|
1
|
Viehweger F, Hoop J, Tinger LM, Bernreuther C, Büscheck F, Clauditz TS, Hinsch A, Jacobsen F, Luebke AM, Steurer S, Hube-Magg C, Kluth M, Marx AH, Krech T, Lebok P, Fraune C, Burandt E, Sauter G, Simon R, Minner S. Frequency of Androgen Receptor Positivity in Tumors: A Study Evaluating More Than 18,000 Tumors. Biomedicines 2024; 12:957. [PMID: 38790919 PMCID: PMC11117763 DOI: 10.3390/biomedicines12050957] [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: 02/27/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Androgen receptor (AR) is a transcription factor expressed in various normal tissues and is a therapeutic target for prostate and possibly other cancers. A TMA containing 18,234 samples from 141 different tumor types/subtypes and 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. AR positivity was found in 116 tumor types including 66 tumor types (46.8%) with ≥1 strongly positive tumor. Moderate/strong AR positivity was detected in testicular sex cord-stromal tumors (93.3-100%) and neoplasms of the prostate (79.3-98.7%), breast (25.0-75.5%), other gynecological tumors (0.9-100%), kidney (5.0-44.1%), and urinary bladder (5.4-24.2%). Low AR staining was associated with advanced tumor stage (pTa versus pT2-4; p < 0.0001) in urothelial carcinoma; advanced pT (p < 0.0001), high tumor grade (p < 0.0001), nodal metastasis (p < 0.0001), and reduced survival (p = 0.0024) in invasive breast carcinoma; high pT (p < 0.0001) and grade (p < 0.0001) in clear cell renal cell carcinoma (RCC); and high pT (p = 0.0055) as well as high grade (p < 0.05) in papillary RCC. AR staining was unrelated to histopathological/clinical features in 157 endometrial carcinomas and in 221 ovarian carcinomas. Our data suggest a limited role of AR immunohistochemistry for tumor distinction and a prognostic role in breast and clear cell RCC and highlight tumor entities that might benefit from AR-targeted therapy.
Collapse
Affiliation(s)
- Florian Viehweger
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Jennifer Hoop
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Lisa-Marie Tinger
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Franziska Büscheck
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Till S. Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
- Pathologie-Hamburg, Labor Lademannbogen Medizinisches Versorgungszentrum (MVZ) GmbH, 22339 Hamburg, Germany
| | - Andreas M. Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Andreas H. Marx
- Department of Pathology, Academic Hospital Fuerth, 90766 Fuerth, Germany;
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
- Institute of Pathology, Clinical Center Osnabrueck, 49076 Osnabrueck, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
- Institute of Pathology, Clinical Center Osnabrueck, 49076 Osnabrueck, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
- Institute of Pathology, Clinical Center Osnabrueck, 49076 Osnabrueck, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (F.V.); (J.H.); (C.B.); (F.B.); (T.S.C.); (A.H.); (F.J.); (A.M.L.); (S.S.); (C.H.-M.); (M.K.); (T.K.); (P.L.); (C.F.); (E.B.); (G.S.); (S.M.)
| |
Collapse
|
|
2
|
Toren P, Wilkins A, Patel K, Burley A, Gris T, Kockelbergh R, Lodhi T, Choudhury A, Bryan RT. The sex gap in bladder cancer survival - a missing link in bladder cancer care? Nat Rev Urol 2024; 21:181-192. [PMID: 37604983 DOI: 10.1038/s41585-023-00806-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/23/2023]
Abstract
The differences in bladder cancer outcomes between the sexes has again been highlighted. Uncommon among cancers, bladder cancer outcomes are notably worse for women than for men. Furthermore, bladder cancer is three to four times more common among men than among women. Factors that might explain these sex differences include understanding the importance of haematuria as a symptom of bladder cancer by both clinicians and patients, the resultant delays in diagnosis and referral of women with haematuria, and health-care access. Notably, these factors seem to have geographical variation and are not consistent across all health-care systems. Likewise, data relating to sex-specific treatment responses for patients with non-muscle-invasive or muscle-invasive bladder cancer are inconsistent. The influence of differences in the microbiome, bladder wall thickness and urine dwell times remain to be elucidated. The interplay of hormone signalling, gene expression, immunology and the tumour microenvironment remains complex but probably underpins the sexual dimorphism in disease incidence and stage and histology at presentation. The contribution of these biological phenomena to sex-specific outcome differences is probable, albeit potentially treatment-specific, and further understanding is required. Notwithstanding these aspects, we identify opportunities to harness biological differences to improve treatment outcomes, as well as areas of fundamental and translational research to pursue. At the level of policy and health-care delivery, improvements can be made across the domains of patient awareness, clinician education, referral pathways and guideline-based care. Together, we aim to highlight opportunities to close the sex gap in bladder cancer outcomes.
Collapse
Affiliation(s)
- Paul Toren
- CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Anna Wilkins
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
- The Royal Marsden Hospitals NHS Trust, London, UK
| | - Keval Patel
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Amy Burley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Typhaine Gris
- CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Roger Kockelbergh
- University Hospitals of Leicester NHS Trust, Leicester, UK
- Action Bladder Cancer UK, Tetbury, UK
| | - Taha Lodhi
- Division of Cancer Sciences, University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - Ananya Choudhury
- Division of Cancer Sciences, University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - Richard T Bryan
- Action Bladder Cancer UK, Tetbury, UK.
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK.
| |
Collapse
|
|
3
|
Chen J, Huang CP, Quan C, Zu X, Ou Z, Tsai YC, Messing E, Yeh S, Chang C. The androgen receptor in bladder cancer. Nat Rev Urol 2023; 20:560-574. [PMID: 37072491 DOI: 10.1038/s41585-023-00761-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 04/20/2023]
Abstract
Bladder cancer is the ninth most common cancer worldwide with a striking sex-based difference in incidence. Emerging evidence indicates that the androgen receptor (AR) might promote the development, progression and recurrence of bladder cancer, contributing to the observed sex differences. Targeting androgen-AR signalling has promise as potential therapy for bladder cancer and helps to suppress progression of this disease. In addition, the identification of a new membrane AR and AR-regulated non-coding RNAs has important implications for bladder cancer treatment. The success of human clinical trials of targeted-AR therapies will help in the development of improved treatments for patients with bladder cancer.
Collapse
Affiliation(s)
- Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Departments of Pathology, Urology, Radiation Oncology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Chi-Ping Huang
- Department of Urology, China Medical University Hospital, Taichung, Taiwan
| | - Chao Quan
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Zhenyu Ou
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Departments of Pathology, Urology, Radiation Oncology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Yu-Chieh Tsai
- Departments of Pathology, Urology, Radiation Oncology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Edward Messing
- Departments of Pathology, Urology, Radiation Oncology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Shuyuan Yeh
- Departments of Pathology, Urology, Radiation Oncology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Chawnshang Chang
- Departments of Pathology, Urology, Radiation Oncology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA.
- Department of Urology, China Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
|
4
|
Tan W, Gao L, Yuan Y, Huang H, Li Y, Gou Y, Hu Z. Relationship between testosterone and male bladder cancer. Sci Rep 2023; 13:12881. [PMID: 37553380 PMCID: PMC10409768 DOI: 10.1038/s41598-023-34646-2] [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: 11/09/2022] [Accepted: 05/04/2023] [Indexed: 08/10/2023] Open
Abstract
Researches had proven that the occurrence of bladder cancer (BC) is much higher in men than those in women, which induced us to explore whether androgen plays a role in BC. A total of 147 patients who were diagnosed with primary BC by histopathological biopsy were included. Meanwhile 154 non-tumor patients were matched as the control group. The continuous variables were expressed as median (interquartile range, IQR) and compared by Mann-Whitney U test, for the reason that the data were not matched the requirementsthe of normal test. A Chi-square test was used to compare the categorical variables, which were expressed as frequency (percentage). Meanwhile univariate and multivariate logistic regression was done to further evaluating the potential independent factor of BC. P < 0.05 was considered statistically significant. Univariate multivariate analyse showed significant difference between two groups in hemoglobin (OR 0.979, 95% CI 0.968-0.991, P < 0.001), hypertension (OR 3.026, 95% CI 1.731-5.288, P < 0.001), diabetes (OR 4.294, 95% CI 1.887-9.771, P = 0.001) and smoking (OR 1.729, 95% CI 1.096-2.729, P = 0.019). Furthermore, multivariate logistic regression analysis was conducted to eliminate the interference of confounding factors, which showed that testosterone seems to be great correlated with the BC (OR 1.002, 95% CI 1.000-1.003, P = 0.017). Similar results were also found in hemoglobin (OR 0.981, 95% CI 0.968-0.993, P = 0.002), hypertension (OR 2.780, 95% CI 1.509-5.120, P = 0.001), diabetes (OR 3.313 95% CI 1.373-7.991, P = 0.008) and smoking (OR 1.938, 95% CI 1.184-3.174, P = 0.009). As a conclusion, our study showed that there was significant correlation between serum total testosterone levels and the occurrence of BC, similar results were shown in hemoglobin, hypertension, diabetes and smoking.
Collapse
Affiliation(s)
- Wei Tan
- Department of Urology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liang Gao
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ye Yuan
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Huang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yadong Li
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanqing Gou
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zili Hu
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| |
Collapse
|
|
5
|
Leo J, Dondossola E, Basham KJ, Wilson NR, Alhalabi O, Gao J, Kurnit KC, White MG, McQuade JL, Westin SN, Wellberg EA, Frigo DE. Stranger Things: New Roles and Opportunities for Androgen Receptor in Oncology Beyond Prostate Cancer. Endocrinology 2023; 164:bqad071. [PMID: 37154098 PMCID: PMC10413436 DOI: 10.1210/endocr/bqad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 05/10/2023]
Abstract
The androgen receptor (AR) is one of the oldest therapeutic targets in oncology and continues to dominate the treatment landscape for advanced prostate cancer, where nearly all treatment regimens include some form of AR modulation. In this regard, AR remains the central driver of prostate cancer cell biology. Emerging preclinical and clinical data implicate key roles for AR in additional cancer types, thereby expanding the importance of this drug target beyond prostate cancer. In this mini-review, new roles for AR in other cancer types are discussed as well as their potential for treatment with AR-targeted agents. Our understanding of these additional functions for AR in oncology expand this receptor's potential as a therapeutic target and will help guide the development of new treatment approaches.
Collapse
Affiliation(s)
- Javier Leo
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
- The University of Texas MD Anderson Cancer Center, UTHealth Graduate School of Biomedical Sciences, Houston, TX 77030, USA
| | - Eleonora Dondossola
- Department of Genitourinary Medical Oncology and the David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kaitlin J Basham
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Nathaniel R Wilson
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Omar Alhalabi
- Department of Genitourinary Medical Oncology and the David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jianjun Gao
- Department of Genitourinary Medical Oncology and the David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Katherine C Kurnit
- Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, The University of Chicago, Chicago, IL 60637, USA
| | - Michael G White
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Shannon N Westin
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Elizabeth A Wellberg
- Department of Pathology, Harold Hamm Diabetes Center, and Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Daniel E Frigo
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
- Department of Genitourinary Medical Oncology and the David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Center for Nuclear Receptors and Cell Signaling, University of Houston, Houston, TX 77204, USA
- Department of Biology and Biochemistry, University of Houston, Houston, TX 77204, USA
| |
Collapse
|
|
6
|
Gakis G, Weckermann D. [Gender-associated differences in bladder cancer]. UROLOGIE (HEIDELBERG, GERMANY) 2022; 61:1060-1067. [PMID: 35980439 DOI: 10.1007/s00120-022-01914-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Although the incidence of bladder cancer among women is lower, they tend to more often have advanced disease at presentation with a more aggressive course. It is still unclear which factors are responsible for the poorer prognosis of bladder cancer in women. MATERIALS AND METHODS Original papers and reviews from 2004 until 2022 were identified in a PubMed search and evaluated. RESULTS Multiple factors are likely responsible for the different courses of bladder cancer in women versus men. In the literature, epidemiologic and clinical aspects are discussed. Furthermore, genetic and hormonal causes and the role of the urobiome have been the focus of discussion more recently. CONCLUSIONS Earlier diagnosis and better surgical treatment could lead to a more favorable course of bladder cancer in women. Further analyses of genetic, hormonal, und microbiological factors could open new perspectives in the prevention, diagnosis, and treatment of bladder cancer.
Collapse
Affiliation(s)
- Georgios Gakis
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Dorothea Weckermann
- Klinik für Urologie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.
| |
Collapse
|
|
7
|
Combining Antiandrogens with Immunotherapy for Bladder Cancer Treatment. EUR UROL SUPPL 2022; 43:35-44. [PMID: 36246841 PMCID: PMC9557088 DOI: 10.1016/j.euros.2022.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/20/2022] Open
|
|
8
|
Cimadamore A, Teoh JY, DI Trapani E, Krajewski W, Tan WS, Mori K, Del Giudice F, Carrion DM, Moschini M. A gender-related dichotomy in bladder cancer. Minerva Urol Nephrol 2022; 74:376-378. [PMID: 35607787 DOI: 10.23736/s2724-6051.22.04954-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Alessia Cimadamore
- Section of Pathological Anatomy, School of Medicine, United Hospitals, Marche Polytechnic University, Ancona, Italy -
| | - Jeremy Y Teoh
- S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Ettore DI Trapani
- Department of Urology, IRCCS IEO European Institute of Oncology, Milan, Italy
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, Wrocław, Poland
| | - Wei Shen Tan
- Department of Urology, University College London Hospital, London, UK
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Diego M Carrion
- Department of Urology, Torrejon University Hospital, Madrid, Spain.,Francisco de Vitoria University, Madrid, Spain
| | - Marco Moschini
- Unit of Urology, Division of Oncology (URI), IRCCS San Raffaele Hospital, Milan, Italy
| | | |
Collapse
|
|
9
|
Xiang P, Du Z, Hao Y, Guan D, Liu D, Yan W, Wang M, Liu Y, Ping H. Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis. Front Oncol 2021; 11:784627. [PMID: 34970495 PMCID: PMC8712679 DOI: 10.3389/fonc.2021.784627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/24/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose The purpose of this study was to summarize the existing evidence and develop a comprehensive systematic review of the impact of androgen suppression therapy (AST) on the incidence or clinical outcomes of bladder cancer. Methods We systematically searched the PubMed and Embase databases from inception to June 20, 2021 to identify all observational studies examining the incidence or clinical outcomes of bladder cancer in patients who received AST. AST is defined as the use of 5-alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT). Results A total of 18 observational studies were included. Our results showed that AST was not significantly associated with a reduced risk of BCa incidence (OR: 0.92, 95% CI: 0.68–1.24) compared with the lack of AST. The subgroup analysis revealed that finasteride use was significantly associated with a reduction in the risk of BCa incidence (OR: 0.75, 95% CI: 0.64–0.88). Recurrence-free survival (RFS) was improved among AST users compared with nonusers (HR: 0.68, 95% CI: 0.48–0.95), while no significant difference between AST users versus nonusers was identified for cancer-specific survival (CSS), overall survival (OS) or progression-free survival (PFS). Conclusion Current evidence indicates that therapy with finasteride may represent a potential strategy aimed at reducing BCa incidence. Moreover, AST has a beneficial effect on the recurrence of bladder cancer. Further well-designed randomized trials or cohort studies with better characterized study populations are needed to validate our preliminary findings. Systematic Review Registration International Prospective Register of Systematic Reviews database [https://www.crd.york.ac.uk/PROSPERO/], identifier CRD42021261685.
Collapse
Affiliation(s)
- Peng Xiang
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Zhen Du
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yongxiu Hao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Di Guan
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dan Liu
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei Yan
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Mingdong Wang
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yutong Liu
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hao Ping
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing Tongren Hospital, Beijing, China
- *Correspondence: Hao Ping, ; orcid.org/0000-0002-0321-7921
| |
Collapse
|
|
10
|
Lutz CT, Livas L, Presnell SR, Sexton M, Wang P. Gender Differences in Urothelial Bladder Cancer: Effects of Natural Killer Lymphocyte Immunity. J Clin Med 2021; 10:jcm10215163. [PMID: 34768683 PMCID: PMC8584838 DOI: 10.3390/jcm10215163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/13/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023] Open
Abstract
Men are more likely to develop cancer than women. In fact, male predominance is one of the most consistent cancer epidemiology findings. Additionally, men have a poorer prognosis and an increased risk of secondary malignancies compared to women. These differences have been investigated in order to better understand cancer and to better treat both men and women. In this review, we discuss factors that may cause this gender difference, focusing on urothelial bladder cancer (UBC) pathogenesis. We consider physiological factors that may cause higher male cancer rates, including differences in X chromosome gene expression. We discuss how androgens may promote bladder cancer development directly by stimulating bladder urothelium and indirectly by suppressing immunity. We are particularly interested in the role of natural killer (NK) cells in anti-cancer immunity.
Collapse
Affiliation(s)
- Charles T. Lutz
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY 40536, USA; (L.L.); (S.R.P.); (M.S.)
- Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky, Lexington, KY 40536, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA;
- Correspondence:
| | - Lydia Livas
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY 40536, USA; (L.L.); (S.R.P.); (M.S.)
| | - Steven R. Presnell
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY 40536, USA; (L.L.); (S.R.P.); (M.S.)
| | - Morgan Sexton
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY 40536, USA; (L.L.); (S.R.P.); (M.S.)
| | - Peng Wang
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA;
- Department of Internal Medicine, University of Kentucky, Lexington, KY 40536, USA
| |
Collapse
|
|
11
|
Creta M, Celentano G, Napolitano L, La Rocca R, Capece M, Califano G, Collà Ruvolo C, Mangiapia F, Morra S, Turco C, Spirito L, Fusco F, Imbimbo C, Mirone V, Longo N. Inhibition of Androgen Signalling Improves the Outcomes of Therapies for Bladder Cancer: Results from a Systematic Review of Preclinical and Clinical Evidence and Meta-Analysis of Clinical Studies. Diagnostics (Basel) 2021; 11:diagnostics11020351. [PMID: 33672461 PMCID: PMC7923424 DOI: 10.3390/diagnostics11020351] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/11/2022] Open
Abstract
Bladder cancer (BCa) is an endocrine-related tumour and the activation of androgen signalling pathways may promote bladder tumorigenesis. We summarized the available preclinical and clinical evidence on the implications of the manipulation of androgen signalling pathways on the outcomes of BCa therapies. A systematic review was performed in December 2020. We included papers that met the following criteria: original preclinical and clinical research; evaluating the impact of androgen signalling modulation on the outcomes of BCa therapies. Six preclinical and eight clinical studies were identified. The preclinical evidence demonstrates that the modulation of androgen receptor-related pathways has the potential to interfere with the activity of the Bacillus Calmette Guerin, doxorubicin, cisplatin, gemcitabine, and radiotherapy. The relative risk of BCa recurrence after transurethral resection of the bladder tumour (TURBT) is significantly lower in patients undergoing therapy with 5 alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT) (Relative risk: 0.50, 95% CI: 0.30–0.82; p = 0.006). Subgroup analysis in patients receiving 5-ARIs revealed a relative risk of BCa recurrence of 0.46 (95% CI: 0.22–0.95; p = 0.040). A significant negative association between the ratio of T1 BCa patients in treated/control groups and the relative risk of BCa recurrence was observed. Therapy with 5-ARIs may represent a potential strategy aimed at reducing BCa recurrence rate, mainly in patients with low stage disease. Further studies are needed to confirm these preliminary data.
Collapse
Affiliation(s)
- Massimiliano Creta
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Giuseppe Celentano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Luigi Napolitano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Roberto La Rocca
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
- Correspondence:
| | - Marco Capece
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Gianluigi Califano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Francesco Mangiapia
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Simone Morra
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Carmine Turco
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Lorenzo Spirito
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania ‘Luigi Vanvitelli’, 80131 Naples, Italy;
| | - Ciro Imbimbo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Vincenzo Mirone
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| |
Collapse
|