High-risk Locally Advanced Prostate Cancer: Multimodal Treatment Is the Key

Poly I:C-priming of adipose-derived mesenchymal stromal cells promotes a pro-tumorigenic phenotype in an immunocompetent mouse model of prostate cancer

Introduction: Mesenchymal stromal cells (MSC) are envisioned as a potential cellular vehicle for targeted cancer therapies due to their tumor tropism and immune permissiveness. An obstacle in their use is the duality in their interactions within tumors, rendering them pro-tumorigenic or anti-tumorigenic, in a context dependent manner. MSC preconditioning, or priming, has been proposed as a strategy for directing the effector properties of MSC at tumor sites. Methods: We primed human MSC derived from adipose tissues (ASC), a clinically advantageous MSC source, utilizing toll-like receptor agonists. Subsequently, we explored the consequences in tumor progression and transcriptome upon the interaction of tumor cells with primed or unprimed ASC in an in vivo model of prostate cancer, the second most common cancer and second leading cause of cancer related death in men in the USA. Results and discussion: In the studied model, poly I:C-primed ASC were found to significantly accelerate tumor growth progression. And while unprimed and LPS-primed ASC did not exert a significant effect on tumor growth at the macroscopic level, gene expression analyses suggested that all treatments promoted distinct modulatory effects in the tumor microenvironment, including altered modulation of angiogenesis, and immune response processes. However, the effects resulting from the collective interaction across these processes must be sufficiently skewed in a pro-tumorigenic or anti-tumorigenic direction for evidence of tumor progression modulation to be detectable at the macroscopic level. Our study highlights potential MSC-tumor microenvironment interactions that may be leveraged and should be considered in the development of cancer therapeutics utilizing MSC.

Treatment outcomes in high-risk prostate cancer: a single-centre experience

Aim: The aim of that study was to evaluate the treatment results of patients with high-risk prostate cancer who received image-guided intensity-modulated radiotherapy with curative intent. Material and Method: Patients who underwent curative radiotherapy (RT) for high-risk prostate cancer were evaluated retrospectively in our clinic from April 2010 to April 2021. Demographics, prostate specific antigen (PSA) levels, gleason score (GS), the TNM stage of the tumor, and the success of treatment and complications were noted. Results: Eighty-two patients were evaluated. The mean follow-up time was 39.1 months. The mean age was 71.2±6.2 (range 50-84 years) years. The mean PSA levels of the patients was 41.1±33.8, and the median was 27 ng/ml (range 8-129 ng/ml). The mean GS of the patients was 8.3±0.6, and the median was 8 (range 7-10). The mean overall survival (OS) rate was 75.6%; survival rates for 24 months and 36 months were 91.1% and 80.4% respectively. The progression-free survival (PFS) was found to be 62.8%. Moreover, the PFS time was found to be 66,6 months. Twenty-four months and 36 months PFS rates were 83.6% and 65.4%, respectively. Conclusion: Intensity-modulated radiotherapy (IMRT) combined with androgen deprivation therapy is a safe and effective treatment modality for elderly patients with high-risk prostate cancer.