Muhammad Tahir
- Department of Chemistry, University of Agriculture Faisalabad, Pakistan
| | - Haq Nawaz
- Department of Chemistry, University of Agriculture Faisalabad, Pakistan
| | | | - Abdulaziz A Al-Saadi
- Department of Chemistry, King Fahd University of Petroleum and Minerals, Dhahran 31261, Saudi Arabia; Interdisciplinary Research Center (IRC) in Refinery and Advanced Chemicals, Dhahran 31261, Saudi Arabia.
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19
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Jain H, Sood R, Faridi MS, Goel H, Sharma U. Role of 68Ga-PSMA-PET/CT for the detection of primary prostate cancer prior to biopsy: a prospective study. Cent European J Urol 2021; 74:315-320. [PMID: 34729219 PMCID: PMC8552950 DOI: 10.5173/ceju.2021.0084.r3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction Prostate-specific membrane antigen (PSMA) positron emission tomography/ computed tomography (PET-CT) is widely used as a staging tool for patients with prostate cancer (PCa). The objective of the study is to assess the diagnostic accuracy of 68Ga-PSMA-PET/CT for PCa, which may help us avoid unnecessary biopsies in patients with intermediate prostate-specific antigen (PSA) levels. Material and methods In this prospective study, 81 patients suspected of PCa, with either raised PSA between 4-20 ng/ml or abnormal digital rectal examination (DRE) findings were included. 68Ga-PSMA-PET/CT was performed for all patients followed by transrectal ultrasound (TRUS) guided prostate biopsy. SUVmax (maximum standardized uptake value) was measured and correlated with biopsy results. Results Out of 81 patients, 31 (38.3%) patients were found to have malignancy on biopsy. Median SUVmax of biopsy positive patients was 10.4 (IQR 6.5-16.1) and biopsy negative patients (n=50) was 3.5 (IQR 1-4.9), (p <0.001). At a cut-off of 6.15, 68GA-PSMA-PET/CT demonstrated sensitivity of 84%, specificity of 80%, positive predictive value of 72.2%, negative predictive value of 88.9% and accuracy of 81.5% with an AUC of 0.876 (95% CI: 0.799-0.953, p <0.001). Conclusions The 68Ga-PSMA-PET/CT helps to localize suspicious lesions and improving the detection of primary prostate cancer. Our findings indicate a significant correlation of SUVmax values with biopsy results. We were also able to determine a cut-off value of SUVmax below which prostate biopsy can be avoided in selected patients.
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Affiliation(s)
- Harsh Jain
- Department of Urology & Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Rajeev Sood
- Department of Urology & Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Mohammad Shazib Faridi
- Department of Urology & Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Hemant Goel
- Department of Urology & Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Umesh Sharma
- Department of Urology & Renal Transplant, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India
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20
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Junqueira PHR, Santos GAD, Xavier M, Romão P, Reis S, Srougi M, Nahas WC, Passerotti CC. PSA density of the lesion: a mathematical formula that uses clinical and pathological data to predict biochemical recurrence in prostate cancer patients. Rev Col Bras Cir 2021; 48:e20212965. [PMID: 34644741 PMCID: PMC10683463 DOI: 10.1590/0100-6991e-20212965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/30/2021] [Indexed: 12/24/2022] Open
Abstract
A main challenge in the clinical management of prostate cancer is to identify which tumor is aggressive and needs invasive treatment. Thus, being able to predict which cancer will progress to biochemical recurrence is a great strategy to stratify prostate cancer patients. With that in mind, we created a mathematical formula that takes into account the patients clinical and pathological data resulting in a quantitative variable, called PSA density of the lesion, which has the potential to predict biochemical recurrence. To test if our variable is able to predict biochemical recurrence, we use a cohort of 219 prostate cancer patients, associating our new variable and classic parameters of prostate cancer with biochemical recurrence. Total PSA, lesion weight, volume and classic PSA density were positively associated with biochemical recurrence (p<0.05). ISUP score was also associated with biochemical recurrence in both biopsy and surgical specimen (p<0.001). The increase of PSA density of the lesion was significantly associated with the biochemical recurrence (p=0.03). Variables derived from the formula, PSA 15% and PSA 152, were also positive associated with the biochemical recurrence (p=0.01 and p=0.002 respectively). Logistic regression analysis shows that classic PSA density, PSA density of the lesion and total PSA, together, can explain up to 13% of cases of biochemical recurrence. PSA density of the lesion alone would have the ability to explain up to 7% of cases of biochemical recurrence. In conclusion, this new mathematical approach could be a useful tool to predict disease recurrence in prostate cancer.
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Affiliation(s)
| | - Gabriel Arantes Dos Santos
- - Faculdade de Medicina da Universidade de São Paulo, Urologia, Laboratório de Investigação Médica - São Paulo - SP - Brasil
| | - Marcelo Xavier
- - Hospital Oswaldo Cruz, Centro de Cirurgia Robótica - São Paulo - SP - Brasil
| | - Poliana Romão
- - Faculdade de Medicina da Universidade de São Paulo, Urologia, Laboratório de Investigação Médica - São Paulo - SP - Brasil
| | - Sabrina Reis
- - Faculdade de Medicina da Universidade de São Paulo, Urologia, Laboratório de Investigação Médica - São Paulo - SP - Brasil
| | - Miguel Srougi
- - Faculdade de Medicina da Universidade de São Paulo, Urologia, Laboratório de Investigação Médica - São Paulo - SP - Brasil
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21
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Diagnostic Yield of Incremental Biopsy Cores and Second Lesion Sampling for In-Gantry MRI-Guided Prostate Biopsy. AJR Am J Roentgenol 2021; 217:908-918. [PMID: 33336582 DOI: 10.2214/ajr.20.24918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND. In-gantry MRI-guided biopsy (MRGB) of the prostate has been shown to be more accurate than other targeted prostate biopsy methods. However, the optimal number of cores to obtain during in-gantry MRGB remains undetermined. OBJECTIVE. The purpose of this study was to assess the diagnostic yield of obtaining an incremental number of cores from the primary lesion and of second lesion sampling during in-gantry MRGB of the prostate. METHODS. This retrospective study included 128 men with 163 prostate lesions who underwent in-gantry MRGB between 2016 and 2019. The men had a total of 163 lesions sampled with two or more cores, 121 lesions sampled with three or more cores, and 52 lesions sampled with four or more cores. A total of 40 men underwent sampling of a second lesion. Upgrade on a given core was defined as a greater International Society of Urological Pathology (ISUP) grade group (GG) relative to the previously obtained cores. Clinically significant prostate cancer (csPCa) was defined as ISUP GG 2 or greater. RESULTS. The frequency of any upgrade was 12.9% (21/163) on core 2 versus 10.7% (13/121) on core 3 (p = .29 relative to core 2) and 1.9% (1/52) on core 4 (p = .03 relative to core 3). The frequency of upgrade to csPCa was 7.4% (12/163) on core 2 versus 4.1% (5/121) on core 3 (p = .13 relative to core 2) and 0% (0/52) on core 4 (p = .07 relative to core 3). The frequency of upgrade on core 2 was higher for anterior lesions (p < .001) and lesions with a higher PI-RADS score (p = .007); the frequency of upgrade on core 3 was higher for apical lesions (p = .01) and lesions with a higher PI-RADS score (p = .01). Sampling of a second lesion resulted in an upgrade in a single patient (2.5%; 1/40); both lesions were PI-RADS category 4 and showed csPCa. CONCLUSION. When performing in-gantry MRGB of the prostate, obtaining three cores from the primary lesion is warranted to optimize csPCa diagnosis. Obtaining a fourth core from the primary lesion or sampling a second lesion has very low yield in upgrading cancer diagnoses. CLINICAL IMPACT. To reduce patient discomfort and procedure times, operators may refrain from obtaining more than three cores or second lesion sampling.
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22
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Wu J, Zhu Y, Zhang X, Wang X, Zhang J. An automatic framework for evaluating the vascular permeability of bone metastases from prostate cancer. Phys Med Biol 2021; 66. [PMID: 34010811 DOI: 10.1088/1361-6560/ac02d3] [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: 04/29/2021] [Accepted: 05/19/2021] [Indexed: 11/11/2022]
Abstract
Objectives.Vascular permeability can reflect tumorigenesis and metastasis. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess microvascular permeability by pharmacokinetic parameter estimation. Most estimation methods require manually selected arterial input function (AIF) or reference regions. However, the result will be unstable due to the annotation, which relies on personal experience. In this study, we propose an automatic framework for evaluating vascular permeability of bone metastases from prostate cancer without selecting AIF.Materials and methods.This retrospective study comprised of 15 prostate cancer patients with bone metastases. Based on clinical consensus for three typical DCE-MRI curve patterns, three characteristic curves as regularization constraints were introduced to the extended Tofts model (ETM) using clustering strategy, and the clustering-based blind identification of multichannel (CBM) framework was then proposed for pharmacokinetic parameter estimation. With automatic segmentation of the whole bone area, we obtained the estimation of the pharmacokinetic parameters in the bone area and quantified for bone metastases. Two experienced radiologists compared the CBM estimations with the diagnostic results and we compared the estimations with those of the ETM in bone metastasis regions to evaluate the feasibility of the CBM framework.Results.The higher signal regions ofKtransandKepindicated the metastasis of prostate cancer, which is consistent with the cancer area marked by the radiologists. In addition, theKtransandKepin bone metastasis regions were significantly higher than in normal bone regions (P < 0.001,P < 0.001). The consistency of estimation by using the CBM framework and conventional ETM method was confirmed by Bland-Altman analysis.Conclusion.The proposed CBM framework can provide a fully automatic and reliable quantitative estimation of vascular permeability for bone metastases in prostate cancer patients.
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Affiliation(s)
- Junjie Wu
- College of Engineering, Peking University, Beijing, People's Republic of China
| | - Yi Zhu
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, People's Republic of China
| | - Xiaodong Zhang
- Department of Radiology, Peking University First Hospital, Beijing, People's Republic of China
| | - Xiaoying Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, People's Republic of China.,Department of Radiology, Peking University First Hospital, Beijing, People's Republic of China
| | - Jue Zhang
- College of Engineering, Peking University, Beijing, People's Republic of China.,Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, People's Republic of China
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23
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Hurwitz LM, Agalliu I, Albanes D, Barry KH, Berndt SI, Cai Q, Chen C, Cheng I, Genkinger JM, Giles GG, Huang J, Joshu CE, Key TJ, Knutsen S, Koutros S, Langseth H, Li SX, MacInnis RJ, Markt SC, Penney KL, Perez-Cornago A, Rohan TE, Smith-Warner SA, Stampfer MJ, Stopsack KH, Tangen CM, Travis RC, Weinstein SJ, Wu L, Jacobs EJ, Mucci LA, Platz EA, Cook MB. Recommended Definitions of Aggressive Prostate Cancer for Etiologic Epidemiologic Research. J Natl Cancer Inst 2021; 113:727-734. [PMID: 33010161 PMCID: PMC8248961 DOI: 10.1093/jnci/djaa154] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/07/2020] [Accepted: 09/15/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND In the era of widespread prostate-specific antigen testing, it is important to focus etiologic research on the outcome of aggressive prostate cancer, but studies have defined this outcome differently. We aimed to develop an evidence-based consensus definition of aggressive prostate cancer using clinical features at diagnosis for etiologic epidemiologic research. METHODS Among prostate cancer cases diagnosed in 2007 in the National Cancer Institute's Surveillance, Epidemiology, and End Results-18 database with follow-up through 2017, we compared the performance of categorizations of aggressive prostate cancer in discriminating fatal prostate cancer within 10 years of diagnosis, placing the most emphasis on sensitivity and positive predictive value (PPV). RESULTS In our case population (n = 55 900), 3073 men died of prostate cancer within 10 years. Among 12 definitions that included TNM staging and Gleason score, sensitivities ranged from 0.64 to 0.89 and PPVs ranged from 0.09 to 0.23. We propose defining aggressive prostate cancer as diagnosis of category T4 or N1 or M1 or Gleason score of 8 or greater prostate cancer, because this definition had one of the higher PPVs (0.23, 95% confidence interval = 0.22 to 0.24) and reasonable sensitivity (0.66, 95% confidence interval = 0.64 to 0.67) for prostate cancer death within 10 years. Results were similar across sensitivity analyses. CONCLUSIONS We recommend that etiologic epidemiologic studies of prostate cancer report results for this definition of aggressive prostate cancer. We also recommend that studies separately report results for advanced category (T4 or N1 or M1), high-grade (Gleason score ≥8), and fatal prostate cancer. Use of this comprehensive set of endpoints will facilitate comparison of results from different studies and help elucidate prostate cancer etiology.
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Affiliation(s)
- Lauren M Hurwitz
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Ilir Agalliu
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Kathryn Hughes Barry
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Jeanine M Genkinger
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tim J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Synnove Knutsen
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Hilde Langseth
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Sherly X Li
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Robert J MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
| | - Sarah C Markt
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Kathryn L Penney
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stephanie A Smith-Warner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Meir J Stampfer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Konrad H Stopsack
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Catherine M Tangen
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Lang Wu
- Cancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Eric J Jacobs
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Rajput A, Hussain SM, Sonthwal N, Gautam G, Ahluwalia P, Punnakal A, Chaturvedi H, Dougall P, Bal J, Gupta A. Clinicoradiological Profile and Treatment Outcomes in Prostate Cancer at a Tertiary Care Cancer Center in India. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_61_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Introduction: Prostate cancer is the most common solid cancer in men and is responsible for 11% of all cancer-related deaths. There are limited data available regarding clinicoradiological (prostate-specific membrane antigen [PSMA]-positron emission tomography [PET]/computed tomography [CT], magnetic resonance imaging, and bone scan) characteristics, treatment outcomes, and correlation of clinicoradiological characteristics with treatment outcomes of prostate cancer patients from India, especially in the era of PSMA-PET/CT scan. Methodology: This was a single center, retrospective, observational study, conducted for 6 months. We retrospectively collected the data of 332 prostate cancer patients treated between January 2015 and December 2017 at our institute. Results: Three hundred and thirty-two patients were enrolled and were divided into three groups depending on the stage and treatment modality, i.e., Group A, B, and C containing 205, 47, and 80 patients, respectively. The median age was 67 years, and the median prostate-specific antigen (PSA) was 19.3 ng/ml. Lower urinary tract symptoms (83.4%) and bone pain (8.1%) were the common presenting symptoms. PSMA-PET/CT scan revealed regional lymph node metastasis in 56.5% patients, bone metastasis in 35.7%, and visceral metastasis in 11.5% patients, respectively. In patients treated with curative intent, radical prostatectomy was performed in 61.74% of patients, whereas radiation therapy was performed in 47 (14.15%) patients. Among those treated with palliative intent, androgen deprivation therapy (ADT) alone (40) was the most preferred therapy followed by the combination of ADT with docetaxel (28) or abiraterone (12). Significantly (P = 0.006), a greater number of patients who were treated with ADT alone progressed to castration-resistant prostate cancer (CRPC) compared to those on combination ADT with either abiraterone or docetaxel. No significant difference was seen in the disease progression when treatment arm containing ADT with docetaxel was compared to ADT with abiraterone. Conclusion: Patients with metastatic disease had a higher median PSA level and also had a higher likelihood of having Gleason score 8–10. Among patients who were treated with palliative intent for metastatic disease, disease progression to CRPC state was significantly higher in those treated with ADT alone compared to those treated with either ADT + docetaxel or ADT + abiraterone.
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Affiliation(s)
- Astha Rajput
- Department of Clinical Research, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Shaik Maheboob Hussain
- Department of Medical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Neha Sonthwal
- Department of Clinical Research, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Gagan Gautam
- Department of Surgical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Puneet Ahluwalia
- Department of Surgical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Anirudh Punnakal
- Department of Radiation Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Harit Chaturvedi
- Department of Surgical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Pankaj Dougall
- Department of Nuclear Medicine, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Jaspriya Bal
- Department of Nuclear Medicine, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
| | - Alok Gupta
- Department of Medical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
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Cole AP, Herzog P, Iyer HS, Marchese M, Mahal BA, Lipsitz SR, Nyambose J, Gershman ST, Kennedy M, Merriam G, Rebbeck TR, Trinh QD. Racial differences in the treatment and outcomes for prostate cancer in Massachusetts. Cancer 2021; 127:2714-2723. [PMID: 33999405 DOI: 10.1002/cncr.33564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Massachusetts is a northeastern state with universally mandated health insurance since 2006. Although Black men have generally worse prostate cancer outcomes, emerging data suggest that they may experience equivalent outcomes within a fully insured system. In this setting, the authors analyzed treatments and outcomes of non-Hispanic White and Black men in Massachusetts. METHODS White and Black men who were 20 years old or older and had been diagnosed with localized intermediate- or high-risk nonmetastatic prostate cancer in 2004-2015 were identified in the Massachusetts Cancer Registry. Adjusted logistic regression models were used to assess predictors of definitive therapy. Adjusted and unadjusted survival models compared cancer-specific mortality. Interaction terms were then used to assess whether the effect of race varied between counties. RESULTS A total of 20,856 men were identified. Of these, 19,287 (92.5%) were White. There were significant county-level differences in the odds of receiving definitive therapy and survival. Survival was worse for those with high-risk cancer (adjusted hazard ratio [HR], 1.50; 95% CI, 1.4-1.60) and those with public insurance (adjusted HR for Medicaid, 1.69; 95% CI, 1.38-2.07; adjusted HR for Medicare, 1.2; 95% CI, 1.14-1.35). Black men were less likely to receive definitive therapy (adjusted odds ratio, 0.78; 95% CI, 0.74-0.83) but had a 17% lower cancer-specific mortality (adjusted HR, 0.83; 95% CI, 0.7-0.99). CONCLUSIONS Despite lower odds of definitive treatment, Black men experience decreased cancer-specific mortality in comparison with White men in Massachusetts. These data support the growing body of research showing that Black men may achieve outcomes equivalent to or even better than those of White men within the context of a well-insured population. LAY SUMMARY There is a growing body of evidence showing that the excess risk of death among Black men with prostate cancer may be caused by disparities in access to care, with few or no disparities seen in universally insured health systems such as the Veterans Affairs and US Military Health System. Therefore, the authors sought to assess racial disparities in prostate cancer in Massachusetts, which was the earliest US state to mandate universal insurance coverage (in 2006). Despite lower odds of definitive treatment, Black men with prostate cancer experience reduced cancer-specific mortality in comparison with White men in Massachusetts. These data support the growing body of research showing that Black men may achieve outcomes equivalent to or even better than those of White men within the context of a well-insured population.
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Affiliation(s)
- Alexander P Cole
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Peter Herzog
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hari S Iyer
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Maya Marchese
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Brandon A Mahal
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Stuart R Lipsitz
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joshua Nyambose
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Susan T Gershman
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Mark Kennedy
- Boston Public Health Commission, Boston, Massachusetts
| | - Gail Merriam
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Timothy R Rebbeck
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Quoc-Dien Trinh
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Zhang Z, Liu S, Ma H, Xiang X, Nie D, Hu P, Tang G. Propionic Acid-Based PET Imaging of Prostate Cancer. Mol Imaging Biol 2021; 23:836-845. [PMID: 33876336 DOI: 10.1007/s11307-021-01608-x] [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: 10/16/2020] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to evaluate the potential value of 2-[18F]fluoropropionic acid ([18F]FPA) for PET imaging of prostate cancer (PCa) and to explore the relationship between [18F]FPA accumulation and fatty acid synthase (FASN) levels in PCa models. The results of the first [18F]FPA PET study of a PCa patient are reported. PROCEDURES The LNCaP, PC-3 cell lines with high FASN expression, and DU145 cell lines with low FASN expression were selected for cell culture. A PET imaging comparison of [18F]FDG and [18F]FPA was performed in LNCaP, PC-3, and DU145 tumors. Additionally, in vivo inhibition experiments in those models were conducted with orlistat. In a human PET study, a patient with PCa before surgery was examined with [18F]FPA PET and [18F]FDG PET. RESULTS The uptake of [18F]FPA in the LNCaP and PC-3 tumors was higher than that of [18F]FDG (P<0.05 and P<0.05), but was lower in DU145 tumors (P<0.05). The accumulation (% ID/g) of [18F]FPA in the LNCaP, PC-3, and DU145 tumors decreased by 27.6, 40.5, and 11.7 %, respectively, after treatment with orlistat. The [18F]FPA showed higher radioactive uptake than [18F]FDG in the first PCa patient. CONCLUSIONS The [18F]FPA uptake in PCa models may be varies with fatty acid synthase activity and could be reduced after administration of a single FASN inhibitor, albeit the activity that is not measured directly. The [18F]FPA seems to be a potential broad-spectrum PET imaging agent and may serve as a valuable tool in the diagnosis of PCa in humans.
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Affiliation(s)
- Zhanwen Zhang
- Department of Nuclear Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.,Department of Nuclear Medicine and Medical Imaging, Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shaoyu Liu
- Department of Nuclear Medicine and Medical Imaging, Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.,Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Hui Ma
- Department of Nuclear Medicine and Medical Imaging, Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.,Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xianhong Xiang
- Department of Nuclear Medicine and Medical Imaging, Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Dahong Nie
- Department of Nuclear Medicine and Medical Imaging, Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ping Hu
- Department of Nuclear Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
| | - Ganghua Tang
- Department of Nuclear Medicine and Medical Imaging, Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China. .,Nanfang PET Center and Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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Guthier CV, Orio PF, Buzurovic I, Cormack RA. Knowledge-based inverse treatment planning for low-dose-rate prostate brachytherapy. Med Phys 2021; 48:2108-2117. [PMID: 33586191 DOI: 10.1002/mp.14775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/17/2021] [Accepted: 02/04/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Permanent low-dose-rate brachytherapy is a widely used treatment modality for managing prostate cancer. In such interventions, treatment planning can be a challenging task and requires experience and skills of the planner. We developed a novel knowledge-based (KB) optimization method based on previous treatment plans. The purpose of this method was to generate clinically acceptable plans that do not require extensive manual adjustments in clinical scenarios. METHODS Objective functions used in current inverse planning methods are preferably based on spatial invariant dose objectives rather than spatial dose distributions. Therefore, they are prone to return suboptimal plans resulting in time consuming plan adjustments. To overcome this limitation, a KB approach is introduced. The KB model uses the dose distributions of previous clinical plans projected onto a standardized geometry. From those standardized distributions a template plan is generated. The treatment plans were optimized with an in-house developed planning system by solving a constraint inverse optimization problem that mimics the projected template dose plan constraint to DVH metrics. The method is benchmarked under an IRB-approved retrospective study by comparing optimization time, dosimetric performance, and clinical acceptability against current clinical practice. The quality of the KB model is evaluated with a Turing test. RESULTS The KB model consists of five high-quality treatment plans. Those plans were selected by one of our experts and showed all desired dosimetric features. After generating the model treatment plans were created with one run of the optimizer for the remaining 20 patients. The optimization time including needle optimization ranged from 6 to 29 s. Based on a Wilcoxon signed rank test the new plans are dosimetrically equivalent to current clinical practice. The Turing test showed that the proposed method generates plans that are equivalent to current clinical practice and that the dose prediction drives the optimization to achieve high-quality treatment plans. CONCLUSIONS This study demonstrated that the proposed KB model was able to capture user-specific features in isodose lines which can be used to generate acceptable treatment plans with a single run of the optimization engine in under a minute. This could potentially reduce the time in the operating room and the time a patient is under anesthesia.
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Affiliation(s)
- Christian V Guthier
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
| | - Peter F Orio
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
| | - Ivan Buzurovic
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
| | - Robert A Cormack
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
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Xu J, Kinnear N, Johns Putra L. Safety, efficacy and cost of intra-operative cell salvage during open radical prostatectomy. Transl Androl Urol 2021; 10:1241-1249. [PMID: 33850759 PMCID: PMC8039577 DOI: 10.21037/tau-20-1265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background We aim to examine the safety and efficacy of intra-operative cell salvage (ICS) in radical prostatectomy. Methods A retrospective cohort study was performed, enrolling consecutive patients undergoing open radical prostatectomy at two institutions during 01/01/18–31/12/19. Patients were grouped by ICS use. Primary outcomes were allogeneic transfusion rates, and biochemical recurrence (prostate specific antigen >0.2 mg/mL). Secondary outcomes were use of adjuvant therapies, Clavien-Dindo complications and transfusion-related cost (allogeneic transfusion + ICS setup + ICS reinfusion). Results In total, 168 men were enrolled. Patients were grouped based on whether they received no blood conservation technique (126 men) or ICS (42 men). Groups were similar in median age, pre- and post-operative haemoglobin and length of stay. They also had similar post-operative tumour Gleason score, TNM-stage and positive surgical margin rates. Compared with controls, the ICS group had shorter follow up (336 vs. 225 days; P=0.003). The groups had similar rates of biochemical recurrence (17% vs. 14%; P=0.90), adjuvant therapy use (30% vs. 29%; P=0.85) and complications (14% vs. 19% patients; P=0.46). There was no metastatic progression or cancer-specific mortality in either group. Although a similar proportion of patients received allogenic transfusion (2.4% vs. 4.8%; P=0.33) and units of packed red blood cells (PRBC) (9 vs. 5 units), transfusion-related costs were higher amongst the ICS group (AUD $11,422 vs. $43,227). Conclusions ICS use in radical prostatectomy was not associated with altered rates of allogeneic transfusion, complications, biochemical recurrence or adjuvant or salvage therapies. Transfusion related costs were higher in the ICS group.
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Affiliation(s)
- Jennifer Xu
- Department of Urology, Ballarat Base Hospital, Ballarat, Australia
| | - Ned Kinnear
- Department of Urology, Ballarat Base Hospital, Ballarat, Australia.,St John of God Hospital, Ballarat, Australia
| | - Lydia Johns Putra
- Department of Urology, Ballarat Base Hospital, Ballarat, Australia.,St John of God Hospital, Ballarat, Australia
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Incidence and Mortality of Prostate Cancer in Canada during 1992-2010. ACTA ACUST UNITED AC 2021; 28:978-990. [PMID: 33617514 PMCID: PMC7985768 DOI: 10.3390/curroncol28010096] [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: 11/27/2020] [Revised: 02/04/2021] [Accepted: 02/14/2021] [Indexed: 12/11/2022]
Abstract
In Canada, prostate cancer is the most common reportable malignancy in men. We assessed the temporal trends of prostate cancer to gain insight into the geographic incidence and mortality trends of this disease. Three independent population-based cancer registries were used to retrospectively analyze demographic data on Canadian men diagnosed with prostate cancer and men who died of prostate cancer between the years of 1992 and 2010. The incidence and mortality rates were calculated at the provincial, city, and forward sortation area (FSA) postal code levels by using population counts that were obtained from the Canadian Census of Population. The Canadian average incidence rate was 113.57 cases per 100,000 males. There has been an overall increasing trend in crude prostate cancer incidence between 1992 and 2010 with three peaks, in 1993, 2001, and 2007. However, age-adjusted incidence rates showed no significant increase over time. The national mortality rate was calculated to be 24.13 deaths per 100,000 males per year. A decrease was noted in crude and age-adjusted mortality rates between 1992 and 2010. Several provinces, cities, and FSAs had higher incidence/mortality rates than the national average. Several of the FSA postal codes with the highest incidence/mortality rates were adjacent to one another. Several Canadian regions of high incidence for prostate cancer have been identified through this study and temporal trends are consistent with those reported in the literature. These results will serve as a foundation for future studies that will seek to identify new regional risk factors and etiologic agents.
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Oczkowski M, Dziendzikowska K, Pasternak-Winiarska A, Włodarek D, Gromadzka-Ostrowska J. Dietary Factors and Prostate Cancer Development, Progression, and Reduction. Nutrients 2021; 13:nu13020496. [PMID: 33546190 PMCID: PMC7913227 DOI: 10.3390/nu13020496] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 12/24/2022] Open
Abstract
Due to the constantly increasing number of cases, prostate cancer has become one of the most important health problems of modern societies. This review presents the current knowledge regarding the role of nutrients and foodstuff consumption in the etiology and development of prostate malignancies, including the potential mechanisms of action. The results of several in vivo and in vitro laboratory experiments as well as those reported by the clinical and epidemiological research studies carried out around the world were analyzed. The outcomes of these studies clearly show the influence of both nutrients and food products on the etiology and prevention of prostate cancer. Consumption of certain nutrients (saturated and trans fatty acids) and food products (e.g., processed meat products) leads to the disruption of prostate hormonal regulation, induction of oxidative stress and inflammation, and alteration of growth factor signaling and lipid metabolism, which all contribute to prostate carcinogenesis. On the other hand, a high consumption of vegetables, fruits, fish, and whole grain products exerts protective and/or therapeutic effects. Special bioactive functions are assigned to compounds such as flavonoids, stilbenes, and lycopene. Since the influence of nutrients and dietary pattern is a modifiable risk factor in the development and prevention of prostate cancer, awareness of the beneficial and harmful effects of individual food ingredients is of great importance in the global strategy against prostate cancer.
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Impact of statin use on overall and time to biochemical failure following radical prostatectomy or radiation therapy. World J Urol 2021; 39:3287-3293. [PMID: 33502557 DOI: 10.1007/s00345-021-03600-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/11/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To assess the impact of statin use on overall and time to biochemical failure following primary treatment of localized prostate cancer (PCa). SUBJECTS/PATIENTS AND METHODS 1581 patients undergoing radical prostatectomy (RP) or radiation therapy (RT) for primary treatment of PCa between July 2007 and January 2020 were evaluated for statin use, demographic/oncologic characteristics, and biochemical outcomes. Rate of biochemical failure (BF) was assessed overall and at 1, 3, and 5 years; time to BF was estimated with Kaplan-Meier. Logistic and linear regression were used to control for treatment modality and disease characteristics. RESULTS The average age was 63.0 ± 7.5 years and median pre-treatment PSA was 6.55 (IQR 4.94). 1473 (93.2%) and 108 (6.8%) underwent RP and RT, respectively. RP patients were younger, had lower pre-PSA, lower BMI, and lower risk disease. At 3.4 ± 2.7 years follow-up, 323 (20.4%) experienced BF. When stratified by statin use, BF overall and within 1, 3, and 5 years were not different. Time to BF, was lower in patients using statins (1.8 ± 1.9 years vs. 2.4 ± 2.6 years; p = 0.016). These results persisted in multivariate analysis, wherein statin use was not associated with BF but was associated with a shorter time to BF. CONCLUSION Overall, statin use was not associated with a reduced risk of BF in RP or RT patients. However, for patients with BF, statin use was associated with a decreased time to BF. Future investigations are warranted to further elucidate the impact of statin use on PCa recurrence.
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Fundora Ramos MI, Maden LB, Casanova FO, Cruz FH, Reyes CS, Gato AH, Lyncon IB, González EV, Morales KP, Lence JJ, Sanz E. Oncoxin-Viusid ® may improve quality of life and survival in patients with hormone-refractory prostate cancer undergoing onco-specific treatments. Mol Clin Oncol 2021; 14:5. [PMID: 33235733 PMCID: PMC7678621 DOI: 10.3892/mco.2020.2167] [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: 03/26/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of the present study was to identify the efficacy and safety of Oncoxin-Viusid (OV) as a supportive treatment for patients with prostate cancer (PCA). A prospective, non-randomised, open-label phase II clinical trial, including 25 patients with hormone-refractory PCA (HRPC) was conducted at the Hospital Universitario General Calixto García (Havana, Cuba) between June 2017 and March 2018. Each of the patients received chemotherapy (CTX) and/or radiotherapy (RT) and OV treatment. Patients had a mean age of 73 years, clinical stage IV cancer and a high risk of relapse. Six cycles of CTX were completed by 80% of the patients, adverse reactions decreased and no weight loss was observed. Among the 25 patients, 5 were lost to follow-up and 4 died of disease progression. A total of 16 of these patients survived, of which 15 had an improved quality of life and 10 responded to treatment, with a significant reduction in pain and prostate symptoms and ≥50% reduction in baseline PSA. The progression-free survival (PFS) rate was 59% and the overall survival (OS) rate 64% at 1 year after treatment began. The OV nutritional supplement was effective, leading to a significant improvement in the patients' quality of life, good nutritional status and greater treatment tolerance. A clinical and humoral response was observed, with high survival rates and a delayed appearance of signs of disease progression. The present study was registered in ClinicalTrials.gov PRS with ID #NCT03543670.
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Affiliation(s)
| | - Lourdes Boulet Maden
- Department of Oncology, Hospital Universitario ‘General Calixto Garcia’, Havana CP10400, Cuba
| | - Fernando Oriol Casanova
- Department of Urologic, Hospital Universitario ‘General Calixto Garcia’, Havana CP10400, Cuba
| | - Frank Hernández Cruz
- Department of Urologic, Hospital Universitario ‘General Calixto Garcia’, Havana CP10400, Cuba
| | - Carina Salgado Reyes
- Department of Medical Imaging, Hospital Universitario ‘General Calixto Garcia’, Havana CP10400, Cuba
| | | | - Israel Benítez Lyncon
- Department of Medical Imaging, Hospital Universitario ‘General Calixto Garcia’, Havana CP10400, Cuba
| | - Etna Vega González
- Department of Laboratory, Hospital Universitario ‘General Calixto Garcia’, Havana CP10400, Cuba
| | - Katia Palau Morales
- Department of Pharmacy, Hospital Universitario ‘General Calixto Garcia’, Havana CP10400, Cuba
| | - Juan J. Lence
- Department of Biostatistics, Instituto Nacional de Oncología y Radiobiología, Havana CP10400, Cuba
| | - Eduardo Sanz
- Pharmaceutical Laboratory, Catalysis, S.L., 28016 Madrid, Spain
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Rezaei H, Negarandeh R, Pasheypoor S, Kazemnejad A. Effect of Educational Program based on the Theory of Planned Behavior on Prostate Cancer Screening: A Randomized Clinical Trial. Int J Prev Med 2020; 11:146. [PMID: 33209216 PMCID: PMC7643565 DOI: 10.4103/ijpvm.ijpvm_137_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/14/2019] [Indexed: 11/29/2022] Open
Abstract
Background and Aims: Prostate cancer screening applied for early diagnosis of prostate cancer. But it is not usually pursued by men. This study was conducted to determine the effect of educational program based on the Theory of Planned Behavior (TPB) on prostate cancer screening. Methods: A randomized clinical trial was carried out on 68 middle-aged men referring to community houses in Iran. Samples were selected consecutively considering the inclusion criteria. Then block randomization was used to assign the participants into two groups. Data collection included demographic characteristics, knowledge and construct of TPB (Attitude towards the behavior, Subjective norms, Perceived behavioral control, behavioral intention) and behavior. The participants in the intervention group attended a theory based program 4 session twice per week. The participants were evaluated before and two month after the intervention. P <0.05 was considered statistically significant. Results: After the 2 months intervention, the pretest-posttest changes in the intervention group compared to the control group were in the Knowledge 9.26 ± 3.5 vs. 0.03 ± 1.68, Attitude 11.46 ± 3.5 vs. -0.16 ± 1.39, Subjective norms 3.16 ± 2.6 vs. 0.29 ± 1.3, Behavioral control 6.76 ± 4 vs. 0.12 ± 1.60 and Behavioral intention 1.4 ± 1.54 vs. 0.00 ± 1.00 (P < 0.05). While none of the subjects in control group performed the prostate screening, 10 people (33.2%) performed it in the intervention group. (P < 0.001). Conclusions: Educational program based on TPB has a positive effect on prostate cancer screening. It is recommended to set up regular training programs based on TPB to encourage middle-aged men for prostate cancer screening.
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Affiliation(s)
- Hesam Rezaei
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Negarandeh
- Department of Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahzad Pasheypoor
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Okidi R, Opira C, Sambo VDC, Achola C, Ogwang DM. Prostate hyperplasia in St Mary's Hospital Lacor: utility of prostate specific antigen in screening for prostate malignancy. Afr Health Sci 2020; 20:1259-1263. [PMID: 33402973 PMCID: PMC7751533 DOI: 10.4314/ahs.v20i3.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Prostate cancer is the second commonest cancer in men worldwide. At present, every patient with lower urinary tract symptoms (LUTS) in St. Mary's Hospital Lacor is undergoing prostate biopsy regardless of the prostate specific antigen (PSA) level. We sought to determine the association between PSA and malignant prostate histology. METHODS This was a retrospective study. Data on age, PSA, prostate volume and prostate histology reported between Jan 2012 and Dec 2019 were retrieved from St. Mary's Hospital Lacor archive and analyzed using STATA SE/13.0. RESULTS Records of 97 patients with LUTS was analyzed. The median (range) age of the patients was 71 (43-100) years. Median (range) of prostate volume was 91.8 (8.0-360.0) cc. Overall, PSA ranged from 0.21 to 399.2 ng/ml. Prostate histology showed 3.1% acinar adenocarcinoma, 24.7% adenocarcinoma and 72.2% benign prostatic hyperplasia. The median PSA amongst patients with malignant and non-malignant prostates were 15.8 ng/ml and 6.07 ng/ml respectively. Serum PSA level was significantly higher in patients with malignant prostate histology (Difference of mean= 9.7; p=0.001). CONCLUSION Patients with LUTS and PSA levels of 15ng/ml or more were more likely to have malignant prostate histology.
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Senbanjo LT, AlJohani H, AlQranei M, Majumdar S, Ma T, Chellaiah MA. Identification of sequence-specific interactions of the CD44-intracellular domain with RUNX2 in the transcription of matrix metalloprotease-9 in human prostate cancer cells. CANCER DRUG RESISTANCE (ALHAMBRA, CALIF.) 2020; 3:586-602. [PMID: 33062960 PMCID: PMC7556329 DOI: 10.20517/cdr.2020.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Aim The Cluster of differentiation 44 (CD44) transmembrane protein is cleaved by γ-secretase, the inhibition of which blocks CD44 cleavage. This study aimed to determine the biological consequence of CD44 cleavage and its potential interaction with Runt-related transcription factor (RUNX2) in a sequence-specific manner in PC3 prostate cancer cells. Methods Using full-length and C-terminal deletion constructs of CD44-ICD (D1-D5) expressed as stable green fluorescent protein-fusion proteins in PC3 cells, we located possible RUNX2-binding sequences. Results Chromatin immunoprecipitation assays demonstrated that the C-terminal amino acid residues between amino acids 671 and 706 in D1 to D3 constructs were indispensable for sequence-specific binding of RUNX2. This binding was minimal for sequences in the D4 and D5 constructs. Correspondingly, an increase in matrix metalloprotease-9 (MMP-9) expression was observed at the mRNA and protein levels in PC3 cells stably expressing D1-D3 constructs. Conclusion These results provide biochemical evidence for the possible sequence-specific CD44-ICD/RUNX2 interaction and its functional relationship to MMP-9 transcription in the promoter region.
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Affiliation(s)
- Linda T Senbanjo
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Hanan AlJohani
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Mohammed AlQranei
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Sunipa Majumdar
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Tao Ma
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Meenakshi A Chellaiah
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
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Shin SH, Kim I, Lee JE, Lee M, Park JW. Loss of EGR3 is an independent risk factor for metastatic progression in prostate cancer. Oncogene 2020; 39:5839-5854. [PMID: 32796959 DOI: 10.1038/s41388-020-01418-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022]
Abstract
Identification of pro-metastatic genomic alterations is urgently needed to help understand and prevent the fatal course of prostate cancer. Here, we found that the transcription factor EGR3, located at chromosome 8p21.3, is a critical metastasis suppressor. Aberrant deletion of EGR3 was found in up to 59.76% (deep deletions, 16.87%; shallow deletions, 42.89%) of prostate cancer patients. In informatics analysis, EGR3 loss was associated with prostate cancer progression and low survival rates. EGR3 expression inversely correlated with the expressions of epithelial-to-mesenchymal transition (EMT) and metastasis-related gene sets in prostate cancer tissues. In prostate cancer cells, EGR3 blocked the EMT process and suppressed cell migration and invasion. In a mouse model for cancer metastasis, EGR3 overexpression significantly suppressed bone metastases of PC3 and 22Rv1 prostate cancer cells. Mechanistically, EGR3 transcriptionally activated ZFP36, GADD45B, and SOCS3 genes by directly binding to their promoter regions. The EMT-inhibitory and tumor-suppressive roles of the EGR3 downstream genes were identified through in vitro and in silico analyses. Together, our results showed that EGR3 may be a biomarker to predict clinical outcomes and that it plays an important role in the metastatic progression of prostate cancer.
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Affiliation(s)
- Seung-Hyun Shin
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.,Department of Pharmacology, Seoul National University College of Medicine, Seoul, South Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Iljin Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.,Department of Pharmacology, Seoul National University College of Medicine, Seoul, South Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.,Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae Eun Lee
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.,Department of Pharmacology, Seoul National University College of Medicine, Seoul, South Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Mingyu Lee
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.,Department of Pharmacology, Seoul National University College of Medicine, Seoul, South Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.,Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, South Korea.,Obstructive Upper airway Research (OUaR) Laboratory, Seoul National University College of Medicine, Seoul, South Korea
| | - Jong-Wan Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea. .,Department of Pharmacology, Seoul National University College of Medicine, Seoul, South Korea. .,Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea. .,Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, South Korea.
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38
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Myint ZW, Kunos CA. Bone Fracture Incidence After Androgen Deprivation Therapy-Investigational Agents: Results From Cancer Therapy Evaluation Program-Sponsored Early Phase Clinical Trials 2006-2013. Front Oncol 2020; 10:1125. [PMID: 32760670 PMCID: PMC7372304 DOI: 10.3389/fonc.2020.01125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/04/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Androgen deprivation therapy (ADT) is a primary treatment option for patients diagnosed with locally advanced-stage or metastatic prostate cancer. Androgen deprivation can be achieved either by radical orchiectomy or by medical castration using a gonadotropin-releasing hormone agonist. ADT has been linked to an initial 12-month loss of bone mineral density, a risk factor for weight-bearing bone fracture, and therefore, a confounding hazard for adverse event when patients are enrolled on early phase trials. To better understand the frequency of ADT-investigational agent-related bone fracture, we conducted a retrospective study of National Cancer Institute Cancer Therapy Evaluation Program (CTEP)-sponsored early phase trials to determine the number of fractures observed among enrolled prostate cancer patients. Patients and Methods: 464 locally advanced-stage or metastatic prostate cancer patients were identified among seven ADT-investigational agent trials conducted between 2006 and 2013. Demographic, co-morbidity, treatment, and adverse event variables were abstracted from CTEP databases and descriptive statistics were used. Results: 464 men had a median age of 64 years, were mostly white (90%), and had a performance status of 0 or 1 (98%). The number of new bone fractures occurring on or after ADT-investigational agent treatment was very low (4.6 per 1000 person-years). The median pretrial prostate specific antigen level was 29 ng/mL and most men (71%) had prostate cancer histopathology Gleason 7 score or higher. In these trials, 43 percent of men had bone only and 35 percent had bone and visceral metastatic disease. The most frequent grade 1 or 2 adverse events were fatigue (36%), hot flashes (27%), and anemia (17%). Grade 3 or higher adverse events were rare, with hypertension (3%) and hyperglycemia (3%) observed. Conclusions: Identifying bone health factors may still be relevant in selected early phase ADT-investigational agent trial patients, emphasizing the need for improved methods for capturing baseline bone health and studying ADT-investigational agent and concurrent medication interactions on bone health.
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Affiliation(s)
- Zin W Myint
- Division of Medical Oncology, Department of Internal Medicine, University of Kentucky, Lexington, KY, United States
| | - Charles A Kunos
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD, United States
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Lan T, Park Y, Colditz GA, Liu J, Wang M, Wu K, Giovannucci E, Sutcliffe S. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control 2020; 31:891-904. [PMID: 32743740 DOI: 10.1007/s10552-020-01330-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/24/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Although a growing body of evidence supports an early-life contribution to prostate cancer (PCa) development, few studies have investigated early-life diet, and only three have examined early-life dairy product intake, a promising candidate risk factor because of its known/suspected influence on insulin-like growth factor levels and height. METHODS We used recalled dietary data from 162,816 participants in the NIH-AARP Diet and Health Study to investigate associations for milk, cheese, ice cream, total dairy, and calcium intake at ages 12-13 years with incident total (n = 17,729), advanced (n = 2,348), and fatal PCa (n = 827) over 14 years of follow-up. We calculated relative risks (RRs) and 95% confidence intervals (CIs) by Cox proportional hazards regression. RESULTS We observed suggestive positive trends for milk, dairy, and calcium intake with total and/or advanced PCa (p-trends = 0.016-0.148). These trends attenuated after adjustment for additional components of adolescent diet, particularly red meat and vegetables/potatoes. In contrast, suggestive inverse trends were observed for cheese and ice cream intake with total and/or advanced PCa (p-trends = 0.043-0.153), and for milk, dairy, and calcium intake with fatal PCa (p-trend = 0.045-0.117). CONCLUSION Although these findings provide some support for a role of adolescent diet in increasing PCa risk, particularly for correlates of milk intake or overall dietary patterns, our protective findings for cheese and ice cream intake with PCa risk and mortality, and for all dairy products with PCa mortality, suggest alternative explanations, such as the influence of early-life socioeconomic status, and increased PCa screening, earlier detection, and better PCa care.
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Affiliation(s)
- Tuo Lan
- Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingxia Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Molin Wang
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Kana Wu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. .,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
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Joyce DD, Heslop DL, Umoh JI, Brown SD, Robles JA, Wallston KA, Moses KA. Examining the association of health literacy and numeracy with prostate-related knowledge and prostate cancer treatment regret. Urol Oncol 2020; 38:682.e11-682.e19. [PMID: 32448502 PMCID: PMC10129910 DOI: 10.1016/j.urolonc.2020.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Educational materials used in prostate cancer shared decision-making are often written above the health literacy levels of the patients that may benefit the most from such tools. Poor understanding the oncologic and functional outcomes of prostate cancer treatment may influence patient regret during this process. In this study, we assess the association between health literacy, numeracy, prostate-related knowledge and treatment regret in a diverse population. MATERIALS AND METHODS Patients obtaining care between June and August of 2016 at both community-based and academic tertiary care facilities were assessed for health literacy and numeracy using validated instruments. Prostate knowledge was tested in those patients without a history of prostate cancer using a 29-item questionnaire and patient-level predictors of knowledge were assessed. Prostate cancer treatment regret was assessed in those patients who had a history of prostate cancer. RESULTS A total of 90 patients were enrolled, 38 (42%) of whom had a history of prostate cancer. African American race (I = 0.039), financial strain (P < 0.001), and educational attainment (P < 0.001) were all associated with lower health literacy on multivariable analysis. Possessing a professional degree (P = 0.021) and higher health literacy (P = 0.001) were associated with greater prostate-related knowledge. Of those with a history of prostate cancer, 9 (24%) expressed treatment regret. Patients with regret were more likely to be African American (n = 6, 66.7% vs. 5, 17.2%, P = 0.004), not married (P = 0.016), and score lower on the literacy (1.0 vs. 8.0, P = 0.009) and numeracy (10.0 vs. 16.0, P = 0.016) scales. CONCLUSIONS We identified lower health literacy among African American men, and lower prostate-related knowledge in those with poor health literacy. To our knowledge, this is the first study to show an association between health literacy and prostate cancer treatment regret.
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Esser P, Mehnert-Theuerkauf A, Friedrich M, Johansen C, Brähler E, Faller H, Härter M, Koch U, Schulz H, Wegscheider K, Weis J, Kuba K, Hinz A, Hartung T. Risk and associated factors of depression and anxiety in men with prostate cancer: Results from a German multicenter study. Psychooncology 2020; 29:1604-1612. [PMID: 32658367 DOI: 10.1002/pon.5471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE In order to optimize psycho-oncological care, studies that quantify the extent of distress and identify certain risk groups are needed. Among patients with prostate cancer (PCa), findings on depression and anxiety are limited. METHODS We analyzed data of PCa patients selected from a German multi-center study. Depression and anxiety were assessed with the PHQ-9 and the GAD-7 (cut-off ≥7). We provided physical symptom burden, calculated absolute and relative risk (AR and RR) of depression and anxiety across patient subsets and between patients and the general population (GP) and tested age as a moderator within the relationship of disease-specific symptoms with depression and anxiety. RESULTS Among 636 participants, the majority reported disease-specific problems (sexuality: 60%; urination: 52%). AR for depression and anxiety was 23% and 22%, respectively. Significant RR were small, with higher risks of distress in patients who are younger (eg, RRdepression = 1.15; 95%-CI: 1.06-1.26), treated with chemotherapy (RRdepression = 1.46; 95%-CI: 1.09-1.96) or having metastases (RRdepression = 1.30; 95%-CI: 1.02-1.65). Risk of distress was slightly elevated compared to GP (eg, RRdepression = 1.13; 95%-CI: 1.07-1.19). Age moderated the relationship between symptoms and anxiety (Burination = -0.10, P = .02; Bsexuality = -0.11, P = .01). CONCLUSIONS Younger patients, those with metastases or treatment with chemotherapy seem to be at elevated risk for distress and should be closely monitored. Many patients suffer from disease-specific symptom burden, by which younger patients seem to be particularly distressed. Support of coping mechanisms associated with disease-specific symptom burden seems warranted.
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Affiliation(s)
- Peter Esser
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Christoffer Johansen
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Oncology Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Martin Härter
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Koch
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, University Medical Center Freiburg, Freiburg, Germany
| | - Katharina Kuba
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Tim Hartung
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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Yari H, Gali H, Awasthi V. Nanoparticles for Targeting of Prostate Cancer. Curr Pharm Des 2020; 26:5393-5413. [PMID: 32693761 DOI: 10.2174/1381612826666200721001500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/27/2020] [Indexed: 11/22/2022]
Abstract
Prostate cancer (PCa) is the leading cause of death by cancer in men. Because of the drastic decline in the survival rate of PCa patients with advanced/metastatic disease, early diagnosis of disease and therapy without toxic side effects is crucial. Chemotherapy is widely used to control the progression of PCa at the later stages; however, it is associated with off-target toxicities and severe adverse effects due to the lack of specificity. Delivery of therapeutic or diagnostic agents by using targeted nanoparticles is a promising strategy to enhance accuracy and sensitivity of diagnosis of PCa and to increase efficacy and specificity of therapeutic agents. Numerous efforts have been made in past decades to create nanoparticles with different architectural bases for specific delivery payloads to prostate tumors. Major PCa associated cell membrane protein markers identified as targets for such purposes include folate receptor, sigma receptors, transferrin receptor, gastrin-releasing peptide receptor, urokinase plasminogen activator receptor, and prostate specific membrane antigen. Among these markers, prostate specific membrane antigen has emerged as an extremely specific and sensitive targetable marker for designing targeted nanoparticle-based delivery systems for PCa. In this article, we review contemporary advances in design, specificity, and efficacy of nanoparticles functionalized against PCa. Whenever feasible, both diagnostic as well as therapeutic applications are discussed.
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Affiliation(s)
- Hooman Yari
- Department of Pharmaceutical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Hariprasad Gali
- Department of Pharmaceutical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Vibhudutta Awasthi
- Department of Pharmaceutical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
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Circulatory and prostatic tissue lipidomic profiles shifts after high-dose atorvastatin use in men with prostate cancer. Sci Rep 2020; 10:12016. [PMID: 32694638 PMCID: PMC7374714 DOI: 10.1038/s41598-020-68868-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 06/29/2020] [Indexed: 12/12/2022] Open
Abstract
Prostate cancer patients using cholesterol-lowering statins have 30% lower risk of prostate cancer death compared to non-users. The effect is attributed to the inhibition of the mevalonate pathway in prostate cancer cells. Moreover, statin use causes lipoprotein metabolism changes in the serum. Statin effect on serum or intraprostatic lipidome profiles in prostate cancer patients has not been explored. We studied changes in the serum metabolomic and prostatic tissue lipidome after high-dose 80 mg atorvastatin intervention to expose biological mechanisms causing the observed survival benefit. Our randomized, double-blind, placebo-controlled clinical trial consisted of 103 Finnish men with prostate cancer. We observed clear difference in post-intervention serum lipoprotein lipid profiles between the study arms (median classification error 11.7%). The atorvastatin effect on intraprostatic lipid profile was not as clear (median classification error 44.7%), although slightly differing lipid profiles by treatment arm was observed, which became more pronounced in men who used atorvastatin above the median of 27 days (statin group median classification error 27.2%). Atorvastatin lowers lipids important for adaptation for hypoxic microenvironment in the prostate suggesting that prostate cancer cell survival benefit associated with statin use might be mediated by both, local and systemic, lipidomic/metabolomic profile changes.
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44
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Okoro FO, Song L, Auten B, Whitaker-Brown C, Cornelius J. African-American survivors of prostate cancer: a meta-synthesis of qualitative studies. J Cancer Surviv 2020; 15:40-53. [PMID: 32666419 DOI: 10.1007/s11764-020-00909-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study is to systematically review the current literature on the post-treatment survivorship experiences of African-American men with prostate cancer by exploring qualitative studies to gain a deep understanding of their survivorship experiences. METHOD We searched five databases for studies published from 2008 to 2018. We identified ten relevant qualitative studies, conducted a meta-synthesis using Noblit and Hare's meta-ethnography approach, and evaluated their quality appraisal using the validated Critical Appraisal Skills Program. RESULTS This review generated a total of four main themes and nine subthemes. The Four main themes included coping strategy, psychophysical impact, health system influence, and socioeconomic impact. Spirituality, healthy behaviors, supportive care of spouse/family/friends and non-communicating/reticent were subthemes identified in the coping strategy theme; physical well-being and sexuality and masculinity were subthemes in the psychophysical impact theme; healthcare provider interaction and treatment decision-making were subthemes identified in the health system influence theme, and health insurance status was the subtheme in the socioeconomic impact theme. CONCLUSION Our findings reveal that the experiences of African-American prostate cancer survivors are complex and multidimensional. IMPLICATIONS FOR CANCER SURVIVORS This review highlights the need for further studies with African-American prostate cancer survivors, precisely identify their needs and plan a culturally appropriate intervention to meet those needs.
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Affiliation(s)
- Florence Osita Okoro
- School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, 28223, USA.
| | - Lixin Song
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, NC, 27599, USA
| | - Beth Auten
- J. Murrey Atkins Library, The University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Judy Cornelius
- School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, 28223, USA
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Mishra SC. A discussion on controversies and ethical dilemmas in prostate cancer screening. JOURNAL OF MEDICAL ETHICS 2020; 47:medethics-2019-105979. [PMID: 32631969 DOI: 10.1136/medethics-2019-105979] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 05/17/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
Prostate cancer (PCa) is one of the the most common cancers in men. A blood test called prostate-specific antigen (PSA) has a potential to pick up this cancer very early and is used for screening of this disease. However, screening for prostate cancer is a matter of debate. Level 1 evidence from randomised controlled trials suggests a reduction in cancer-specific mortality from PCa screening. However, there could be an associated impact on quality of life due to a high proportion of overdiagnosis and overtreatment as part of the screening. The US Preventive Services Task Force (USPSTF) in 2012 recommended that PSA-based PCa screening should not to be offered at any age. However, considering the current evidence, USPSTF recently revised its recommendation to offer the PSA test to men aged 55-69 years with shared decision-making, in line with earlier guidelines from the American Cancer Society and the American Urological Association. A shared decision making is necessary since the PSA test could potentially harm an individual. However, the literature suggests that clinicians often neglect a discussion on this issue before ordering the test. This narrative discusses the main controversies regarding PCa screening including the PSA threshold for biopsy, the concept of overdiagnosis and overtreatment, the practical difficulties of active surveillance, the current level 1 evidence on the mortality benefit of screening, and the associated pitfalls. It offers a detailed discussion on the ethics involved in the PSA test and highlights the barriers to shared decision-making and possible solutions.
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Affiliation(s)
- Satish Chandra Mishra
- Department of Surgery, WHO Collaboration Centre for Research in Surgical Care Delivery in LMIC, Bhabha Atomic Research Centre Hospital, Mumbai, MH 400094, India
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Packiam VT, Tsivian M, Avulova S, Sharma V, Tarrell R, Cheville JC, Frank I, Thompson RH, Tollefson MK, Gettman MT, Karnes RJ, Thapa P, Boorjian SA. Long-term outcomes of incidental prostate cancer at radical cystectomy. Urol Oncol 2020; 38:848.e17-848.e22. [PMID: 32624422 DOI: 10.1016/j.urolonc.2020.05.018] [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: 02/06/2020] [Revised: 04/18/2020] [Accepted: 05/16/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We evaluated the natural history and long-term outcomes of incidentally detected prostate cancer (PCa) at radical cystectomy (RC) for bladder cancer (BCa). PATIENTS AND METHODS We identified 1,640 male patients who underwent RC between 1992 and 2012. Patients were stratified as clinically insignificant and clinically significant PCa, based on Grade Group (GG) 1 and ≥2, respectively. Survival was assessed using the Kaplan-Meier method. RESULTS There were 329 (20%) patients with incidentally detected PCa at RC: 245 (15%) GG1, 52 (3.2%) GG2, 20 (1.2%) GG3, 6 (0.4%) GG4, and 6 (0.4%) GG5. Median follow-up among survivors was 9.6 years (interquartile range 7.5-13.3), during which time 253 patients died, of whom 127 died of BCa and 1 died of PCa. Nine patients experienced biochemical recurrence (BCR), 4 underwent salvage PCa therapies, and 2 developed PCa metastases. Patients with clinically significant PCa were significantly more likely to experience BCR (6% vs. 1.6%; P = 0.04) and had shorter median time to BCR (1.8 vs. 10.4 years; P = 0.01) than those with clinically insignificant PCa. No patients with BCR had greater than pT2N0 BCa or positive BCa margins. Ten-year PCa-specific survival, BCa-specific survival, other cause-specific survival, and overall survival were 99%, 57%, 63%, and 35%, respectively. CONCLUSIONS In a large RC series, we note a 20% rate of incidental PCa, the majority of which are clinically insignificant. On long-term follow-up, we determined that BCR and PCa mortality are extremely rare events among these patients. Pending validation, future guidelines may consider omission of PCa surveillance for some patients with incidental PCa at RC.
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Affiliation(s)
| | | | | | - Vidit Sharma
- Department of Urology, Mayo Clinic, Rochester, MN
| | - Robert Tarrell
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - John C Cheville
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Igor Frank
- Department of Urology, Mayo Clinic, Rochester, MN
| | | | | | | | | | - Prabin Thapa
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
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Chen M, Yuan C, Xu T. An increase in prostate cancer diagnosis during inflammatory bowel disease: A systematic review and meta-analysis. Clin Res Hepatol Gastroenterol 2020; 44:302-309. [PMID: 31447293 DOI: 10.1016/j.clinre.2019.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/13/2019] [Accepted: 07/16/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND In recent years, some studies showed that inflammatory bowel disease (IBD) might be associated with an increased risk of prostate cancer (PC), whereas some other studies indicated that IBD was not associated with the increased risk of PC. In the present study, we aimed to conduct a systematic review and meta-analysis to evaluate the association of IBD and PC risk. METHODS Web of Science and PubMed were systematically searched on for link of PC risk and IBD published from January 1976 to February 2019. The pooled multivariate odd ratio (OR) or relative risk (RR) and 95% confidence intervals (CI) were obtained by the use of STATA 12.0 software. RESULTS The meta-analysis indicated that IBD showed a 78% increase in PC risk (95% CI: 1.32-2.41). Sensitivity analyses showed no changes in the direction of effect after excluding any one study (supplementary figure 1). A significant heterogeneity was detected between different studies (Q test, P<0.001). Moreover, Begg's test, Egger's tests and funnel plots indicated no significant publication bias between included studies [Begg's test (P=0.371); Egger's test (p=0.100)]. CONCLUSION The present meta-analysis demonstrated that IBD was associated with an increased diagnosis of PC. In addition, large scale prospective studies are essential to determine whether IBD increase the PC risk.
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Affiliation(s)
- Mingshi Chen
- Department of Traditional Chinese Medicine, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, N°321 Zhongshan Road, 210008 Nanjing, Jiangsu, China
| | - Caihong Yuan
- Department of Endocrinology, Kunshan Hospital on Integration of Chinese and Western Medicine, 215332 Jiangsu, China
| | - Tianshu Xu
- Department of Traditional Chinese Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, N°321 Zhongshan Road, 210008 Nanjing, Jiangsu, China.
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Marlin R, Créoff M, Merle S, Jean-Marie-Flore M, Rose M, Malsa S, Promeyrat X, Martin F, Comlan G, Rabia N, Taouil T, Issoufaly I, Escarmant P, Vinh-Hung V, Béra O. Mutation HOXB13 c.853delT in Martinican prostate cancer patients. Prostate 2020; 80:463-470. [PMID: 32040869 DOI: 10.1002/pros.23960] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/24/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND In Martinique, prostate cancer (Pca) incidence rates are nowadays among the highest worldwide with a high incidence of early-onset and familial forms. Despite the demonstration of a strong familial component, identification of the genetic basis for hereditary Pca is challenging. The HOXB13 germline variant G84E (rs138213197) was described in men of European descent with Pca risk. METHODS To investigate the potential involvement of HOXB13 mutations in Martinique, we performed sequencing of the HOXB13 coding regions of 46 index cases with early-onset Pca (before the age of 51). Additional breast cancers and controls were performed. All cancer cases analyzed in this study have been observed in the context of genetic counseling. RESULTS We identified a rare heterozygous germline variant c.853delT (p.Ter285Lysfs) rs77179853, reported only among patients of African ancestry with a minor allele frequency of 3.2%. This variant is a stop loss reported only among patients of African ancestry with a frequency of 0.2%. CONCLUSION In conclusion, we think that this study provides supplementary arguments that HOXB13 variants are involved in Pca.
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Affiliation(s)
- Régine Marlin
- Department of Molecular Cancer Genetic, University Hospital of Martinique, Fort de France, France
| | - Morgane Créoff
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Sylvie Merle
- Department of Methodology, Methodology and Biostatistics Unit (DRCI), University Hospital of Martinique, Fort de France, France
| | - Magalie Jean-Marie-Flore
- Department of Molecular Cancer Genetic, University Hospital of Martinique, Fort de France, France
| | - Mickaelle Rose
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Sarah Malsa
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Xavier Promeyrat
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - François Martin
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Georges Comlan
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Nicolas Rabia
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Taoufiq Taouil
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Irfane Issoufaly
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Patrick Escarmant
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Vincent Vinh-Hung
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
| | - Odile Béra
- Department of Molecular Cancer Genetic, University Hospital of Martinique, Fort de France, France
- Department of Oncology, Hematology, Urology, University Hospital of Martinique, Fort de France, France
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Abstract
PURPOSE OF REVIEW To provide the reader an understanding of the importance and limitations of prostate cancer (PCa) screening, the heritable component of PCa and the role that germline genetic markers can play in risk-adapted screening and treatment. RECENT FINDINGS Despite strong science supporting the association of germline genetic change with PCa risk and outcome, there has been a reluctance to pursue practical application of these technologies. Recent findings suggest that actionable information may now be garnered from this form of testing, which can help men at risk for and with PCa. SUMMARY This is an exciting time whereby germline genetic markers can help overcome some of the shortcomings of current PCa screening and treatment paradigms. Understanding their benefit and limitations while keeping the patient's best interest in mind will be the key for the responsible application of these exciting technologies.
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Appetite-regulating hormones-leptin, adiponectin and ghrelin-and the development of prostate cancer: a systematic review and exploratory meta-analysis. Prostate Cancer Prostatic Dis 2020; 23:11-23. [PMID: 31147627 DOI: 10.1038/s41391-019-0154-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/27/2019] [Accepted: 04/13/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Obesity has been proposed as a risk factor for prostate cancer (PCa). In obesity, serum levels of the appetite-regulating hormones-leptin, adiponectin, and ghrelin-become deregulated. OBJECTIVE To explore whether serum levels of appetite-regulating hormones associate with the incidence of PCa, the incidence of advanced disease, or PCa-specific mortality. METHODS PRISMA guidelines were followed. A systematic search for relevant articles published until March 2019 was performed using the databases PubMed, EMBASE, and Web of Science. Observational studies with data on serum levels of leptin, adiponectin, or ghrelin and PCa outcome were included. Meta-analysis was used to combine risk estimates. Meta-relative risks (mRRs) were calculated using random effects models. When available, raw data was pooled. Publication bias was assessed by funnel plot and Begg's test. RESULTS Thirty-five studies were eligible for inclusion. The qualitative analysis indicated that leptin was not consistently associated with any PCa outcome, although several cohorts reported decreased adiponectin levels in men who later developed advanced PCa. Based on the meta-analysis, there was no significant effect of leptin on PCa incidence (mRR = 0.93 (95% CI 0.75-1.16), p = 0.52) or advanced PCa (mRR = 0.90 (95% CI 0.74-1.10), p = 0.30). There were insufficient studies to estimate the mRR of PCa incidence for men with the highest levels of adiponectin. The combined risk of advanced PCa for men with the highest levels of adiponectin was reduced but did not reach significance (mRR = 0.81 (95% CI 0.61-1.08), p = 0.15). CONCLUSIONS The current evidence does not suggest an association between leptin and PCa outcome. However, there may be an inverse association between adiponectin and the incidence of advanced PCa that should be investigated by further studies. Serum ghrelin has not been largely investigated.
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