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Hadadi A, Smith KE, Wan L, Brown JR, Russler G, Yantorni L, Caulfield S, Lafollette J, Moore M, Kucuk O, Carthon B, Nazha B, Liu Y, Bilen MA. Baseline basophil and basophil-to-lymphocyte status is associated with clinical outcomes in metastatic hormone sensitive prostate cancer. Urol Oncol 2022; 40:271.e9-271.e18. [PMID: 35466038 PMCID: PMC9117505 DOI: 10.1016/j.urolonc.2022.03.016] [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: 10/17/2021] [Revised: 02/17/2022] [Accepted: 03/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Biomarkers have the potential to provide clinical guidance, but there is limited data for biomarkers in metastatic hormone sensitive prostate cancer (mHSPC). METHODS We performed a retrospective multicenter review from Winship Cancer Institute at Emory University and Georgia Cancer Center for Excellence at Grady Memorial Hospital (2014-2020) in the United States of America (USA). We collected demographics, disease characteristics, and laboratory data, including complete blood counts (CBC) at the start of upfront therapy. We evaluated overall survival (OS) and progression-free survival (PFS) associated with baseline lab values. RESULTS 165 patients were included with a median follow-up time of 33.5 months (mo). 105 (63.6%) had Gleason scores of 8-10 and 108 (65.9%) were classified as high-volume disease. 92 patients received upfront docetaxel (55.8%) and 73 received upfront abiraterone (44.2%). Univariate analyses (UVA) and multivariable analyses (MVA) identified worse clinical outcomes (CO) associated with elevated basophils and basophil-to-lymphocyte ratio (BLR). Based on MVA, elevated basophils (defined as ≥0.1, optimal cut) were associated with a hazard ratio (HR) of 3.51 (95% CI 1.65-7.43, P 0.001) for OS and HR of 1.88 (95% CI 1.05-3.38, P 0.034) for PFS. Our MVA also found that BLR ≥0.0142 was associated with HR 2.11 (95% CI 1.09-4.10, P 0.028) for OS; however, PFS was not statistically significant. CONCLUSION We conclude that elevated baseline basophils and BLR are associated with worse clinical outcomes in mHSPC. Although results require further validation, BLR is a potential prognostic biomarker.
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Affiliation(s)
- Agreen Hadadi
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
| | - Katherine Er Smith
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
| | - Limeng Wan
- Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, GA
| | - Jacqueline R Brown
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Greta Russler
- Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Lauren Yantorni
- Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Sarah Caulfield
- Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - Melvin Moore
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA
| | - Omer Kucuk
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA
| | - Bradley Carthon
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA
| | - Bassel Nazha
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA
| | - Yuan Liu
- Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, GA
| | - Mehmet A Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA.
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Mota STS, Vecchi L, Alves DA, Cordeiro AO, Guimarães GS, Campos-Fernández E, Maia YCP, Dornelas BDC, Bezerra SM, de Andrade VP, Goulart LR, Araújo TG. Annexin A1 promotes the nuclear localization of the epidermal growth factor receptor in castration-resistant prostate cancer. Int J Biochem Cell Biol 2020; 127:105838. [PMID: 32858191 DOI: 10.1016/j.biocel.2020.105838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/30/2020] [Accepted: 08/20/2020] [Indexed: 12/24/2022]
Abstract
Epidermal growth factor receptor is a cancer driver whose nuclear localization has been associated with the progression of prostate cancer to the castration-resistant phenotype. Previous reports indicated a functional interaction between this receptor and the protein Annexin A1, which has also been associated with aggressive tumors. The molecular pathogenesis of castration-resistant prostate cancer remains largely unresolved, and herein we have demonstrated the correlation between the expression levels and localization of the epidermal growth factor receptor and Annexin A1 in prostate cancer samples and cell lines. Interestingly, a higher expression of both proteins was detected in castration-resistant prostate cancer cell lines and the strongest correlation was seen at the nuclear level. We verified that Annexin A1 interacts with the epidermal growth factor receptor, and by using prostate cancer cell lines knocked down for Annexin A1, we succeeded in demonstrating that Annexin A1 promotes the nuclear localization of epidermal growth factor receptor. Finally, we showed that Annexin A1 activates an autocrine signaling in castration-resistant prostate cells through the formyl peptide receptor 1. The inhibition of such signaling by Cyclosporin H inhibits the nuclear localization of epidermal growth factor receptor and its downstream signaling. The present work sheds light on the functional interaction between nuclear epidermal growth factor receptor and nuclear Annexin A1 in castration-resistant prostate cancer. Therefore, strategies to inhibit the nuclear localization of epidermal growth factor receptor through the suppression of the Annexin A1 autocrine loop could represent an important intervention strategy for castration-resistant prostate cancer.
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Affiliation(s)
- Sara Teixeira Soares Mota
- Laboratory of Genetics and Biotechnology, Institute of Biotechnology, Federal University of Uberlandia, Patos de Minas, MG, 387400-128, Brazil; Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlandia, Uberlandia, MG, 38400-902, Brazil.
| | - Lara Vecchi
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlandia, Uberlandia, MG, 38400-902, Brazil.
| | - Douglas Alexsander Alves
- Laboratory of Genetics and Biotechnology, Institute of Biotechnology, Federal University of Uberlandia, Patos de Minas, MG, 387400-128, Brazil; Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlandia, Uberlandia, MG, 38400-902, Brazil.
| | - Antonielle Oliveira Cordeiro
- Laboratory of Genetics and Biotechnology, Institute of Biotechnology, Federal University of Uberlandia, Patos de Minas, MG, 387400-128, Brazil; Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlandia, Uberlandia, MG, 38400-902, Brazil.
| | - Gabriela Silva Guimarães
- Laboratory of Genetics and Biotechnology, Institute of Biotechnology, Federal University of Uberlandia, Patos de Minas, MG, 387400-128, Brazil; Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlandia, Uberlandia, MG, 38400-902, Brazil.
| | - Esther Campos-Fernández
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlandia, Uberlandia, MG, 38400-902, Brazil.
| | | | - Bruno de Carvalho Dornelas
- Pathology Division, Internal Medicine, University Hospital, Federal University of Uberlandia, Uberlandia, MG, 38400-902, Brazil.
| | | | | | - Luiz Ricardo Goulart
- Laboratory of Genetics and Biotechnology, Institute of Biotechnology, Federal University of Uberlandia, Patos de Minas, MG, 387400-128, Brazil; University of California, Davis, Dept. of Medical Microbiology and Immunology, Davis, CA, 95616, USA.
| | - Thaise Gonçalves Araújo
- Laboratory of Genetics and Biotechnology, Institute of Biotechnology, Federal University of Uberlandia, Patos de Minas, MG, 387400-128, Brazil; Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlandia, Uberlandia, MG, 38400-902, Brazil.
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Rosar F, Ribbat K, Ries M, Linxweiler J, Bartholomä M, Maus S, Schreckenberger M, Ezziddin S, Khreish F. Neuron-specific enolase has potential value as a biomarker for [ 18F]FDG/[ 68Ga]Ga-PSMA-11 PET mismatch findings in advanced mCRPC patients. EJNMMI Res 2020; 10:52. [PMID: 32449086 PMCID: PMC7246282 DOI: 10.1186/s13550-020-00640-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/04/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND PSMA-targeted radioligand therapy (PSMA-RLT) yielded impressive results in the metastasized castration-resistant prostate carcinoma (mCRPC) setting. High expression of PSMA is essential for successful PSMA-RLT. However, some patients develop [18F]FDG-avid lesions with low or no PSMA expression ([18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings on PET/CT) in the course of treatment. Those lesions are not affected by PSMA-RLT and a change in therapy management is needed. To enable early mismatch detection, possible blood parameters as indicators for the occurrence of [18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings on PET/CT were evaluated. METHODS Retrospective study of N = 66 advanced mCRPC patients with dual [68Ga]Ga-PSMA-11 and [18F]FDG PET/CT imaging within 4 weeks, who were referred for or received [177Lu]Lu-PSMA-617 radioligand therapy. Prostate-specific antigen (PSA), neuron-specific enolase (NSE), gamma-glutamyltransferase (GGT), and alkaline phosphatase (ALP) were tested as indicators for the occurrence of [18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings. Additional to absolute values, relative changes (ΔPSA, ΔNSE, ΔGGT, ΔALP) over a period of 4 ± 1 weeks prior to [18F]FDG PET/CT were analyzed. RESULTS In total, 41/66 (62%) patients revealed at least one [18F]FDG/[68Ga]Ga-PSMA-11 mismatch finding on PET/CT. These mismatch findings were detected in 13/41 (32%) patients by screening for and in 28/41 (68%) patients during PSMA-RLT. NSE serum level (55.4 ± 44.6 μg/l vs. 18.5 ± 8 μg/l, p < 0.001) and ΔNSE (93.8 ± 124.5% vs. 2.9 ± 39.5%, p < 0.001) were significantly higher in the mismatch group than in the non-mismatch group. No significant differences were found for serum PSA (p = 0.424), ΔPSA (p = 0.417), serum ALP (p = 0.937), ΔALP (p = 0.611), serum GGT (p = 0.773), and ΔGGT (p = 0.971). For NSE and ΔNSE, the maximum value of the Youden index in ROC analysis was at a cut-off level of 26.8 μg/l (sensitivity 78%, specificity 96%) and at + 13.9% (sensitivity 84%, specificity 75%), respectively. An introduced scoring system of both parameters achieved a sensitivity of 90% and a specificity of 88% for the occurrence of [18F]FDG/[68Ga]Ga-PSMA-11 mismatch. CONCLUSION We observed a significantly higher absolute serum concentration and a higher relative increase of NSE in advanced mCRPC patients with [18F]FDG-avid and insufficient PSMA expressing metastases ([18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings on PET/CT) in our cohort. NSE might be used as a potential laboratory indicator for [18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings, if this observation is confirmed in future, ideally prospective, studies in larger patient cohorts.
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Affiliation(s)
- Florian Rosar
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany.
| | - Kalle Ribbat
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | - Martin Ries
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | | | - Mark Bartholomä
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | - Stephan Maus
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | | | - Samer Ezziddin
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | - Fadi Khreish
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
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Stangl-Kremser J, Kramer G, Shariat SF. Association of Hyponatremia With Survival in Patients With Castration-resistant Prostate Cancer: A Clinical Commentary. Clin Genitourin Cancer 2019; 17:e1188-e1192. [PMID: 31623929 DOI: 10.1016/j.clgc.2019.08.001] [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: 05/10/2019] [Revised: 07/31/2019] [Accepted: 08/10/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the prognostic value of hyponatremia in patients with castration-resistant prostate cancer (CRPC) undergoing docetaxel chemotherapy. PATIENTS AND METHODS We retrospectively assessed 186 patients who received docetaxel chemotherapy in addition to androgen deprivation for CRPC between 2005 and 2015. We stratified the patients according to their pre-chemotherapy serum sodium level. Hyponatremia was defined as sodium < 135 mmol/L. A Cox proportional regression model was used to estimate overall survival (OS). RESULTS The median sodium level was 139 mmol/L (interquartile range, 137-141 mmol/L). Hyponatremia was detected in 13 (6.9%) patients. One-half of the patients died during the studied period. The presence of hyponatremia was associated with a decreased probability of OS (hazard ratio, 2.5; 95% confidence interval, 1.0-6.3; P = .04) in univariate analysis. These findings could not be confirmed in the multivariable OS model (P = .21). CONCLUSION We observed an association between hyponatremia and worse survival outcomes in our patients with CRPC undergoing docetaxel chemotherapy. However, further well-designed studies with full workup of hyponatremia are needed to validate these findings and to identify the underlying causes for this association in patients with CRPC.
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Affiliation(s)
- Judith Stangl-Kremser
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Gero Kramer
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Department of Urology, Motol Hospital, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
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Heinrich D, Bruland Ø, Guise TA, Suzuki H, Sartor O. Alkaline phosphatase in metastatic castration-resistant prostate cancer: reassessment of an older biomarker. Future Oncol 2018; 14:2543-2556. [PMID: 29925281 DOI: 10.2217/fon-2018-0087] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Since most patients with metastatic castration-resistant prostate cancer (mCRPC) have bone metastases, it is important to understand the potential impact of therapies on prognostic biomarkers, such as ALP. Clinical studies involving mCRPC life-prolonging agents (i.e., sipuleucel-T, abiraterone, enzalutamide, docetaxel, cabazitaxel, and radium-223) have shown that baseline ALP level is prognostic for overall survival, and may be a better prognostic marker for overall survival than prostate-specific antigen in patients with bone-dominant mCRPC. Mechanism of action differences between therapies may partly explain ALP dynamics during treatment. ALP changes can be interpreted within the context of other parameters while monitoring disease activity to better understand the underlying pathology. This review evaluates the current role of ALP in mCRPC.
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Affiliation(s)
- Daniel Heinrich
- Department of Oncology, Akershus University Hospital, Sykehusveien 25, 1478 Lørenskog, Norway
| | - Øyvind Bruland
- Department of Oncology, Oslo University Hospital-Norwegian Radium Hospital, Ullernchausseen 70, 0379 Oslo, Norway
| | - Theresa A Guise
- Department of Medicine, Indiana University School of Medicine, 980 W. Walnut St, Walther Hall, R3, Room C130 Indianapolis, IN 46202, USA
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimazu, Sakura-shi, Chiba 285-8741, Japan
| | - Oliver Sartor
- Departments of Medicine & Urology, Tulane Cancer Center, 1430 Tulane Ave., SL-42, New Orleans, LA 70112, USA
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