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Thompson JJ, McGovern J, Roxburgh CSD, Edwards J, Dolan RD, McMillan DC. The relationship between LDH and GLIM criteria for cancer cachexia: Systematic review and meta-analysis. Crit Rev Oncol Hematol 2024; 199:104378. [PMID: 38754770 DOI: 10.1016/j.critrevonc.2024.104378] [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: 10/12/2023] [Revised: 04/02/2024] [Accepted: 04/30/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Cancer cachexia is a clinical condition characterized by recognizable "sickness behaviors" accompanied by loss of lean body tissue. The Global Leadership on Malnutrition (GLIM) has proposed phenotypic (unintentional weight loss, low body mass index and low muscle mass) and aetiologic (reduced food intake and inflammation or disease burden) diagnostic criteria. Recent work has suggested serum lactate dehydrogenase (LDH) might represent a 3rd aetiologic criteria. Little is known of its relationship with GLIM. A systematic review and meta-analysis of their comparative prognostic value and association was performed. METHODS A search of electronic databases (PubMed, Medline, Ovid, Cochrane) up to February 2023 was used to identify studies that compared the prognostic value of LDH and components of the GLIM criteria in cancer. An analysis of the relationship between LDH and the components of GLIM was undertaken where this data was available. RevMan 5.4.1 was used to perform a meta-analysis for each diagnostic criteria that had 3 or more studies which reported hazard ratios with a 95 per cent confidence interval for overall survival (OS). RESULTS A total of 119 studies were reviewed. Advanced lung cancer was the most studied population. Included in the meta-analysis were 6 studies (n=2165) on LDH and weight loss, 17 studies (n=7540) on LDH and low BMI, 5 studies (n=758) on LDH and low muscle mass, 0 studies on LDH and food intake and 93 studies (n=32,190) on LDH and inflammation. There was a significant association between elevated serum LDH and each of low BMI (OR 1.39, 1.09 - 1.77; p=0.008), elevated NLR (OR 2.04, 1.57 - 2.65; p<0.00001) and elevated CRP (OR 2.58, 1.81 - 3.67; p<0.00001). There was no association between elevated serum LDH and low muscle mass. Only one study presented data on the association between LDH and unintentional weight loss. Elevated LDH showed a comparative OS (HR 1.86, 1.57 - 2.07; p<0.00001) to unintentional weight loss (HR 1.57, 1.23 - 1.99; p=0.0002) and had a similar OS (HR 2.00, 1.70 - 2.34; p<0.00001) to low BMI (HR 1.57, 1.29-2.90; p<0.0001). LDH also showed an OS (HR 2.25, 1.76 - 2.87; p<0.00001) congruous with low muscle mass (HR 1.93, 1.14 - 3.27; p=0.01) and again, LDH conferred as poor an OS (HR 1.77, 1.64-1.90; p<0.00001) as elevated NLR (HR 1.61, 1.48 - 1.77; p<0.00001) or CRP (HR 1.55, 1.43 - 1.69; p<0.00001). CONCLUSION Current literature suggests elevated serum LDH is associated with inflammation in cancer (an aetiologic GLIM criterion), however more work is required to establish the relationship between LDH and the phenotypic components of GLIM. Additionally, elevated serum LDH appears to be a comparative prognosticator of overall survival in cancer when compared to the GLIM criteria.
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Affiliation(s)
- Joshua J Thompson
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
| | - Josh McGovern
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Campbell S D Roxburgh
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Joanne Edwards
- Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Ross D Dolan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
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Gebrael G, Jo Y, Swami U, Plets M, Hage Chehade C, Narang A, Gupta S, Myint ZW, Sayegh N, Tangen CM, Hussain M, Dorff T, Lara PN, Lerner SP, Thompson I, Agarwal N. Bone Pain and Survival Among Patients With Metastatic, Hormone-Sensitive Prostate Cancer: A Secondary Analysis of the SWOG-1216 Trial. JAMA Netw Open 2024; 7:e2419966. [PMID: 38980676 PMCID: PMC11234233 DOI: 10.1001/jamanetworkopen.2024.19966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
Importance The presence of bone pain is significantly associated with worse overall survival (OS) in patients with castration-resistant prostate cancer. However, there are few data regarding bone pain and survival outcomes in the context of metastatic, hormone-sensitive prostate cancer (MHSPC). Objective To compare survival outcomes among patients with MHSPC by presence or absence of baseline bone pain at diagnosis. Design, Setting, and Participants This post hoc secondary analysis, conducted from September 1 to December 31, 2023, used patient-level data from SWOG-1216, a phase 3, prospective randomized clinical trial that enrolled patients with newly diagnosed MHSPC from 248 academic and community centers across the US from March 1, 2013, to July 15, 2017. All patients in the intention-to-treat population who had available bone pain status were eligible and included in this secondary analysis. Interventions In the SWOG-1216 trial, patients were randomized (1:1) to receive either androgen deprivation therapy (ADT) with orteronel, 300 mg orally twice daily (experimental group), or ADT with bicalutamide, 50 mg orally daily (control group), until disease progression, unacceptable toxic effects, or patient withdrawal. Main Outcomes and Measures Overall survival was the primary end point; progression-free survival (PFS) and prostate-specific antigen (PSA) response were secondary end points. Cox proportional hazards regression models were used for both univariable and multivariable analyses adjusting for age, treatment type, Gleason score, disease volume, Zubrod performance status, and PSA level. Results Of the 1279 male study participants, 301 (23.5%) had baseline bone pain at MHSPC diagnosis and 896 (70.1%) did not. Bone pain status was unavailable in 82 patients (6.4%). The median age of the 1197 patients eligible and included in this secondary analysis was 67.6 years (IQR, 61.8-73.6 years). Compared with patients who did not experience bone pain, those with baseline bone pain were younger (median age, 66.0 [IQR, 60.1-73.4] years vs 68.2 [IQR, 62.4-73.7] years; P = .02) and had a higher incidence of high-volume disease (212 [70.4%] vs 373 [41.6%]; P < .001). After adjustment, bone pain was associated with shorter PFS and OS. At a median follow-up of 4.0 years (IQR, 2.5-5.4 years), patients with bone pain had median PFS of 1.3 years (95% CI, 1.1-1.7 years) vs 3.7 years (95% CI, 3.3-4.2 years) in patients without initial bone pain (adjusted hazard ratio [AHR], 1.46; 95% CI, 1.22-1.74; P < .001) and OS of 3.9 years (95% CI, 3.3-4.8 years) vs not reached (NR) (95% CI, 6.6 years to NR) in patients without initial bone pain (AHR, 1.66; 95% CI, 1.34-2.05; P < .001). Conclusions and Relevance In this post hoc secondary analysis of the SWOG-1216 randomized clinical trial, patients with baseline bone pain at MHSPC diagnosis had worse survival outcomes than those without bone pain. These data suggest prioritizing these patients for enrollment in clinical trials, may aid patient counseling, and indicate that the inclusion of bone pain in prognostic models of MHSPC may be warranted. Trial Registration ClinicalTrials.gov Identifier: NCT01809691.
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Affiliation(s)
- Georges Gebrael
- Huntsman Cancer Institute at the University of Utah, Salt Lake City
| | - Yeonjung Jo
- Huntsman Cancer Institute at the University of Utah, Salt Lake City
| | - Umang Swami
- Huntsman Cancer Institute at the University of Utah, Salt Lake City
| | - Melissa Plets
- SWOG Statistics and Data Management Center, Seattle, Washington
| | | | - Arshit Narang
- Huntsman Cancer Institute at the University of Utah, Salt Lake City
| | - Shilpa Gupta
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Zin W Myint
- Department of Internal Medicine-Division of Medical Oncology, University of Kentucky, Lexington
| | - Nicolas Sayegh
- Huntsman Cancer Institute at the University of Utah, Salt Lake City
| | | | - Maha Hussain
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Tanya Dorff
- City of Hope Comprehensive Cancer Center, Duarte, California
| | - Primo N Lara
- University of California, Davis Comprehensive Cancer Center, Sacramento
| | | | - Ian Thompson
- University of Texas Health Science Center at San Antonio, San Antonio
| | - Neeraj Agarwal
- Huntsman Cancer Institute at the University of Utah, Salt Lake City
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Gómez-Aparicio MA, López-Campos F, Buchser D, Lazo A, Willisch P, Ocanto A, Sargos P, Shelan M, Couñago F. Is There an Opportunity to De-Escalate Treatments in Selected Patients with Metastatic Hormone-Sensitive Prostate Cancer? Cancers (Basel) 2024; 16:2331. [PMID: 39001393 PMCID: PMC11240449 DOI: 10.3390/cancers16132331] [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: 05/21/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024] Open
Abstract
The treatment landscape for metastatic hormone-sensitive prostate cancer continues to evolve, with systemic treatment being the mainstay of current treatment. Prognostic and predictive factors such as tumour volume and disease presentation have been studied to assess responses to different treatments. Intensification and de-escalation strategies arouse great interest, so several trials are being developed to further personalize the therapy in these populations. Is there an optimal sequence and a possible option to de-intensify treatment in selected patients with a favourable profile? This and other goals will be the subject of this review.
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Affiliation(s)
| | - Fernando López-Campos
- Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
- Department of Radiation Oncology, Hospital Universitario San Francisco de Asis and Hospital Vithas La Milagrosa, GenesisCare, 28002 Madrid, Spain; (A.O.); (F.C.)
| | - David Buchser
- Department of Radiation Oncology, Hospital Universitario Cruces, 48903 Barakaldo, Spain;
| | - Antonio Lazo
- Department of Radiation Oncology, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain;
| | - Patricia Willisch
- Department of Radiation Oncology, Hospital Meixoeiro, 36214 Vigo, Spain;
| | - Abrahams Ocanto
- Department of Radiation Oncology, Hospital Universitario San Francisco de Asis and Hospital Vithas La Milagrosa, GenesisCare, 28002 Madrid, Spain; (A.O.); (F.C.)
| | - Paul Sargos
- Department of Radiation Oncology, Institut Bergonié, 33000 Bordeaux, France;
| | - Mohamed Shelan
- Department of Radiation Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland;
| | - Felipe Couñago
- Department of Radiation Oncology, Hospital Universitario San Francisco de Asis and Hospital Vithas La Milagrosa, GenesisCare, 28002 Madrid, Spain; (A.O.); (F.C.)
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Watanabe H, Nakane K, Takahara K, Naiki T, Yasui T, Shiroki R, Koie T, Miyake H. Prognostic outcomes in Japanese patients with metastatic castration-sensitive prostate cancer: Comparative assessments between conventional androgen deprivation therapy (ADT) and ADT with novel androgen receptor signal inhibitor. Int J Urol 2024. [PMID: 38764245 DOI: 10.1111/iju.15498] [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: 11/27/2023] [Accepted: 05/08/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE The objective of this study was to compare the prognostic outcomes between metastatic castration-sensitive prostate cancer (mCSPC) patients receiving conventional androgen deprivation therapy (ADT) and those receiving ADT plus a novel androgen-receptor signaling inhibitor (ARSI) in routine clinical practice in Japan. METHODS This was conducted as a retrospective multicenter study including 581 mCSPC patients, consisting of 305 receiving ADT alone or in combination with bicalutamide (group 1) and 276 receiving ADT plus one of the following ARSIs: abiraterone acetate, apalutamide, or enzalutamide (group 2). Prognostic outcomes between these 2 groups were comprehensively compared. RESULTS In the entire cohort, prostate-specific antigen-progression-free survival (PSA-PFS) in group 2 was significantly longer than that in group 1, while no significant difference was noted in overall survival (OS) between the two groups. In patients corresponding to the LATITUDE high-risk group, however, both PSA-PFS and OS in group 2 were significantly longer than those in group 1. Of several factors examined, the following were identified as independent predictors of poor PSA-PFS in the entire cohort as well as the LATITUDE high-risk group: high C-reactive protein, high lactate dehydrogenase, high alkaline phosphatase, high Gleason score, and group 1. Furthermore, it was possible to precisely classify both the entire cohort and LATITUDE high-risk group into 3 risk groups regarding PSA-PFS according to the positive numbers of independent factors: positive for ≤1 factor, favorable; 2 factors, intermediate; and ≥3 factors, poor. CONCLUSION Combined use of ARSIs with ADT could improve the prognostic outcomes of mCSPC patients, particularly those in the LATITUDE high-risk group, in real-world clinical practice in Japan.
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Affiliation(s)
- Hiromitsu Watanabe
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Keita Nakane
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kiyoshi Takahara
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Taku Naiki
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Ryoichi Shiroki
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takuya Koie
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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5
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Hoyos JA, Londoño DR, Hoyos AG, Reyes EC, Varela R, Giraldo JS. Impact of presentation timing in metastatic hormone-sensitive prostate cancer: Characterization of patients and identification of prognostic factors. Prostate 2024; 84:560-569. [PMID: 38311854 DOI: 10.1002/pros.24672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND The treatment and surveillance of metastatic hormone-sensitive prostate cancer (mHSPC) has evolved since the introduction of several treatment intensification options associated with hormonal blockade and classifications based on the timing of metastatic disease presentation and disease volume. Using a hospital-based registry, we aimed to assess whether these new classifications are applicable to our population, as few studies have demonstrated their prognostic value for overall survival (OS) and time to development of castration-resistant prostate cancer (CRPC), and to establish prognostic factors in our population. METHODS A retrospective cohort of mHSPC patients who were attended at an oncology referral hospital in Bogota between 2017 and 2021 were included in this study. The primary and secondary endpoints were OS and time to CRPC. The distribution of outcome measures was estimated using the Kaplan-Meier method. Proportional hazard models were constructed using the Cox regression approach and stratified according to risk factors. RESULTS The study cohort included 373 patients. The median castration resistance-free survival was 48 months (CI: 32-73 months), and OS was 43 months (CI: 37-48 months). In multivariate analysis, nodal staging, ECOG status, and surgical castration were independent prognostic factors. CONCLUSION In our hospital-based registry, the independent impact of the time of presentation on castration-resistant-free survival or OS could not be demonstrated, nor could the grouping of prognostic categories based on metastatic presentation temporality and volume. Other independent prognostic factors have been proposed.
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Affiliation(s)
- Juliana Arenas Hoyos
- Division of Urology, Pontificia Universidad Javeriana, Hospital Universitario San Igancio, Bogota, Colombia
| | - David Ruiz Londoño
- Division of Uro-Oncology, Colombian National Cancer Institute, Bogotá, Colombia
| | - Andres Gomez Hoyos
- Division of Uro-Oncology, Colombian National Cancer Institute, Bogotá, Colombia
| | | | - Rodolfo Varela
- Division of Uro-Oncology, Colombian National Cancer Institute, Bogotá, Colombia
| | - Julian Serrano Giraldo
- Division of Urology, Pontificia Universidad Javeriana, Hospital Universitario San Igancio, Bogota, Colombia
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Grisay G, Lavaud P, Fizazi K. Current Systemic Therapy in Men with Metastatic Castration-Sensitive Prostate Cancer. Curr Oncol Rep 2024; 26:488-495. [PMID: 38592590 DOI: 10.1007/s11912-024-01509-6] [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] [Accepted: 02/11/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE OF REVIEW This review aims to explore the evolving landscape of treatments available for metastatic castration-sensitive prostate cancer (mCSPC) patients. RECENT FINDINGS In less than a decade, evidence was chronologically provided that (1) systemic treatment intensification with docetaxel improves outcomes, including survival, in men with mCSPC, (2) then that these outcomes are also improved when a second-generation androgen receptor pathway inhibitor (ARPI) is combined with androgen deprivation therapy (ADT), and (3) using a "triplet systemic therapy," which consists in the combination of ADT, an ARPI and docetaxel, further improves outcomes, including survival. Radiotherapy to the prostate combined with ADT alone is now recommended in men with low-volume mCSPC. Combining prostate radiotherapy and intensified systemic treatment including abiraterone may be synergistic as suggested in the PEACE-1 trial. Also, the role of metastases-directed local therapies (mostly stereotactic radiotherapy) is currently being assessed in phase 3 trials. Finally, the integration of biomarkers (e.g. BRCA2 gene alterations, PTEN loss, PSMA expression) for decision making is not currently established, though trials are also currently underway. Importantly, most evidence currently available was obtained in men with de novo metastases, while for those with metastatic relapse after definitive local treatment, the role of treatment intensification is less well established. Treatment intensification is nowadays the standard of care for patients with de novo mCSPC as it leads to outcomes improvement, including survival, and the standard of care is evolving almost on a yearly basis.
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Affiliation(s)
- Guillaume Grisay
- Department of Medical Oncology, Centres Hospitaliers Universitaires Helora, La Louvière, Belgium.
| | - Pernelle Lavaud
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France
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Pisano C, Turco F, Arnaudo E, Fea E, Vanella P, Ruatta F, Filippi R, Brusa F, Prati V, Vana F, Mennitto A, Cattrini C, Vignani F, Dionisio R, Icardi M, Guglielmini P, Buosi R, Stevani I, Vormola R, Numico G, Depetris I, Comandone A, Gennari A, Airoldi M, Rossi M, Vellani G, Ortega C, Tucci M, Maio MD, Buttigliero C. TEAM Study: Upfront Docetaxel Treatment in Patients With Metastatic Hormone-Sensitive Prostate Cancer: A Real-World, Multicenter, Retrospective Analysis. Clin Genitourin Cancer 2024; 22:56-67.e16. [PMID: 37798164 DOI: 10.1016/j.clgc.2023.08.006] [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: 07/08/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Treatment of metastatic hormone-sensitive prostate cancer (mHSPC) dramatically changed. PEACE-1 and ARASENS trials established triplet therapy efficacy. Identifying prognostic factors supporting treatment choice is pivotal. METHODS TEAM is an observational, retrospective study to evaluate prognostic role of variables in mHSPC patients receiving upfront docetaxel in 11 Italian centers. Outcome measures were progression-free survival (PFS) and overall-survival (OS). RESULTS From September 2014 to December 2020, 147 patients were included. Median PFS and OS were 11.6 and 37.4 months. At univariate analysis, PFS-related variables were Gleason Score (GS) (P = .001), opioid use (P = .004), bone metastases number (P < .001), baseline PSA (P = .006), Hb (P < .001), ALP (P < .001) and LDH (P = .002), time between ADT and docetaxel start (P = .018), 3-month PSA (P < .001) and ALP (P < .001), and number of docetaxel cycles (P < .001). OS-related variables were PSA at diagnosis (P = .024), primary tumor treatment (P = .022), baseline pain (P = .015), opioid use (P < .001), bone metastases number (P < . 001), baseline Hb (P < .001), ALP (P < .001) and LDH (P = .001), NLR ratio (P = .039), 3-month PSA (P < .001) and ALP (P < .001) and docetaxel cycles number (P < .001). At multivariate analysis, independent prognostic variables were GS, opioid use, baseline LDH and time between ADT and docetaxel initiation for PFS, and baseline Hb and LDH for OS. CONCLUSION Patients receiving upfront docetaxel with high GS, high disease burden, pain or opioid use, baseline unfavorable laboratory values had worse outcomes. Patients had greater docetaxel benefit when initiated early after ADT start. These parameters could be taken into account when selecting candidates for triplet therapy.
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Affiliation(s)
- Chiara Pisano
- Department of Medical Oncology, S Croce e Carle Hospital, Cuneo, Italy
| | - Fabio Turco
- Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, Orbassano, Italy
| | - Elena Arnaudo
- Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, Orbassano, Italy
| | - Elena Fea
- Department of Medical Oncology, S Croce e Carle Hospital, Cuneo, Italy
| | - Paola Vanella
- Department of Medical Oncology, S Croce e Carle Hospital, Cuneo, Italy
| | - Fiorella Ruatta
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Roberto Filippi
- Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, Orbassano, Italy; Division of Medical Oncology 1, Department of Oncology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Federica Brusa
- Department of Medical Oncology, Cardinal Massaia Hospital, Asti, Italy
| | - Veronica Prati
- Department of Medical Oncology, Michele e Pietro Ferrero Hospital, Verduno-Azienda Sanitaria Locale CN2, Alba-Bra, Cuneo, Italy
| | - Federica Vana
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
| | - Alessia Mennitto
- Medical Oncology-Department of Translational Medicine (DIMET), Università del Piemonte Orientale (UPO), Maggiore della Carità University Hospital, Novara, Italy
| | - Carlo Cattrini
- Medical Oncology-Department of Translational Medicine (DIMET), Università del Piemonte Orientale (UPO), Maggiore della Carità University Hospital, Novara, Italy
| | - Francesca Vignani
- Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - Rossana Dionisio
- Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - Massimiliano Icardi
- Division of Medical Oncology 2, Department of Oncology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Pamela Guglielmini
- Oncology Unit, S. Spirito Hospital, Casale Monferrato, Alessandria, Italy
| | - Roberta Buosi
- Oncology Unit, S. Spirito Hospital, Casale Monferrato, Alessandria, Italy
| | - Ilaria Stevani
- Oncology Unit, S. Spirito Hospital, Casale Monferrato, Alessandria, Italy
| | - Roberto Vormola
- Department of Oncology, Ivrea Community Hospital, Ivrea, Italy
| | - Gianmauro Numico
- Department of Medical Oncology, S Croce e Carle Hospital, Cuneo, Italy
| | - Ilaria Depetris
- Division of Medical Oncology 1, Department of Oncology, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Alessandra Gennari
- Medical Oncology-Department of Translational Medicine (DIMET), Università del Piemonte Orientale (UPO), Maggiore della Carità University Hospital, Novara, Italy
| | - Mario Airoldi
- Division of Medical Oncology 2, Department of Oncology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Maura Rossi
- Oncology Unit, S. Spirito Hospital, Casale Monferrato, Alessandria, Italy
| | - Giorgio Vellani
- Department of Oncology, Ivrea Community Hospital, Ivrea, Italy
| | - Cinzia Ortega
- Department of Medical Oncology, Michele e Pietro Ferrero Hospital, Verduno-Azienda Sanitaria Locale CN2, Alba-Bra, Cuneo, Italy
| | - Marcello Tucci
- Department of Medical Oncology, Cardinal Massaia Hospital, Asti, Italy.
| | - Massimo Di Maio
- Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - Consuelo Buttigliero
- Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, Orbassano, Italy
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Prigol AN, Rode MP, da Luz Efe F, Saleh NA, Creczynski-Pasa TB. The Bone Microenvironment Soil in Prostate Cancer Metastasis: An miRNA Approach. Cancers (Basel) 2023; 15:4027. [PMID: 37627055 PMCID: PMC10452124 DOI: 10.3390/cancers15164027] [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: 05/14/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023] Open
Abstract
Bone metastatic prostate cancer (PCa) is associated with a high risk of mortality. Changes in the expression pattern of miRNAs seem to be related to early aspects of prostate cancer, as well as its establishment and proliferation, including the necessary steps for metastasis. Here we compiled, for the first time, the important roles of miRNAs in the development, diagnosis, and treatment of bone metastasis, focusing on recent in vivo and in vitro studies. PCa exosomes are proven to promote metastasis-related events, such as osteoblast and osteoclast differentiation and proliferation. Aberrant miRNA expression in PCa may induce abnormal bone remodeling and support tumor development. Furthermore, miRNAs are capable of binding to multiple mRNA targets, a dynamic property that can be harnessed for the development of treatment tools, such as antagomiRs and miRNA mimics, which have emerged as promising candidates in PCa treatment. Finally, miRNAs may serve as noninvasive biomarkers, as they can be detected in tissue and bodily fluids, are highly stable, and show differential expression between nonmetastatic PCa and bone metastatic samples. Taken together, the findings underscore the importance of miRNA expression profiles and miRNA-based tools as rational technologies to increase the quality of life and longevity of patients.
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Affiliation(s)
| | | | | | | | - Tânia Beatriz Creczynski-Pasa
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianopolis 88040-900, Santa Catarina State, Brazil; (A.N.P.); (M.P.R.); (F.d.L.E.); (N.A.S.)
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9
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Jiang Z, Fan J, Gan C, Dong X, Gao G, Wang Z, He D, Li L, Duan X, Wu K. Impact of non-regional lymph node metastases accurately revealed on 18F-PSMA-1007 PET/CT in the clinical management of metastatic hormone-sensitive prostate cancer. EJNMMI Res 2023; 13:64. [PMID: 37410264 DOI: 10.1186/s13550-023-01009-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/06/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Non-regional lymph node (NRLN) metastases has shown increasing importance in the prognosis evaluation and clinical management of primary metastatic hormone-sensitive prostate cancer (mHSPC). Hence, this study aimed to investigate the concordance rates between 18F-PSMA-1007 PET/CT and conventional imaging (CI) in revealing NRLN metastases, and explore the impact of NRLN metastases on the management of primary mHSPC. METHODS The medical records of 224 patients with primary mHSPC were retrospectively reviewed, including 101 patients (45.1%) only received CI for TNM classification, 24 patients (10.7%) only received 18F-PSMA-1007 PET/CT, and 99 patients (44.2%) received both 18F-PSMA-1007 PET/CT and CI. Among patients who received 18F-PSMA-1007 PET/CT and CI before initial treatment, the concordance rates between 18F-PSMA-1007 PET/CT and CI were analyzed. The high-volume disease was defined as the presence of visceral metastases and/or ≥ 4 bone metastases (≥ 1 beyond the vertebral bodies or the pelvis) based on the findings of 18F-PSMA-1007 PET/CT and/or CI. The primary endpoint was progression-free survival (PFS), and Cox regression analyses were performed to explore independent predictors of PFS. RESULTS A total of 99 patients (44.2%) received both 18F-PSMA-1007 PET/CT and CI, the concordance rate in revealing NRLN metastases between 18F-PSMA-1007 PET/CT and CI was only 61.62%, and Cohen's kappa coefficient was as low as 0.092. Moreover, 18F-PSMA-1007 PET/CT detected an additional 37 of 94 (39.4%) patients with positive NRLNs who were negative on CI. Cox regression revealed that androgen deprivation therapy (ADT), N1, high-volume, NRLN and visceral metastases were associated with worse PFS (all P < 0.05) in 224 patients. Furthermore, in patients with low-volume disease, the median PFS of patients with NRLN metastases was significantly shorter than that of patients without NRLN metastases (19.5 vs. 27.5 months, P = 0.01), while the difference between patients with low-volume plus NRLN metastases and high-volume disease was not significant (19.5 vs. 16.9 months, P = 0.55). Moreover, early docetaxel chemotherapy significantly prolonged the PFS of these patients compared with ADT alone (20.7 vs. 12.3 months, P = 0.008). CONCLUSION NRLN metastases could be accurately revealed by 18F-PSMA-1007 PET/CT, which should be considered a high-volume feature, especially concomitant with bone metastases. Furthermore, patients with low-volume plus NRLN metastases may be suitable for more intensive treatment, such as early docetaxel chemotherapy.
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Affiliation(s)
- Zhangdong Jiang
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Junjie Fan
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Urology, Baoji Central Hospital, Baoji, Shaanxi, People's Republic of China
| | - Chaosheng Gan
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Xiaoxin Dong
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Guoqiang Gao
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Zhuonan Wang
- Department of PET/CT Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Dalin He
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Lei Li
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - XiaoYi Duan
- Department of PET/CT Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Kaijie Wu
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China.
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10
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Saito S, Sakamoto S, Higuchi K, Sato K, Zhao X, Wakai K, Kanesaka M, Kamada S, Takeuchi N, Sazuka T, Imamura Y, Anzai N, Ichikawa T, Kawakami E. Machine-learning predicts time-series prognosis factors in metastatic prostate cancer patients treated with androgen deprivation therapy. Sci Rep 2023; 13:6325. [PMID: 37072487 PMCID: PMC10113215 DOI: 10.1038/s41598-023-32987-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023] Open
Abstract
Machine learning technology is expected to support diagnosis and prognosis prediction in medicine. We used machine learning to construct a new prognostic prediction model for prostate cancer patients based on longitudinal data obtained from age at diagnosis, peripheral blood and urine tests of 340 prostate cancer patients. Random survival forest (RSF) and survival tree were used for machine learning. In the time-series prognostic prediction model for metastatic prostate cancer patients, the RSF model showed better prediction accuracy than the conventional Cox proportional hazards model for almost all time periods of progression-free survival (PFS), overall survival (OS) and cancer-specific survival (CSS). Based on the RSF model, we created a clinically applicable prognostic prediction model using survival trees for OS and CSS by combining the values of lactate dehydrogenase (LDH) before starting treatment and alkaline phosphatase (ALP) at 120 days after treatment. Machine learning provides useful information for predicting the prognosis of metastatic prostate cancer prior to treatment intervention by considering the nonlinear and combined impacts of multiple features. The addition of data after the start of treatment would allow for more precise prognostic risk assessment of patients and would be beneficial for subsequent treatment selection.
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Affiliation(s)
- Shinpei Saito
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
- Department of Artificial Intelligence Medicine, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan.
| | | | - Kodai Sato
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
- Department of Artificial Intelligence Medicine, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Xue Zhao
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
| | - Ken Wakai
- Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Manato Kanesaka
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
| | - Shuhei Kamada
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
| | - Nobuyoshi Takeuchi
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
| | - Tomokazu Sazuka
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
| | - Yusuke Imamura
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
| | - Naohiko Anzai
- Department of Pharmacology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba, 260-8670, Japan
| | - Eiryo Kawakami
- Department of Artificial Intelligence Medicine, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
- Advanced Data Science Project (ADSP), RIKEN Information R&D and Strategy Headquarters, RIKEN, Kanagawa, Japan
- Institute for Advanced Academic Research (IAAR), Chiba University, Chiba, Chiba, Japan
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11
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Roy S, Sun Y, Wallis CJD, Morgan SC, Grimes S, Malone J, Kishan AU, Mukherjee D, Spratt DE, Saad F, Malone S. Development and validation of a multivariable prognostic model in de novo metastatic castrate sensitive prostate cancer. Prostate Cancer Prostatic Dis 2023; 26:119-125. [PMID: 35790787 DOI: 10.1038/s41391-022-00560-3] [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] [Received: 04/02/2022] [Revised: 05/08/2022] [Accepted: 06/01/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Metastatic castrate sensitive prostate cancer (mCSPC) is a heterogeneous disease state with variable prognosis. Although several life-prolonging systemic agents are available, there is no robust multivariable model to predict prognosis and improve risk stratification in mCSPC. The objective of this study was to build and validate a multivariable prognostic model to predict overall survival (OS) in mCSPC. METHODS We used data from LATITUDE, a phase III randomized controlled trial in which men with de novo mCSPC were randomly allocated to either ADT plus abiraterone or ADT with placebo. Patients with non-missing data (n = 1,058) were randomly split in a 70:30 ratio to training (n = 743) and testing (n = 315) sets. Elastic net regression was used for variable selection. A multivariable Cox regression model for OS was then fitted using the selected variables. The predictive accuracy of the model was assessed on the testing set using the time-dependent area under curve (tAUC) with bootstrapped confidence intervals [CI] primarily for OS and secondarily for radiographic progression-free survival (rPFS). RESULTS The 11 prognostic variables in the final model were performance status, number of skeletal metastases, Gleason score, presence of liver metastasis, worst pain score, albumin, lactate dehydrogenase, prostate-specific antigen, hemoglobin, and treatment regimen. The tAUC for predicting OS at 2- and 3-years was 0.74 (95% CI, 0.67-0.80) and 0.72 (95% CI, 0.65-0.77), respectively. The tAUC for rPFS at 2- and 3-years was 0.72 (95% CI, 0.65-0.77) and 0.77 (95% CI, 0.70-0.82), respectively. CONCLUSIONS A prognostic model for men with de novo mCSPC was developed and validated in an independent testing set. Our model had high accuracy for predicting OS and rPFS. The model includes commonly used clinical and laboratory parameters and can guide risk stratification of these patients for participation in future trials.
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Affiliation(s)
- Soumyajit Roy
- Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Yilun Sun
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Cristopher J D Wallis
- Department of Urology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - Scott C Morgan
- Division of Radiation Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada
| | - Scott Grimes
- Division of Radiation Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada
| | - Julia Malone
- Division of Radiation Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada
| | - Amar U Kishan
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Daniel E Spratt
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Fred Saad
- Department of Surgery, Université de Montréal, Montreal, QC, Canada
| | - Shawn Malone
- Division of Radiation Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada.
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12
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Krausewitz P, Ritter M, Essler M. [Diagnosis and staging of metastatic hormone-sensitive prostate cancer]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:347-353. [PMID: 36735034 DOI: 10.1007/s00120-023-02028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Risk stratification of patients with metastatic hormone-sensitive prostate cancer (mHSPC) has undergone significant changes in recent years in light of new therapies and innovative imaging. OBJECTIVES Established and innovative methods for detection of metastasis, risk group stratification, and treatment of mHSPC are outlined and compared. MATERIALS AND METHODS Background knowledge and treatment-relevant guideline recommendations on mHSPC are presented and complemented by recent study results. RESULTS Integration of modern imaging techniques, especially prostate-specific membrane antigen (PSMA) PET/CT, into the diagnostic algorithm has the potential to significantly improve risk stratification and treatment of mHSPC. By using PSMA PET/CT, metastases are detected early and sensitively. This leads to the definition of new subgroups amenable to modern therapeutic strategies. The prognostic value of using PSMA PET/CT with regard to established risk categories in mHSPC is currently being evaluated. CONCLUSIONS Modern imaging, especially PSMA PET/CT, has significant added value for the diagnosis and treatment of mHSPC in almost all subgroups. In particular, it helps to select patients who will benefit from intensification or de-escalation of systemic therapy.
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Affiliation(s)
- Philipp Krausewitz
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn (AöR), Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Manuel Ritter
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn (AöR), Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Markus Essler
- Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Bonn (AöR), Venusberg-Campus 1, 53127, Bonn, Deutschland
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13
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18F-NaF PET-CT versus 99mTc SPECT in bone metastasis assessment - Authors' reply. Lancet Oncol 2023; 24:e69. [PMID: 36725149 DOI: 10.1016/s1470-2045(23)00017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 02/01/2023]
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14
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Koshiro N, Nakajima K, Oyama M, Kaneko G, Takahashi S, Matsuyama H, Shiina H, Ichikawa T, Horikoshi H, Hashine K, Sugiyama Y, Miyao T, Kamiyama M, Harada K, Ito A, Mizokami A. Predictive factors for the effectiveness of novel androgen receptor axis-targeted agents in patients with metastatic prostate cancer. Int J Urol 2022; 29:1477-1487. [PMID: 36070138 DOI: 10.1111/iju.15022] [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: 01/25/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Novel androgen receptor axis-targeted agents (ARATAs) have been developed for mCRPC and improved overall survival (OS). Here, we aimed to find predictors who will receive the greatest benefits from ARATAs. METHODS We previously performed a multicenter study to identify prognostic factors for metastatic hormone-sensitive prostate cancer (mHSPC, n = 148) and mCRPC (n = 99), and showed that the bone scan index (BSI) was one of the significant prognostic factors for 3-year OS (PROSTAT-BSI study). mHSPC progressed to mCRPC (n = 101), for which 69 patients were treated with (n = 39) or without ARATAs (n = 30, prior to the approval of ARATAs). The 69 patients were divided into two groups according to patient factors, and these cohorts were further divided into two subgroups by usage of ARATAs. OS was compared between subgroups in each group. RESULTS The predictors were age (<71.4 years), serum levels of C-reactive protein (≥0.16 ng/ml) and alkaline phosphatase (≥548 U/L), time to PSA progression after ADT (<8.9 months), the lowest PSA level (≥1 ng/ml) after ADT, and the rate of PSA decline 3 months after ADT (<0.987), whereas hemoglobin levels, PSA before ADT, Gleason scores, existence of visceral metastases, and BSI were not. CONCLUSIONS The present study identified predictors for the effectiveness of ARATAs. The number of bone metastases (≒BSI), existence of visceral metastases, and Gleason scores, which were identified as high-risk factors in the LATITUDE study and disease volume in CHAARTED criteria, did not appear to be useful for predicting effectiveness from ARATAs.
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Affiliation(s)
- Nishimoto Koshiro
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Masafumi Oyama
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Go Kaneko
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Hiroaki Shiina
- Department of Urology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroyuki Horikoshi
- Department of Diagnostic Radiology, Gunma Prefectural Cancer Center, Ota, Japan
| | - Katsuyoshi Hashine
- Department of Urology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Yutaka Sugiyama
- Department of Urology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takeshi Miyao
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Manabu Kamiyama
- Department of Urology, University of Yamanashi, Yamanashi, Japan
| | - Kenichi Harada
- Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akito Ito
- Department of Urology, Iwate Medical University, Iwate, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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15
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Jayalath VH, Clark R, Lajkosz K, Fazelzad R, Fleshner NE, Klotz LH, Hamilton RJ. Statin Use and Survival Among Men Receiving Androgen-Ablative Therapies for Advanced Prostate Cancer: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2242676. [PMID: 36449294 PMCID: PMC9713611 DOI: 10.1001/jamanetworkopen.2022.42676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
IMPORTANCE Epidemiological evidence supports a role for statins in improving survival in advanced prostate cancer, particularly among men receiving androgen-ablative therapies. OBJECTIVE To study the association between statin use and survival among men with prostate cancer receiving androgen deprivation therapy (ADT) or androgen receptor axis-targeted therapies (ARATs). DATA SOURCES This systemic review and meta-analysis used sources from MEDLINE, EMBASE, Epub Ahead of Print, Cochrane Clinical Trials, Cochrane Systematic Reviews, and Web of Science from inception to September 6, 2022. STUDY SELECTION Observational studies reporting associations of concurrent statin use and survival outcomes (in hazard ratios [HRs]). DATA EXTRACTION AND SYNTHESIS Two authors independently abstracted all data. Summary estimates pooled multivariable HRs with 95% CIs using the generic inverse variance method with random-effects modeling. A priori specified subgroup and sensitivity analyses were undertaken, and heterogeneity, study quality, and publication bias were evaluated. Confidence in the evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. MAIN OUTCOMES AND MEASURES Overall mortality and prostate cancer-specific mortality (PCSM). RESULTS Twenty-five cohorts of 119 878 men (65 488 statin users [55%]) with more than 74 416 deaths were included. Concurrent statin use was associated with a 27% reduction in the risk of overall mortality (HR, 0.73 [95% CI, 0.66-0.82]; I2 = 83%) and a 35% reduction in the risk of PCSM (HR, 0.65 [95% CI, 0.58-0.73]; I2 = 74%), with substantial heterogeneity in both estimates. Subgroup analyses identified a PCSM advantage associated with statins for men receiving ARATs compared with ADT alone (HR, 0.40 [95% CI, 0.30-0.55] vs 0.68 [95% CI, 0.60-0.76]; P = .002 for difference). Confidence in the evidence was rated low for both outcomes. CONCLUSIONS AND RELEVANCE The findings of this meta-analysis show that concurrent statin use was associated with reduced overall mortality and PCSM among men receiving androgen-ablative therapies for advanced prostate cancer. These findings are limited by the observational nature of the data and residual unexplained interstudy heterogeneity. Randomized clinical trials are warranted to validate these results.
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Affiliation(s)
- Viranda H. Jayalath
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Roderick Clark
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Toronto, Ontario, Canada
- Division of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Katherine Lajkosz
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Rouhi Fazelzad
- Library Services, University Health Network, Toronto, Ontario, Canada
| | - Neil E. Fleshner
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Laurence H. Klotz
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Urology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Robert J. Hamilton
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
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16
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Hanusek K, Poletajew S, Kryst P, Piekiełko-Witkowska A, Bogusławska J. piRNAs and PIWI Proteins as Diagnostic and Prognostic Markers of Genitourinary Cancers. Biomolecules 2022; 12:biom12020186. [PMID: 35204687 PMCID: PMC8869487 DOI: 10.3390/biom12020186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 12/30/2022] Open
Abstract
piRNAs (PIWI-interacting RNAs) are small non-coding RNAs capable of regulation of transposon and gene expression. piRNAs utilise multiple mechanisms to affect gene expression, which makes them potentially more powerful regulators than microRNAs. The mechanisms by which piRNAs regulate transposon and gene expression include DNA methylation, histone modifications, and mRNA degradation. Genitourinary cancers (GC) are a large group of neoplasms that differ by their incidence, clinical course, biology, and prognosis for patients. Regardless of the GC type, metastatic disease remains a key therapeutic challenge, largely affecting patients’ survival rates. Recent studies indicate that piRNAs could serve as potentially useful biomarkers allowing for early cancer detection and therapeutic interventions at the stage of non-advanced tumour, improving patient’s outcomes. Furthermore, studies in prostate cancer show that piRNAs contribute to cancer progression by affecting key oncogenic pathways such as PI3K/AKT. Here, we discuss recent findings on biogenesis, mechanisms of action and the role of piRNAs and the associated PIWI proteins in GC. We also present tools that may be useful for studies on the functioning of piRNAs in cancers.
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Affiliation(s)
- Karolina Hanusek
- Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, 01-813 Warsaw, Poland;
| | - Sławomir Poletajew
- Centre of Postgraduate Medical Education, II Department of Urology, 01-813 Warsaw, Poland; (S.P.); (P.K.)
| | - Piotr Kryst
- Centre of Postgraduate Medical Education, II Department of Urology, 01-813 Warsaw, Poland; (S.P.); (P.K.)
| | - Agnieszka Piekiełko-Witkowska
- Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, 01-813 Warsaw, Poland;
- Correspondence: (A.P.-W.); (J.B.)
| | - Joanna Bogusławska
- Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, 01-813 Warsaw, Poland;
- Correspondence: (A.P.-W.); (J.B.)
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17
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Heesterman BL, van der Poel HG, Schoots IG, Mehra N, Aben KKH. Prognostic importance of concomitant non-regional lymph node and bone metastases in men with newly diagnosed metastatic prostate cancer. BJU Int 2021; 130:217-225. [PMID: 34741789 DOI: 10.1111/bju.15632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 09/09/2021] [Accepted: 11/04/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To evaluate the prognostic importance of concomitant non-regional lymph node (NRLN) and bone metastases in men with synchronous metastatic hormone-sensitive prostate cancer (mHSPC), and to determine whether M1b/M1c is the most appropriate M-stage and evaluate the additional importance to the distinction in low/high volume disease. PATIENTS AND METHODS All men diagnosed with synchronous mHSPC from 2010 to 2018 in the Netherlands were identified in the Netherlands Cancer Registry. Men were categorised as having NRLN (M1a), bone (M1b), NRLN and bone (M1c), or visceral metastases (M1c). For men diagnosed since October 2015 disease volume could be determined. Analyses were performed in this cohort (>5600 men) and repeated in the 2010-2018 cohort (>14 000 men). The primary outcome measure in this observational cohort study was overall survival (OS) and Cox regression was used to calculate hazard ratios (HRs). RESULTS Compared to men with NRLN and bone metastases (reference group), OS of men with only NRLN (HR 0.70, 95% confidence interval [CI] 0.55-0.88) was better. This was also true for men with only bone metastases in the low-volume subgroup (HR 0.75, 95% CI0.58-0.98), but not in the high-volume subgroup (HR 0.99, 95% CI 0.84-1.18). In contrast, the OS of men with visceral metastases was worse (HR 2.20, 95% CI 1.75-2.77 + 0.97/month, 95% CI 0.96-0.98). CONCLUSION In men with low-volume synchronous mHSPC, presence of concomitant NRLN and bone metastases (currently classified as M1c), is a poor prognostic sign. However, survival of men with visceral metastases (M1c) is worse. Implying that classifying concomitant NRLN and bone metastases as M1c or M1b is not appropriate. Adding a fourth M1-category to the ninth edition of the Tumour-Node-Metastasis classification should be contemplated. Furthermore, definitions of metastatic burden need to be re-evaluated.
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Affiliation(s)
| | - Henk G van der Poel
- Department of Urology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Ivo G Schoots
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Niven Mehra
- Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Katja K H Aben
- Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
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18
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Shiota M, Terada N, Kitamura H, Kojima T, Saito T, Yokomizo A, Kohei N, Goto T, Kawamura S, Hashimoto Y, Takahashi A, Kimura T, Tabata K, Tomida R, Hashimoto K, Sakurai T, Shimazui T, Sakamoto S, Kamiyama M, Tanaka N, Mitsuzuka K, Kato T, Narita S, Yasumoto H, Teraoka S, Kato M, Osawa T, Nagumo Y, Matsumoto H, Enokida H, Sugiyama T, Kuroiwa K, Inoue T, Sugimoto M, Mizowaki T, Kamoto T, Nishiyama H, Eto M. Novel metastatic burden-stratified risk model in de novo metastatic hormone-sensitive prostate cancer. Cancer Sci 2021; 112:3616-3626. [PMID: 34145921 PMCID: PMC8409413 DOI: 10.1111/cas.15038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/09/2021] [Accepted: 06/17/2021] [Indexed: 12/21/2022] Open
Abstract
The metastatic burden is a critical factor for decision-making in the treatment of metastatic hormone-sensitive prostate cancer (HSPC). This study aimed to develop and validate a novel risk model for survival in patients with de novo low- and high-burden metastatic HSPC. The retrospective observational study included men with de novo metastatic prostate cancer who were treated with primary androgen-deprivation therapy at 30 institutions across Japan between 2008 and 2017. We created a risk model for overall survival (OS) in the discovery cohort (n = 1449) stratified by the metastatic burden (low vs high) and validated its predictive ability in a separate cohort (n = 951). Based on multivariate analyses, lower hemoglobin levels, higher Gleason grades, and higher clinical T-stage were associated with poor OS in low-burden disease. Meanwhile, lower hemoglobin levels, higher Gleason grade group, liver metastasis, and higher extent of disease scores in bone were associated with poor OS in patients with high-burden disease. In the discovery and validation cohorts, the risk model using the aforementioned parameters exhibited excellent discriminatory ability for progression-free survival and OS. The predictive ability of this risk model was superior to that of previous risk models. Our novel metastatic burden-stratified risk model exhibited excellent predictive ability for OS, and it is expected to have several clinical uses, such as precise prognostic estimation.
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Affiliation(s)
| | - Naoki Terada
- Department of UrologyMiyazaki UniversityMiyazakiJapan
| | - Hiroshi Kitamura
- Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for ResearchUniversity of ToyamaToyamaJapan
| | - Takahiro Kojima
- Department of UrologyUniversity of Tsukuba HospitalTsukubaJapan
| | - Toshihiro Saito
- Department of UrologyNiigata Cancer Center HospitalNiigataJapan
| | | | - Naoki Kohei
- Department of UrologyShizuoka General HospitalShizuokaJapan
| | | | | | | | | | | | | | - Ryotaro Tomida
- Department of UrologyShikoku Cancer CenterMatsuyamaJapan
| | | | | | - Toru Shimazui
- Department of UrologyIbaraki Prefectural Central Hospital, Ibaraki Cancer CenterKasamaJapan
| | | | - Manabu Kamiyama
- Department of UrologyUniversity of Yamanashi HospitalChuoJapan
| | | | | | - Takuma Kato
- Department of UrologyKagawa UniversityKagawaJapan
| | | | | | | | - Masashi Kato
- Department of UrologyNagoya UniversityNagoyaJapan
| | - Takahiro Osawa
- Department of Renal and Genitourinary SurgeryHokkaido UniversitySapporoJapan
| | | | | | | | - Takayuki Sugiyama
- Department of UrologyHamamatsu University School of MedicineHamamatsuJapan
| | - Kentaro Kuroiwa
- Department of UrologyMiyazaki Prefectural Miyazaki HospitalMiyazakiJapan
| | - Takahiro Inoue
- Department of Nephro‐Urologic Surgery and AndrologyMie University Graduate School of MedicineTsuJapan
| | | | - Takashi Mizowaki
- Department of Radiation Oncology & Image‐applied TherapyKyoto UniversityKyotoJapan
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19
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Rivera-Izquierdo M, Pérez de Rojas J, Martínez-Ruiz V, Pérez-Gómez B, Sánchez MJ, Khan KS, Jiménez-Moleón JJ. Obesity as a Risk Factor for Prostate Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of 280,199 Patients. Cancers (Basel) 2021; 13:cancers13164169. [PMID: 34439328 PMCID: PMC8392042 DOI: 10.3390/cancers13164169] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Results from individual studies on the association between obesity and prostate cancer mortality remain inconclusive; additionally, several large cohort studies have recently been conducted. We aimed to systematically review all available evidence and synthetize it using meta-analytic techniques. The results of our study showed that obesity was associated with prostate cancer specific mortality and all-cause mortality. The temporal association was consistent with a dose-response relationship. Our results demonstrated that obesity, a potentially modifiable prognostic factor, was associated with higher prostate cancer mortality. This study improved the evidence regarding the potential impact of lifestyle on improving prostate cancer prognosis. Strategies aimed at maintaining normal, or reducing abnormal, body mass index in diagnosed prostate cancer patients might improve survival. These results should guide urologists, oncologists, patients, policy-makers and primary care providers with respect to evidence-based practice and counselling concerning lifestyle changes after prostate cancer diagnosis. Abstract The aim of this study was to systematically review all evidence evaluating obesity as a prognostic factor for PC mortality. Cohort and case-control studies reporting mortality among PC patients stratified by body mass index (BMI) were included. The risk of mortality among obese patients (BMI ≥ 30) was compared with the risk for normal weight (BMI < 25) patients, pooling individual hazard ratios (HR) in random-effects meta-analyses. Reasons for heterogeneity were assessed in subgroup analyses. Dose-response associations for BMI per 5 kg/m2 change were assessed. Among 7278 citations, 59 studies (280,199 patients) met inclusion criteria. Obesity was associated with increased PC-specific mortality (HR: 1.19, 95% CI: 1.10–1.28, I2: 44.4%) and all-cause mortality (HR: 1.09, 95% CI: 1.00–1.18, I2: 43.9%). There was a 9% increase (95% CI: 5–12%, I2: 39.4%) in PC-specific mortality and 3% increase (95% CI: 1–5%, I2: 24.3%) in all-cause mortality per 5 kg/m2 increase in BMI. In analyses restricted to the higher quality subgroup (NOS ≥ 8), obesity was associated with increased PC-specific mortality (HR: 1.24, 95% CI: 1.14–1.35, I2: 0.0%) and maintained the dose-response relationship (HR: 1.11 per 5 kg/m2 increase in BMI, 95% CI: 1.07–1.15, I2: 26.6%). Obesity had a moderate, consistent, temporal, and dose-response association with PC mortality. Weight control programs may have a role in improving PC survival.
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Affiliation(s)
- Mario Rivera-Izquierdo
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Correspondence:
| | - Javier Pérez de Rojas
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
| | - Virginia Martínez-Ruiz
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
| | - Beatriz Pérez-Gómez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- National Centre for Epidemiology, Department of Epidemiology of Chronic Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María-José Sánchez
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Escuela Andaluza de Salud Pública (EASP), 18011 Granada, Spain
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
| | - José Juan Jiménez-Moleón
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
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20
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Wang Y, Zhang Y, Lin H, Xu M, Zhou X, Zhuang J, Yang Y, Chen B, Liu X, Guan G. Risk factors for lymph node metastasis in rectal neuroendocrine tumors: A recursive partitioning analysis based on multicenter data. J Surg Oncol 2021; 124:1098-1105. [PMID: 34291822 DOI: 10.1002/jso.26615] [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: 04/15/2021] [Revised: 05/22/2021] [Accepted: 07/11/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The well-differentiated rectal neuroendocrine tumors (RNETs) can also have lymph node metastasis (LNM). Large multicenter data were reviewed to explore the risk factors for LNM in RNETs. Further, we developed a model to predict the risk of LNM in RNETs. METHODS In total, 223 patients with RNETs from the Fujian Medical University Union Hospital, the First Affiliated Hospital of Fujian Medical University, and the First Affiliated Hospital of Xiamen University were retrospectively enrolled. Logistic regression analysis was performed to study the factors affecting LNM, and recursive partitioning analysis (RPA) was performed to stratify the risk of LNM. RESULTS Among the 223 patients diagnosed with RNETs, the incidence of LNM was 10.8%. Univariate and multivariate regression analyses revealed that tumor size, World Health Organization (WHO) grade, and depth of tumor invasion were independent risk factors for LNM (p < 0.05). The area under the curve was 0.948 (95% confidence interval: 0.890-1.000). Furthermore, the incidence of LNM in patients divided into low- and high-risk groups according to RPA was 1.1% and 56.4%, respectively. CONCLUSION Compared with tumor size, the depth of tumor invasion and WHO grade are more important factors in predicting LNM. Then, we developed a model based on RPA to predict the risk of LNM in RNETs and identify patients who are suitable for local resection.
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Affiliation(s)
- Ye Wang
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yiyi Zhang
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Hexin Lin
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Meifang Xu
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xin Zhou
- Departments of Colorectal Cancer Surgery, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Jinfu Zhuang
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yuanfeng Yang
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Bin Chen
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xing Liu
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Guoxian Guan
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, China
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21
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Jahrreiss V, Laukhtina E, D'Andrea D, Shariat SF. The prognostic value of sarcopenia in patients with prostate cancer: a systematic review. Curr Opin Urol 2021; 31:315-323. [PMID: 33965982 DOI: 10.1097/mou.0000000000000885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Sarcopenia is known to affect perioperative and oncologic outcomes in patients with different urological malignancies. Nevertheless, the use of pretreatment sarcopenia as a predictor of clinical outcomes in patients with prostate cancer is still poorly studied. Therefore, we aimed to conduct a systematic review summarizing the available evidence and identifying the prognostic value of sarcopenia in prostate cancer patients. RECENT FINDINGS Sarcopenia was not predictive of biochemical recurrence in patients treated with radical prostatectomy. However, it was associated with worse long-term survival outcomes as well as the likelihood of developing postoperative complications after radical prostatectomy. In the context of radiotherapy, sarcopenia was a predictive factor for overall survival. In patients with hormone-sensitive prostate cancer treated with androgen deprivation, sarcopenia was associated with overall and cancer-specific survival. In patients with castration-resistant prostate cancer, sarcopenia was associated with poorer tolerance to docetaxel-based chemotherapy. SUMMARY Most studies found sarcopenia to be a predictor for worse perioperative and oncologic outcomes in patients treated with radical surgery, radiotherapy, or systemic therapy for prostate cancer. However, there is significant heterogeneity across the studies in terms of sarcopenia definition. For a better understanding of the prognostic value of sarcopenia in patients with prostate cancer, large-scale prospective studies are needed.
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Affiliation(s)
- Victoria Jahrreiss
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - David D'Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Department of Urology, Weill Cornell Medical College, New York, New York
- Department of Urology, University of Texas Southwestern, Dallas, Texas, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
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22
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Miyazawa Y, Sekine Y, Arai S, Oka D, Nakayama H, Syuto T, Nomura M, Koike H, Matsui H, Shibata Y, Suzuki K. Prognostic Factors in Hormone-sensitive Prostate Cancer Patients Treated With Combined Androgen Blockade: A Consecutive 15-year Study at a Single Japanese Institute. In Vivo 2021; 35:373-384. [PMID: 33402486 DOI: 10.21873/invivo.12268] [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: 09/28/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIM There are several treatment options for metastatic hormone-sensitive prostate cancer (mHSPC) in the world. In recent years, the use of docetaxel, abiraterone, enzalutamide, and apalutamide has been used for mHSPC, but combined androgen blockade (CAB) therapy using first-generation antiandrogens has been widely used in Japan. There is a background. We performed a consecutive study of patients who received combined androgen blockade (CAB) at a single institute to determine the prognostic factors for mHSPC. PATIENTS AND METHODS We conducted a consecutive study of 237 mHSPC patients treated with CAB from 2003 to 2017 at the Gunma University Hospital. Prostate-specific antigen progression-free survival (PSA-PFS) and overall survival (OS) were estimated by the Kaplan-Meier method. The associations between pre-treatment risk factors and the PSA response 3 months after starting CAB, PSA-PFS, and OS were evaluated by the Cox proportional hazards model. RESULTS Among the 237 cases, the median PSA-PFS and OS times were 63.0 and 91.4 months, respectively. The median PSA-PFS and OS times of M1 cases (174 cases, 73.4% of all 237 cases) were 36.1 and 75.9 months, respectively. The Eastern Cooperative Oncology Group performance status (ECOG PS) score, hemoglobin (Hb), lactate dehydrogenase, extent of disease, visceral metastasis (no vs. yes), and PSA response after 3 months were significant predictors of OS according to Cox regression analysis of prognostic factors in M1 patients. The ECOG PS, Hb, visceral metastasis (no vs. yes), and PSA response after 3 months predicted OS high-risk patients in LATITUDE criteria. The OS was 92.1 months in the low-risk group (0-1 risk factors), 48.2 months in the intermediate-risk group (2 risk factors), and 16.9 months in the high-risk group (3-4 risk factors). CONCLUSION CAB should be considered as a treatment option for strictly selected patients with mHSPC, even though novel treatments are available.
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Affiliation(s)
- Yoshiyuki Miyazawa
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Yoshitaka Sekine
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Seiji Arai
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Daisuke Oka
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hiroshi Nakayama
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Takahiro Syuto
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Masashi Nomura
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hidekazu Koike
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hiroshi Matsui
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Yasuhiro Shibata
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Kazuhiro Suzuki
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
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23
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Prognostic Association between Common Laboratory Tests and Overall Survival in Elderly Men with De Novo Metastatic Castration Sensitive Prostate Cancer: A Population-Based Study in Canada. Cancers (Basel) 2021; 13:cancers13112844. [PMID: 34200349 PMCID: PMC8200983 DOI: 10.3390/cancers13112844] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 12/16/2022] Open
Abstract
Simple Summary Despite significant advancements in the treatment of metastatic prostate cancer, a validated prognostic tool for patients with de novo metastatic castration-sensitive prostate cancer (mCSPC) is still lacking. Using population-based data from Ontario, Canada, we examined the prognostic association between common laboratory tests and survival for patients with mCSPC. These low-cost commonly available laboratory tests, including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, albumin, hemoglobin, PSA decrease and PSA nadir, were significantly associated with OS. They can provide important prognostic information and should be utilized more frequently among patients with newly diagnosed mCSPC. Abstract De novo cases of metastatic prostate cancer (mCSPC) are associated with poorer prognosis. To assist in clinical decision-making, we aimed to determine the prognostic utility of commonly available laboratory-based markers with overall survival (OS). In a retrospective population-based study, a cohort of 3556 men aged ≥66 years diagnosed with de novo mCSPC between 2014 and 2019 was identified in Ontario (Canada) administrative database. OS was assessed by using the Kaplan–Meier method. Multivariate Cox regression analysis was performed to evaluate the association between laboratory markers and OS adjusting for patient and disease characteristics. Laboratory markers that were assessed include neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), albumin, hemoglobin, serum testosterone and PSA kinetics. Among the 3556 older men with de novo mCSPC, their median age was 77 years (IQR: 71–83). The median survival was 18 months (IQR: 10–31). In multivariate analysis, a statistically significant association with OS was observed with all the markers (NLR, PLR, albumin, hemoglobin, PSA decrease, reaching PSA nadir and a 50% PSA decline), except for testosterone levels. Our findings support the use of markers of systemic inflammation (NLR, PLR and albumin), hemoglobin and PSA metrics as prognostic indicators for OS in de novo mCSPC.
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24
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High Serum Alkaline Phosphatase Flare after First-Line Androgen Deprivation Therapy Predicts Poor Prognosis in Metastatic Prostate Cancer Patients Treated with Second-Generation Androgen Receptor Targeted Therapy. Prostate Cancer 2021; 2021:5574067. [PMID: 33898066 PMCID: PMC8052161 DOI: 10.1155/2021/5574067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/21/2021] [Accepted: 03/30/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives To determine whether an alkaline phosphatase (ALP) flare after androgen deprivation therapy (ADT) is associated with the treatment response in castration-resistant prostate cancer (CRPC) and predicts the prognosis of metastatic prostate cancer (PCa) patients. Methods One hundred and nineteen patients diagnosed with metastatic PCa between 2008 and 2017 were retrospectively studied. The ALP flare ratio was calculated as the ratio of ALP levels 1 month after beginning ADT to ALP levels at diagnosis. The association of the ALP flare ratio with the prostate-specific antigen (PSA) response to CRPC treatment (second-generation androgen receptor targeted therapy (ART) or docetaxel), time to CRPC, and overall survival (OS) were investigated. Results The time to CRPC and OS was significantly longer in patients with an ALP flare ratio less than 1.33 compared to a ratio more than 1.33. No difference in PSA response was seen regarding the ALP flare ratio in both ART and docetaxel treatment. Second-generation ART-treated patients with a low ALP flare ratio showed longer OS than those with a higher ALP flare ratio (p=0.0367). However, no difference was seen between a high and low ALP flare ratio (p=0.8054) in docetaxel-treated patients. The ALP flare ratio was the most significant prognostic factor for OS (p < 0.0001). Conclusions A higher ALP flare ratio after first-line ADT was a significant prognostic factor in metastatic PCa, especially in patients treated with second-generation ART for CRPC. Chemotherapy for patients with a higher ALP flare ratio 1 month after induction of ADT may be a clinically relevant decision.
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25
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Kwan EM, Fettke H, Crumbaker M, Docanto MM, To SQ, Bukczynska P, Mant A, Ng N, Foroughi S, Graham LJK, Haynes AM, Azer S, Lim LE, Segelov E, Mahon K, Davis ID, Parente P, Pezaro C, Todenhöfer T, Sathianathen N, Hauser C, Horvath LG, Joshua AM, Azad AA. Whole blood GRHL2 expression as a prognostic biomarker in metastatic hormone-sensitive and castration-resistant prostate cancer. Transl Androl Urol 2021; 10:1688-1699. [PMID: 33968657 PMCID: PMC8100842 DOI: 10.21037/tau-20-1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background As potent systemic therapies transition earlier in the prostate cancer disease course, molecular biomarkers are needed to guide optimal treatment selection for metastatic hormone-sensitive prostate cancer (mHSPC). The value of whole blood RNA to detect candidate biomarkers in mHSPC remains largely undefined. Methods In this cohort study, we used a previously optimised whole blood reverse transcription polymerase chain reaction assay to assess the prognostic utility [measured by seven-month undetectable prostate-specific antigen (PSA) and time to castration-resistance (TTCR)] of eight prostate cancer-associated gene transcripts in 43 mHSPC patients. Transcripts with statistically significant associations (P<0.05) were further investigated in a metastatic castration-resistant prostate cancer (mCRPC) cohort (n=119) receiving contemporary systemic therapy, exploring associations with PSA >50% response (PSA50), progression-free survival (PFS) and overall survival (OS). Clinical outcomes were prospectively collected in a protected digital database. Kaplan-Meier estimates and multivariable Cox proportional-hazards models assessed associations between gene transcripts and clinical outcomes (mHSPC covariates: disease volume, docetaxel use and haemoglobin level; mCRPC covariates: prior exposure to chemotherapy or ARPIs, haemoglobin, performance status and presence of visceral disease). Follow-up was performed monthly during ARPI treatment, three-weekly during taxane chemotherapy, and three-monthly during androgen deprivation therapy (ADT) monotherapy. Serial PSA measurements were performed before each follow-up visit and repeat imaging was at the discretion of the investigator. Results Detection of circulating Grainyhead-like 2 (GRHL2) transcript was associated with poor outcomes in mHSPC and mCRPC patients. Detectable GRHL2 expression in mHSPC was associated with a lower rate of seven-month undetectable PSA levels (25% vs. 65%, P=0.059), and independently associated with shorter TTCR (HR 7.3, 95% CI: 1.5–36, P=0.01). In the mCRPC cohort, GRHL2 expression predicted significantly lower PSA50 response rates (46% vs. 69%, P=0.01), and was independently associated with shorter PFS (HR 3.1, 95% CI: 1.8–5.2, P<0.001) and OS (HR 2.9, 95% CI: 1.6–5.1, P<0.001). Associations were most apparent in patients receiving ARPIs. Conclusions Detectable circulating GRHL2 was a negative prognostic biomarker in our mHSPC and mCRPC cohorts. These data support further investigation of GRHL2 as a candidate prognostic biomarker in metastatic prostate cancer, in addition to expanding efforts to better understand a putative role in therapeutic resistance to AR targeted therapies.
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Affiliation(s)
- Edmond M Kwan
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia.,Department of Medical Oncology, Monash Health, Melbourne, Australia
| | - Heidi Fettke
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Megan Crumbaker
- Department of Medical Oncology, Kinghorn Cancer Centre, St Vincent's Hospital, New South Wales, Australia.,Garvan Institute of Medical Research, New South Wales, Australia.,University of Sydney, New South Wales, Australia
| | - Maria M Docanto
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Sarah Q To
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | | | - Andrew Mant
- Department of Medical Oncology, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Nicole Ng
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Siavash Foroughi
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.,Department of Medical Biology, The University of Melbourne, Melbourne, Australia
| | | | | | - Sarah Azer
- Department of Urology, Monash Health, Melbourne, Australia
| | | | - Eva Segelov
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia.,Department of Medical Oncology, Monash Health, Melbourne, Australia
| | - Kate Mahon
- Garvan Institute of Medical Research, New South Wales, Australia.,University of Sydney, New South Wales, Australia.,Medical Oncology, Chris O'Brien Lifehouse, New South Wales, Australia
| | - Ian D Davis
- Department of Medical Oncology, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Phillip Parente
- Department of Medical Oncology, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia
| | | | | | - Niranjan Sathianathen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | | | - Lisa G Horvath
- Garvan Institute of Medical Research, New South Wales, Australia.,University of Sydney, New South Wales, Australia.,Medical Oncology, Chris O'Brien Lifehouse, New South Wales, Australia.,Royal Prince Alfred Hospital, New South Wales, Australia
| | - Anthony M Joshua
- Department of Medical Oncology, Kinghorn Cancer Centre, St Vincent's Hospital, New South Wales, Australia.,Garvan Institute of Medical Research, New South Wales, Australia
| | - Arun A Azad
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
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Can PSMA-based tumor burden predict response to docetaxel treatment in metastatic castration-resistant prostate cancer? Ann Nucl Med 2021; 35:680-690. [PMID: 33783752 DOI: 10.1007/s12149-021-01610-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE We investigated the role of PSMA-derived tumor burden in predicting docetaxel (DTX) therapy response in metastatic castration-resistant prostate cancer (mCRPC). METHODS Fifty-two mCRPC patients who received at least six cycles of DTX as the first-line treatment following 68Ga-PSMA PET/CT were enrolled in this retrospective study. Total PSMA-derived tumor volume (TV-PSMA) and total lesion PSMA activity (TL-PSMA) were derived from metastatic lesions. A ≥ 50% decline in PSA was defined as a response; a ≥ 25% increase in PSA was defined as progression. Univariate/multivariate logistic and cox regression analyses were performed to predict PSA response, OS, and TTP. RESULTS Twelve (23%) patients had PSA progression after chemotherapy, while 40 patients (77%) achieved a PSA response. On univariate analysis, a significant association was found between TV-PSMA (p = 0.001), TL-PSMA (p = 0.001), pre-PSA (p = 0.012), LDH (p = 0.003), Hg (p = 0.035), and PSA response to DTX. High TV-PSMA (> 107 cm3) (p = 0.04) and high LDH (> 234 U/L) (p = 0.017) were 8.2 times and 12.2 times more likely for DTX failure in multivariate regression analyses. The median TTP was 16 months, and the median OS was not reached. Patients with high TV-PSMA (p = 0.017), high TL-PSMA (> 1013 cm3) (p = 0.042), high age (> 70 years) (p = 0.016), and high LDH (p ≤ 0.001) had significantly shorter OS, while only high TV-PSMA (p = 0.038) and high age (p = 0.006) were significantly related with shorter TTP. High TV-PSMA (p = 0.017) and high age (p = 0.01) were significant predictors for shorter OS, while only high age (p = 0.006) was a significant predictor for shorter TTP in multivariate analysis. CONCLUSION Patients with high TV-PSMA had a significantly higher risk for DTX failure. PSMA-based tumor burden prior to DTX therapy seems to be a reliable predictive tool for survival in mCRPC patients.
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Manafi-Farid R, Harsini S, Saidi B, Ahmadzadehfar H, Herrmann K, Briganti A, Walz J, Beheshti M. Factors predicting biochemical response and survival benefits following radioligand therapy with [ 177Lu]Lu-PSMA in metastatic castrate-resistant prostate cancer: a review. Eur J Nucl Med Mol Imaging 2021; 48:4028-4041. [PMID: 33677734 PMCID: PMC8484081 DOI: 10.1007/s00259-021-05237-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/01/2021] [Indexed: 12/21/2022]
Abstract
Background Prostate cancer (PC) is one of the most common cancers in men. Although the overall prognosis is favorable, the management of metastatic castration-resistant prostate cancer (mCRPC) patients is challenging. Usually, mCRPC patients with progressive disease are considered for radioligand therapy (RLT) after exhaustion of other standard treatments. The prostate-specific membrane antigen (PSMA) labeled with Lutetium-177 ([177Lu]Lu-PSMA) has been widely used, showing favorable and successful results in reducing prostate-specific antigen (PSA) levels, increasing quality of life, and decreasing pain, in a multitude of studies. Nevertheless, approximately thirty percent of patients do not respond to [177Lu]Lu-PSMA RLT. Here, we only reviewed and reported the evaluated factors and their impact on survival or biochemical response to treatment to have an overview of the potentialprognostic parameters in [177Lu]Lu-PSMA RLT. Methods Studies were retrieved by searching MEDLINE/PubMed and GoogleScholar. The search keywords were as follows: {(“177Lu-PSMA”) AND (“radioligand”) AND (“prognosis”) OR (“predict”)}. Studies discussing one or more factors which may be prognostic or predictive of response to [177Lu]Lu-PSMA RLT, that is PSA response and survival parameters, were included. Results Several demographic, histological, biochemical, and imaging factors have been assessed as predictive parameters for the response to thistreatment; however, the evaluated factors were diverse, and the results mostly were divergent, except for the PSA level reduction after treatment, which unanimously predicted prolonged survival. Conclusion Several studies have investigated a multitude of factors to detect those predicting response to [177Lu]Lu-PSMA RLT. The results wereinconsistent regarding some factors, and some were evaluated in only a few studies. Future prospective randomized trials are required to detect theindependent prognostic factors, and to further determine the clinical and survival benefits of [177Lu]Lu-PSMA RLT.
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Affiliation(s)
- Reyhaneh Manafi-Farid
- Research Center for Nuclear Medicine, Tehran University of Medical sciences, Tehran, Iran
| | - Sara Harsini
- Research Center for Nuclear Medicine, Tehran University of Medical sciences, Tehran, Iran.,Association of Nuclear Medicine and Molecular Imaging (ANMMI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Bahare Saidi
- Research Center for Nuclear Medicine, Tehran University of Medical sciences, Tehran, Iran
| | | | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital, Essen, Germany
| | - Alberto Briganti
- Urological Research Institute, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Jochen Walz
- Department of Urology, Institute Paoli-Calmettes Cancer Centre, Marseille, France
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine & Endocrinology, Paracelsus Medical University, Salzburg, Austria. .,Department of Nuclear Medicine, University Hospital, RWTH University, Aachen, Germany.
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Zhong Y, Zhan J, Xu G, Chen Y, Qin Q, Liao X, Ma S, Yang Z, Cai Y. Enzyme‐Instructed Self‐Assembly Enabled Monomer–Excimer Transition to Construct Higher Ordered Luminescent Supramolecular Assembly for Activity‐based Bioimaging. Angew Chem Int Ed Engl 2021; 60:8121-8129. [PMID: 33410570 DOI: 10.1002/anie.202014278] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/20/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Yuanzhi Zhong
- Guangdong Provincial Key Laboratory of New Drug Screening School of Pharmaceutical Sciences Southern Medical University Guangzhou 510515 China
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Jie Zhan
- Shunde Hospital (The First People's Hospital of Shunde, Foshan) Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering Southern Medical University Guangzhou 510515 China
| | - Guanghui Xu
- Guangdong Provincial Key Laboratory of New Drug Screening School of Pharmaceutical Sciences Southern Medical University Guangzhou 510515 China
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Yumiao Chen
- Key Laboratory of Bioactive Materials Ministry of Education State Key Laboratory of Medicinal Chemical Biology College of Life Sciences Nankai University Tianjin 300071 China
| | - Qin Qin
- Guangdong Provincial Key Laboratory of New Drug Screening School of Pharmaceutical Sciences Southern Medical University Guangzhou 510515 China
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Xu Liao
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Shaodan Ma
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Zhimou Yang
- Guangdong Provincial Key Laboratory of New Drug Screening School of Pharmaceutical Sciences Southern Medical University Guangzhou 510515 China
- Key Laboratory of Bioactive Materials Ministry of Education State Key Laboratory of Medicinal Chemical Biology College of Life Sciences Nankai University Tianjin 300071 China
| | - Yanbin Cai
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
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Zhong Y, Zhan J, Xu G, Chen Y, Qin Q, Liao X, Ma S, Yang Z, Cai Y. Enzyme‐Instructed Self‐Assembly Enabled Monomer–Excimer Transition to Construct Higher Ordered Luminescent Supramolecular Assembly for Activity‐based Bioimaging. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202014278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Yuanzhi Zhong
- Guangdong Provincial Key Laboratory of New Drug Screening School of Pharmaceutical Sciences Southern Medical University Guangzhou 510515 China
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Jie Zhan
- Shunde Hospital (The First People's Hospital of Shunde, Foshan) Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering Southern Medical University Guangzhou 510515 China
| | - Guanghui Xu
- Guangdong Provincial Key Laboratory of New Drug Screening School of Pharmaceutical Sciences Southern Medical University Guangzhou 510515 China
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Yumiao Chen
- Key Laboratory of Bioactive Materials Ministry of Education State Key Laboratory of Medicinal Chemical Biology College of Life Sciences Nankai University Tianjin 300071 China
| | - Qin Qin
- Guangdong Provincial Key Laboratory of New Drug Screening School of Pharmaceutical Sciences Southern Medical University Guangzhou 510515 China
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Xu Liao
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Shaodan Ma
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
| | - Zhimou Yang
- Guangdong Provincial Key Laboratory of New Drug Screening School of Pharmaceutical Sciences Southern Medical University Guangzhou 510515 China
- Key Laboratory of Bioactive Materials Ministry of Education State Key Laboratory of Medicinal Chemical Biology College of Life Sciences Nankai University Tianjin 300071 China
| | - Yanbin Cai
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Diseases Department of Cardiology and Laboratory of Heart Center Zhujiang Hospital Southern Medical University Guangzhou 510280 China
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Efficace F, Collins GS, Cottone F, Giesinger JM, Sommer K, Anota A, Schlussel MM, Fazi P, Vignetti M. Patient-Reported Outcomes as Independent Prognostic Factors for Survival in Oncology: Systematic Review and Meta-Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:250-267. [PMID: 33518032 DOI: 10.1016/j.jval.2020.10.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/05/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Assessment of patient-reported outcomes (PROs) in oncology is of critical importance because it provides unique information that may also predict clinical outcomes. METHODS We conducted a systematic review of prognostic factor studies to examine the prognostic value of PROs for survival in cancer. A systematic literature search was performed in PubMed for studies published between 2013 and 2018. We considered any study, regardless of the research design, that included at least 1 PRO domain in the final multivariable prognostic model. The protocol (EPIPHANY) was published and registered in the International Prospective Register of Systematic Reviews (CRD42018099160). RESULTS Eligibility criteria selected 138 studies including 158 127 patients, of which 43 studies were randomized, controlled trials. Overall, 120 (87%) studies reported at least 1 PRO to be statistically significantly prognostic for overall survival. Lung (n = 41, 29.7%) and genitourinary (n = 27, 19.6%) cancers were most commonly investigated. The prognostic value of PROs was investigated in secondary data analyses in 101 (73.2%) studies. The EORTC QLQ-C30 questionnaire was the most frequently used measure, and its physical functioning scale (range 0-100) the most frequent independent prognostic PRO, with a pooled hazard ratio estimate of 0.88 per 10-point increase (95% CI 0.84-0.92). CONCLUSIONS There is convincing evidence that PROs provide independent prognostic information for overall survival across cancer populations and disease stages. Further research is needed to translate current evidence-based data into prognostic tools to aid in clinical decision making.
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Affiliation(s)
- Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center and Health Outcomes Research Unit, Rome, Italy.
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Francesco Cottone
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Kathrin Sommer
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Amelie Anota
- French National Platform Quality of Life and Cancer, Besançon, France; Methodology and Quality of Life in Oncology Unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
| | - Michael Maia Schlussel
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Paola Fazi
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Marco Vignetti
- Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center and Health Outcomes Research Unit, Rome, Italy
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Efecto de la densidad muscular en pacientes con cáncer de próstata metastásico tratados con terapia de privación androgénica. ENDOCRINOL DIAB NUTR 2021; 68:92-98. [DOI: 10.1016/j.endinu.2020.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/23/2020] [Accepted: 03/16/2020] [Indexed: 10/23/2022]
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Wibmer AG, Morris MJ, Gonen M, Zheng J, Hricak H, Larson S, Scher HI, Vargas HA. Quantification of Metastatic Prostate Cancer Whole-Body Tumor Burden with 18F-FDG PET Parameters and Associations with Overall Survival After First-Line Abiraterone or Enzalutamide: A Single-Center Retrospective Cohort Study. J Nucl Med 2021; 62:1050-1056. [PMID: 33419944 DOI: 10.2967/jnumed.120.256602] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/14/2020] [Indexed: 12/16/2022] Open
Abstract
New biomarkers for metastatic prostate cancer are needed. The aim of this study was to evaluate the prognostic value of 18F-FDG PET whole-body tumor burden parameters in patients with metastatic prostate cancer who received first-line abiraterone or enzalutamide therapy. Methods: This was a retrospective study of patients with metastatic castration-sensitive prostate cancer (mCSPC, n = 25) and metastatic castration-resistant prostate cancer (mCRPC, n = 71) who underwent 18F-FDG PET/CT within 90 d before first-line treatment with abiraterone or enzalutamide at a tertiary-care academic cancer center. Whole-body tumor burden on PET/CT was quantified as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) and correlated with overall survival (OS) probabilities using Kaplan-Meier curves and Cox models. Results: The median follow-up in survivors was 56.3 mo (interquartile range, 37.7-66.8 mo); the median OSs for patients with mCRPC and mCSPC were 27.8 and 76.1 mo, respectively (P < 0.001). On univariate analysis, the OS probability of mCRPC patients was significantly associated with plasma levels of alkaline phosphatase (hazard ratio [HR], 1.90; P < 0.001), plasma levels of lactate dehydrogenase (HR, 1.01; P < 0.001), hemoglobin levels (HR, 0.80; P = 0.013), whole-body SUVmax (HR, 1.14; P < 0.001), the number of 18F-FDG-avid metastases (HR, 1.08; P < 0.001), whole-body metabolic tumor volume (HR, 1.86; P < 0.001), and TLG (HR, 1.84; P < 0.001). On multivariable analysis with stepwise variable selection, hemoglobin levels (HR, 0.81; P = 0.013) and whole-body TLG (HR, 1.88; P < 0.001) were independently associated with OS. In mCSPC patients, no significant association was observed between these variables and OS. Conclusion: In patients with mCRPC receiving first-line treatment with abiraterone or enzalutamide, 18F-FDG PET WB TLG is independently associated with OS and might be used as a quantitative prognostic imaging biomarker.
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Affiliation(s)
- Andreas G Wibmer
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York;
| | - Michael J Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Mithat Gonen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Junting Zheng
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hedvig Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Steven Larson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Howard I Scher
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; and
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Abstract
PURPOSE OF REVIEW The standard treatment in metastatic prostate cancer (mPCa) is systemic, based on androgen deprivation therapy recommended in different forms, alone or combined with abiraterone acetate or docetaxel. The aim of this review is to synthesize the available data from literature regarding the optimal treatment of the primary in patients diagnosed with metastatic prostate cancer. RECENT FINDINGS Multimodal treatments offer the best chance for survival for these patients, but the optimal strategy lacks consensus. Using retrospective studies as an argument, recent articles sustain the clinical and oncological benefits of local therapies in hormone-naïve metastatic prostate cancer, represented by radical prostatectomy or radiotherapy. Through these procedures, local control of disease can be achieved, thus avoiding potential complications and further surgical interventions. Even if the current results are not evenly relevant, the treatment of the primary along with metastasis-directed therapy could improve survival and even cure-selected patients. SUMMARY This article emphasizes important aspects regarding a feasible management of mPCa, with possible impact on subsequent guidelines. The expected results from ongoing trials may provide another perspective in treatment of these cases.
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Caffo O, Maines F, Kinspergher S, Veccia A, Messina C. To treat or not to treat: is it acceptable to avoid active therapies in advanced prostate cancer today? Expert Rev Anticancer Ther 2020; 21:389-400. [PMID: 33245666 DOI: 10.1080/14737140.2021.1856661] [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: 10/22/2022]
Abstract
Introduction: Recently, there has been a paradigm shift in the treatment of advanced prostate cancer (PCa) because the approval of a number of new agents has significantly improved overall survival. However, as PCa is a heterogeneous disease that may be more or less aggressive and patients may be more or less responsive to treatment, it is often debated whether or not it is acceptable to avoid active therapies.Areas covered: This review discusses different settings of advanced PCa.Expert opinion: In metastatic castration-resistant PCa, it is unethical not to use active treatments but the use of both androgen receptor targeting agents (ARTA) in sequence should be avoided in most patients and the use of the available agents for fourth-line treatment or beyond should only be considered for highly selected patients. In metastatic hormone-sensitive PCa, patients with de novo disease should receive one additional agent in combination with androgen deprivation therapy (ADT), whereas patients in relapse should be managed with ADT alone. In non-metastatic castration-resistant prostate cancer (PCa), all patients with a PSA doubling time of ≤6 months should receive one ARTA, whereas the others might wait until there is an acceleration in the kinetics of their PSA levels.
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Affiliation(s)
- Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d'Oro, Trento, Italy
| | - Francesca Maines
- Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d'Oro, Trento, Italy
| | - Stefania Kinspergher
- Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d'Oro, Trento, Italy
| | - Antonello Veccia
- Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d'Oro, Trento, Italy
| | - Carlo Messina
- Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d'Oro, Trento, Italy
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Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Grummet J, Henry AM, der Kwast THV, Lam TB, Lardas M, Liew M, Mason MD, Moris L, Oprea-Lager DE, der Poel HGV, Rouvière O, Schoots IG, Tilki D, Wiegel T, Willemse PPM, Mottet N. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. Part II-2020 Update: Treatment of Relapsing and Metastatic Prostate Cancer. Eur Urol 2020; 79:263-282. [PMID: 33039206 DOI: 10.1016/j.eururo.2020.09.046] [Citation(s) in RCA: 588] [Impact Index Per Article: 147.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 09/24/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To present a summary of the 2020 version of the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy & Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Geriatric Oncology (SIOG) guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (CRPC). EVIDENCE ACQUISITION The working panel performed a literature review of the new data (2016-2019). The guidelines were updated, and the levels of evidence and/or grades of recommendation were added based on a systematic review of the literature. EVIDENCE SYNTHESIS Prostate-specific membrane antigen positron emission tomography computed tomography scanning has developed an increasingly important role in men with biochemical recurrence after local therapy. Early salvage radiotherapy after radical prostatectomy appears as effective as adjuvant radiotherapy and, in a subset of patients, should be combined with androgen deprivation. New treatments have become available for men with metastatic hormone-sensitive prostate cancer (PCa), nonmetastatic CRPC, and metastatic CRPC, along with a role for local radiotherapy in men with low-volume metastatic hormone-sensitive PCa. Also included is information on quality of life outcomes in men with PCa. CONCLUSIONS The knowledge in the field of advanced and metastatic PCa and CRPC is changing rapidly. The 2020 EAU-EANM-ESTRO-ESUR-SIOG guidelines on PCa summarise the most recent findings and advice for use in clinical practice. These PCa guidelines are first endorsed by the EANM and reflect the multidisciplinary nature of PCa management. A full version is available from the EAU office or online (http://uroweb.org/guideline/prostate-cancer/). PATIENT SUMMARY This article summarises the guidelines for the treatment of relapsing, metastatic, and castration-resistant prostate cancer. These guidelines are evidence based and guide the clinician in the discussion with the patient on the treatment decisions to be taken. These guidelines are updated every year; this summary spans the 2017-2020 period of new evidence.
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Affiliation(s)
- Philip Cornford
- Department of Urology, Liverpool University Hospitals NHS Trust, Liverpool, UK.
| | | | | | | | | | - Maria De Santis
- Department of Urology, Charité Universitätsmedizin, Berlin, Germany; Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Stefano Fanti
- Department of Nuclear Medicine, Policlinico S. Orsola, University of Bologna, Italy
| | - Nicola Fossati
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giorgio Gandaglia
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland; University of Bern, Bern, Switzerland; Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Nikolaos Grivas
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeremy Grummet
- Department of Surgery, Central Clinical School, Monash University, Caulfield North, Victoria, Australia
| | - Ann M Henry
- Leeds Cancer Centre, St. James's University Hospital and University of Leeds, Leeds, UK
| | | | - Thomas B Lam
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Michael Lardas
- Department of Urology, Metropolitan General Hospital, Athens, Greece
| | - Matthew Liew
- Department of Urology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - Malcolm D Mason
- Division of Cancer & Genetics, School of Medicine Cardiff University, Velindre Cancer Centre, Cardiff, UK
| | - Lisa Moris
- Department of Urology, University Hospitals Leuven, Leuven, Belgium; Laboratory of Molecular Endocrinology, KU Leuven, Leuven, Belgium
| | - Daniela E Oprea-Lager
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Henk G van der Poel
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Olivier Rouvière
- Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France; Faculté de Médecine Lyon Est, Université de Lyon, Université Lyon 1, Lyon, France
| | - Ivo G Schoots
- Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Wiegel
- Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
| | - Peter-Paul M Willemse
- Department of Urology, Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nicolas Mottet
- Department of Urology, University Hospital, St. Etienne, France
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Tian S, Lei Z, Gong Z, Sun Z, Xu D, Piao M. Clinical implication of prognostic and predictive biomarkers for castration-resistant prostate cancer: a systematic review. Cancer Cell Int 2020; 20:409. [PMID: 32863768 PMCID: PMC7448351 DOI: 10.1186/s12935-020-01508-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
Background Diagnosis of metastatic castrate resistant prostate cancer (mCRPC) with current biomarkers is difficult and often results in unnecessary invasive procedures as well as over-diagnosis and over-treatment. There are a number of prognostic biomarkers for CRPC, but there are no validated predictive biomarkers to guide in clinical decision-making. Specific biomarkers are needed that enable to understand the natural history and complex biology of this heterogeneous malignancy, identify early response to treatment outcomes and to identify the population of men most likely to benefit from the treatment. In this systematic review, we discuss the existing literature for the role of biomarkers in CRPC and how they aid in the prognosis, treatment selection and survival outcomes. Methods We performed a literature search on PubMed and EMBASE databases from January 2015 through February 2020 in accordance to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Articles were assessed to identify relevant observational studies and randomized controlled trials regarding biomarkers which aid in identifying progression to mCRPC as well as predictive biomarkers which help in treatment selection. Results We identified 3640 number of hits of which 58 articles were found to be relevant. Here we addressed biomarkers in the context of prognosis, prediction and patient selection of therapy. These biomarkers were found to be effective as prognostic or predictive factors under variety of conditions. The higher levels for all these biomarkers were associated with shorter median OS and sometimes PFS. Lower amounts of biomarkers in serum or urine were associated with prolonged survival outcomes, longer time to CRPC development or CRPC progression and longer median follow-up irrespective of any therapy. Conclusion We observed that the biomarkers included in our study predicted clinically relevant survival outcomes and treatment exposure. Though the current biomarkers are prognostic when measured prior to initiating treatment, not all are validated as predictive markers in post treatment setting. A greater understanding of biomarkers in CRPC is need of the hour for development of more personalized approach to maximize benefit and minimize harm in men with CRPC.
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Affiliation(s)
- Shengri Tian
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Zhen Lei
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Zuo Gong
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Zhonghai Sun
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Dongyuan Xu
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Minhu Piao
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
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Rii J, Sakamoto S, Yamada Y, Takeshita N, Yamamoto S, Sazuka T, Imamura Y, Nakamura K, Komiya A, Komaru A, Fukasawa S, Nakatsu H, Akakura K, Ichikawa T. Prognostic factors influencing overall survival in de novo oligometastatic prostate cancer patients. Prostate 2020; 80:850-858. [PMID: 32501559 DOI: 10.1002/pros.24016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/17/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Oligometastatic cancer has been suggested as an intermediate state between localized disease and wide-ranging metastases. The clinical significance of local treatment in oligometastatic prostate cancer (PCa) has been a recent topic of interest. However, standard definitions of oligometastasis are lacking. Here we studied risk factors among Japanese de novo oligometastatic patients with PCa. METHODS We retrospectively assessed clinical data from 264 patients, including locally advanced (T3 or T4N0M0) cancer, lymph-node-positive cancer (Tany N1M0), and cancer with ≤10 bone metastases. All patients received androgen deprivation therapy only. The number of bone metastases and clinical factors were evaluated in association with overall survival (OS) and progression-free survival (PFS). The Mann-Whitney U test, Cox proportional hazard models, and Kaplan-Meier methods were used as statistical analyses. RESULTS Median age, PSA at baseline and OS were 74 years, 55.2 ng/mL, and 129.0 months, respectively. The cutoff for the number of bone metastases having the greatest impact on OS was ≥3 (hazard ratio [HR]: 2.67; P = .0001). In multivariate analysis, non-regional lymph node (LN) metastases (HR: 2.15; P = .0222), ISUP grade group (GG) 5 (HR: 2.04; P = .0186) and ≥3 bone metastases (HR: 1.82; P = .0390) were independent predictors of OS. In risk classification based on these factors, OS and PFS were significantly classifiable into poor (2-3 factors), intermediate (1 factor), and good (no factors) risk groups (P < .0001). CONCLUSION Not only the number of bone metastases, but also non-regional LN metastases predict OS in patients with de novo oligometastatic PCa.
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Affiliation(s)
- Junryo Rii
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasutaka Yamada
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Satoshi Yamamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomokazu Sazuka
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Imamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kazuyoshi Nakamura
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akira Komiya
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Atsushi Komaru
- Prostate Center and Division of Urology, Chiba Cancer Center, Chiba, Japan
| | - Satoshi Fukasawa
- Prostate Center and Division of Urology, Chiba Cancer Center, Chiba, Japan
| | | | - Koichiro Akakura
- Department of Urology, Japan Community Health Care Organization, Tokyo, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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Iacovelli R, Ciccarese C, Caffo O, De Giorgi U, Tucci M, Mosillo C, Bimbatti D, Pierantoni F, Maines F, Casadei C, Buttigliero C, Milella M, Tortora G. The prognostic value of pain in castration-sensitive prostate cancer. Prostate Cancer Prostatic Dis 2020; 23:654-660. [PMID: 32651468 DOI: 10.1038/s41391-020-0255-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/07/2020] [Accepted: 07/02/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cancer-related pain, usually associated with bone metastases, is a frequent and debilitating morbidity in patients with prostate cancer. To date there are only limited data regarding the prognostic role of pain in men with metastatic castration-sensitive prostate cancer (mCSPC). The objective of our analysis was to assess if the presence of pain can be considered an independent prognostic factor in mCSPC patients. METHODS A retrospective analysis was performed on patients with mCSPC referring to six oncology centers in Italy. Clinical and pathological features were recorded. Patients were considered to have pain if this was reported within the patient's file or in case of a chronic analgesic therapy was found among the concomitant medications. Survivals were estimated by the Kaplan-Meier method, and compared across groups using the log-rank test. Cox proportional hazard models, stratified according to the baseline characteristics, were used to estimate hazard ratios for overall survival (OS). All the variables were significant if p < 0.05. RESULTS Data about pain were available for 365 cases and pain was present in 34.8% of patients. Pain was mainly associated with high value of prostate-specific antigen, metastatic bone extension regardless of the site, and lymph node involvement. mCSPC patients with pain had in most of the cases high-volume or Hr disease, and significant shorter OS (27.0 vs. 58.2 months, p < 0.001) and PFS (10.1 vs. 17.4 months, p < 0.001) compared to those without pain. The negative impact of pain on OS remained significant even if adjusted for CHAARTED or LATITUDE classification, and other significant baseline prognostic factors. CONCLUSIONS This analysis supports the poor prognostic role of cancer-related pain in the setting of mCSPC patients. A prospective validation is required.
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Affiliation(s)
- Roberto Iacovelli
- Medical Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Chiara Ciccarese
- Medical Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, 38112, Trento, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, Scientific Institute Romagnolo for the Study and Treatment of Cancer (IRST) IRCCS, Meldola, Italy
| | | | - Claudia Mosillo
- Medical Oncology Unit, Azienda Ospedaliera Santa Maria di Terni, Terni, Italy
| | - Davide Bimbatti
- Medical Oncology Unit 1, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | | | - Francesca Maines
- Department of Medical Oncology, Santa Chiara Hospital, 38112, Trento, Italy
| | - Chiara Casadei
- Department of Medical Oncology, Scientific Institute Romagnolo for the Study and Treatment of Cancer (IRST) IRCCS, Meldola, Italy
| | - Consuelo Buttigliero
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - Michele Milella
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Giampaolo Tortora
- Medical Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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39
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Aragon-Ching JB, Dreicer R. Treatment in hormone-sensitive metastatic prostate cancer: factors to consider when personalizing therapy. Expert Rev Anticancer Ther 2020; 20:483-490. [PMID: 32406281 DOI: 10.1080/14737140.2020.1770087] [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: 10/24/2022]
Abstract
INTRODUCTION The addition of the androgen-signaling inhibitors (ASI) apalutamide, enzalutamide and abiraterone acetate or docetaxel to standard androgen deprivation therapy (ADT) has been demonstrated to improve overall survival in men with hormone-sensitive metastatic prostate cancer (HSMPC). AREAS COVERED The majority of men presenting with metastatic prostate cancer will now benefit from the addition of either a novel ASI or docetaxel to standard ADT. In the absence of comparative studies of these agents, clinicians are left with assessing the individual studies and attempting to individualize therapy. EXPERT OPINION ADT with either docetaxel or androgen-signaling inhibitors (ASI) have changed the treatment landscape of HSMPC with clinically meaningful improvement in overall survival compared to ADT alone. Among the factors to consider in the selection of the optimal agent include the volume of disease, performance status and comorbidities, toxicity profile cost and drug availability, and further resistance or sequencing options.
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Affiliation(s)
| | - Robert Dreicer
- Medical Oncology, University of Virginia Cancer Center , Charlottesville, VA, USA
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40
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Li F, Xiang H, Pang Z, Chen Z, Dai J, Chen S, Xu B, Zhang T. Association between lactate dehydrogenase levels and oncologic outcomes in metastatic prostate cancer: A meta-analysis. Cancer Med 2020; 9:7341-7351. [PMID: 32452656 PMCID: PMC7541156 DOI: 10.1002/cam4.3108] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose Previous studies have provided evidence of the high expression of lactate dehydrogenase (LDH) in multiple solid tumors; however, its prognostic relationship with metastatic prostate cancer (mPCa) remains controversial. We performed a meta‐analysis to better understand the prognostic potential of LDH in mPCa. Methods In our investigation, we included PubMed, Embase, Web of Science, and Cochrane Library as web‐based resources, as well as studies published before January 2020 on the predictive value of LDH in mPCa. We independently screened the studies according to the inclusion and exclusion criteria, evaluated the quality of the literature, extracted the data, and used RevMan 5.3 and STATA12.0 software for analysis. Result From the 38 published studies, the records of 9813 patients with mPCa were included in this meta‐analysis. We observed that higher levels of LDH in patients with mPCa were significantly associated with poorer overall survival (OS) (HR = 2.17, 95% CI: 1.91‐2.47, P < .00001) and progression‐free survival (PFS) (HR = 1.60, 95% CI: 1.20‐2.13, P = .001). The subgroup analyses indicated that the negative prognostic impact of higher levels of LDH on the oncologic outcomes of mPCa was significant regardless of ethnicity, publication year, sample size, analysis type, treatment type, age, and disease state. Conclusion Our analysis suggested the association between a higher level of LDH and poorer OS and PFS in patients with mPCa. As a parameter that can be conveniently evaluated, the LDH levels should be included as a valuable biomarker in the management of mPCa.
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Affiliation(s)
- Fan Li
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Hui Xiang
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Zisen Pang
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Zejia Chen
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Jinlong Dai
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Shu Chen
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Bin Xu
- Department of Urology, Affiliated Hospital of Guilin Medical University, The Second Affiliated Hospital Of Guilin Medical University, Guilin, China
| | - Tianyu Zhang
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
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41
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Abou DS, Rittenbach A, Tomlinson RE, Finley PA, Tsui B, Simons BW, Jha AK, Ulmert D, Riddle RC, Thorek DLJ. Preclinical Single Photon Emission Computed Tomography of Alpha Particle-Emitting Radium-223. Cancer Biother Radiopharm 2020; 35:520-529. [PMID: 32182119 DOI: 10.1089/cbr.2019.3308] [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] [Indexed: 12/12/2022] Open
Abstract
Objective: Dose optimization and pharmacokinetic evaluation of α-particle emitting radium-223 dichloride (223RaCl2) by planar γ-camera or single photon emission computed tomography (SPECT) imaging are hampered by the low photon abundance and injected activities. In this study, we demonstrate SPECT of 223Ra using phantoms and small animal in vivo models. Methods: Line phantoms and mice bearing 223Ra were imaged using a dedicated small animal SPECT by detecting the low-energy photon emissions from 223Ra. Localization of the therapeutic agent was verified by whole-body and whole-limb autoradiography and its radiobiological effect confirmed by immunofluorescence. Results: A state-of-the-art commercial small animal SPECT system equipped with a highly sensitive collimator enables collection of sufficient counts for three-dimensional reconstruction at reasonable administered activities and acquisition times. Line sources of 223Ra in both air and in a water scattering phantom gave a line spread function with a full-width-at-half-maximum of 1.45 mm. Early and late-phase imaging of the pharmacokinetics of the radiopharmaceutical were captured. Uptake at sites of active bone remodeling was correlated with DNA damage from the α particle emissions. Conclusions: This work demonstrates the capability to noninvasively define the distribution of 223RaCl2, a recently approved α-particle-emitting radionuclide. This approach allows quantitative assessment of 223Ra distribution and may assist radiation-dose optimization strategies to improve therapeutic response and ultimately to enable personalized treatment planning.
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Affiliation(s)
- Diane S Abou
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.,Program in Quantitative Molecular Therapeutics, Washington University School of Medicine, St. Louis, Missouri, USA.,Radiology Cyclotron Facility, Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri, USA.,Oncologic Imaging Program, Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Andrew Rittenbach
- Information Sciences Institute, University of Southern California, Los Angeles, California, USA
| | - Ryan E Tomlinson
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Paige A Finley
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Benjamin Tsui
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Brian W Simons
- Center for Comparative Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Abhinav K Jha
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Biomedical Engineering, Washington University, St. Louis, Missouri, USA
| | - David Ulmert
- Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, California, USA.,Division of Urological Research, Department of Clinical Sciences, Lünd University, Malmö, Sweden
| | - Ryan C Riddle
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel L J Thorek
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.,Program in Quantitative Molecular Therapeutics, Washington University School of Medicine, St. Louis, Missouri, USA.,Oncologic Imaging Program, Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Biomedical Engineering, Washington University, St. Louis, Missouri, USA
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42
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Survival and prognostic determinants of prostate cancer patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A retrospective cohort study. PLoS One 2020; 15:e0229854. [PMID: 32134996 PMCID: PMC7058322 DOI: 10.1371/journal.pone.0229854] [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: 11/21/2018] [Accepted: 02/16/2020] [Indexed: 12/18/2022] Open
Abstract
Background Globally, the incidence of prostate cancer is increasing, particularly in low- and middle-income countries. It is the most common cancer among men worldwide, with higher mortality in low and middle-income countries. In Ethiopia, it is the second most common cause of cancer morbidity and mortality among men. Despite a few studies done regarding the disease burden, the evidence is scarce about the survival and prognostic determinants of prostate cancer patients in Ethiopia. Thus, this study assessed the survival and prognostic determinants of patients with prostate cancer. Methods We retrospectively followed patients who were newly diagnosed from 2012 to 2016 at the Oncology Department of Tikur Anbessa Specialized Hospital. We extracted the data from patient charts that were available in the cancer registry using a checklist with the help of oncology nurses. Kaplan-Meier survival analyses with the log-rank test were used to estimate and compare the probability of survival among covariate categories. After checking for assumptions, a multivariable Cox regression analysis was performed to identify prognostic determinants of survival. Results The median survival time was 28 months with an overall 2-, 3- and 5-year survival of 57%, 38.9% and 22%, respectively. The overall survival differs according to the clinical stage (P-value<0.01), presence or absence of distant metastasis (P<0.01) and androgen deprivation therapy (ADT) (P<0.05). Cancer stage at diagnosis (adjusted hazard ratio (AHR) = 0.309, 95%CI = 0.151–0.633) and ADT (AHR = 3.884, 95%CI = 1.677–8.997) remained significant in the final Cox proportional hazards model. Conclusions The overall 2-, 3- and 5-year survival of prostate cancer patients in Ethiopia is very low. The cancer stage at diagnosis and treatment modalities are significant prognostic determinants of survival. Therefore, early detection through screening and timely initiation of treatment are essential to improve the survival of prostate cancer patients.
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43
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Narita S, Hatakeyama S, Takahashi M, Sakurai T, Kawamura S, Hoshi S, Ishida M, Kawaguchi T, Ishidoya S, Shimoda J, Sato H, Koizumi A, Mitsuzuka K, Tochigi T, Tsuchiya N, Ohyama C, Arai Y, Nomura K, Habuchi T. Clinical outcomes and prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy: a retrospective multicenter study in Japan. Int J Clin Oncol 2020; 25:912-920. [PMID: 31919691 DOI: 10.1007/s10147-019-01614-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/27/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE Clinical outcomes of patients with newly diagnosed metastatic hormone-naïve prostate cancer (mHNPC) and initially treated with androgen deprivation therapy (ADT) were evaluated. METHODS The medical records of 605 consecutive mHNPC patients with initial ADT or combined androgen blockade (CAB) at nine study centers between 2008 and 2016 were retrospectively reviewed. Castration-resistant prostate cancer (CRPC)-free and overall survival (OS) were estimated by the Kaplan-Meier method. The association of pretreatment risk factors with CRPC-free survival and OS was evaluated by Cox proportional hazard models and differences in survival were classified by the number of risk factors. RESULTS Median follow-up was 2.95 years, median CRPC-free survival was 21.9 months and median OS was 5.37 years. Multivariable analysis found that four risk factors, a Gleason score ≥ 9, lymph node metastasis, an extent of disease score ≥ 2, and serum LDH of > 220 IU were independently associated with both CRPC-free survival and OS. Median CRPC-free survival of low-risk patients with no or one factor was 86.5 months, 17.9 months in intermediate-risk patients with two or three factors, and 11.0 months in high-risk patients with four factors. Median OS was 4.72 years in intermediate- and 2.44 years in high-risk patients. It was not reached in low-risk patients. CONCLUSION In this series, CRPC-free and OS of a subset of mHNPC patients in Japan who were treated with ADT or CAB had better CRPC-free and overall survivals in Japan. Risk-adapted treatment based on the presence of novel prognostic factors may be beneficial for selected mHNPC patients.
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Affiliation(s)
- Shintaro Narita
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. .,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan.
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Masahiro Takahashi
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Toshihiko Sakurai
- Department of Urology, Yamagata University School of Medicine, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Sadafumi Kawamura
- Department of Urology, Miyagi Cancer Center, Natori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Senji Hoshi
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Masanori Ishida
- Department of Urology, Iwate Prefectural Isawa Hospital, Oshu, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Toshiaki Kawaguchi
- Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Shigeto Ishidoya
- Department of Urology, Sendai City Hospital, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Jiro Shimoda
- Department of Urology, Iwate Prefectural Isawa Hospital, Oshu, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Hiromi Sato
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Atsushi Koizumi
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Tatsuo Tochigi
- Department of Urology, Miyagi Cancer Center, Natori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Yamagata University School of Medicine, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Yoichi Arai
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
| | - Kyoko Nomura
- Department of Public Health, Akita University School of Medicine, Akita, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan
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Scintigraphic load of bone disease evaluated by DASciS software as a survival predictor in metastatic castration-resistant prostate cancer patients candidates to 223RaCl treatment. Radiol Oncol 2019; 54:40-47. [PMID: 31855572 PMCID: PMC7087429 DOI: 10.2478/raon-2019-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/22/2019] [Indexed: 11/28/2022] Open
Abstract
Background Aim of our study was to assess the load of bone disease at starting and during Ra-223 treatment as an overall survival (OS) predictor in metastatic castration-resistant prostate cancer (mCRPC) patients. Bone scan index (BSI) is defined as the percentage of total amount of bone metastasis on whole-body scintigraphic images. We present a specific software (DASciS) developed by an engineering team of “Sapienza” University of Rome for BSI calculation. Patients and methods 127 mCRPC patients bone scan images were processed with DASciS software, and BSI was tested as OS predictor. Results 546 bone scans were analyzed revealing that the extension of disease is a predictor of OS (0–3% = 28 months of median survival (MoMS]; 3%–5% = 11 MoMS, > 5% = 5 MoMS). BSI has been analyzed as a single parameter for OS, determining an 88% AUC. Moreover, the composition between the BSI and the 3-PS (3-variable prognostic score) determines a remarkable improvement of the AUC (91%), defining these two parameters as the best OS predictors. Conclusions This study suggests that OS is inversely correlated with the load of bone disease in mCRPC Ra-223-treated subjects. DASciS software appears a promising tool in identifying mCRPC patients that more likely take advantage from Ra-223 treatment. BSI is proposed as a predictive variable for OS and included to a multidimensional clinical evaluation permits to approach the patients’ enrollment in a rational way, allowing to enhance the treatment effectiveness together with cost optimization.
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Mori K, Janisch F, Mostafaei H, Lysenko I, Karakiewicz PI, Enikeev DV, Briganti A, Kimura S, Egawa S, Shariat SF. Prognostic Value of Hemoglobin in Metastatic Hormone-sensitive Prostate Cancer: A Systematic Review and Meta-analysis. Clin Genitourin Cancer 2019; 18:e402-e409. [PMID: 32007439 DOI: 10.1016/j.clgc.2019.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/07/2019] [Accepted: 12/09/2019] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to assess the prognostic value of hemoglobin (Hb) in patients with metastatic hormone-sensitive prostate cancer (HSPC). The PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in December 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared patients with HSPC with normal and low Hb levels to determine their ability to predict overall survival, cancer-specific survival, progression-free survival, and castration-resistant prostate cancer-free survival. Formal meta-analyses were performed for these outcomes. The systematic review identified 25 studies including 6614 patients; 21 studies comprising 5782 patients were eligible for meta-analysis. Low Hb levels were associated with worse overall survival (pooled hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.15-1.29), cancer-specific survival (pooled HR, 1.46; 95% CI, 1.24-1.72), progression-free survival (pooled HR, 1.21; 95% CI, 1.14-1.28), and castration-resistant prostate cancer-free survival (pooled HR, 1.37; 95% CI: 1.18-1.57). Subgroup analyses revealed that low Hb levels were also associated with poor overall survival in patients with both "high-volume" (pooled HR, 1.49; 95% CI, 1.29-1.72) and "low-volume" HSPC (pooled HR, 1.40; 95% CI, 1.13-1.73). This meta-analysis revealed that low Hb serum levels in patients with metastatic HSPC were associated with increased risks of overall mortality, cancer-specific mortality, disease progression, and biochemical recurrence. Furthermore, Hb levels were independently associated with overall survival in the "high-volume" and "low-volume" HSPC subgroups. Therefore, it might be useful to incorporate Hb testing into prognostic tools for metastatic HSPC.
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Affiliation(s)
- Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Florian Janisch
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Hamburg, Hamburg, Germany
| | - Hadi Mostafaei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Research Center for Evidence-based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ivan Lysenko
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Pierre I Karakiewicz
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada
| | - Dmitry V Enikeev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alberto Briganti
- Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Shoji Kimura
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology, Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
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So AI, Chi KN, Danielson B, Fleshner NE, Kapoor A, Niazi T, Pouliot F, Rendon RA, Shayegan B, Sridhar S, Vigneault E, Saad F. Canadian Urological Association-Canadian Urologic Oncology Group guideline on metastatic castration-naive and castration-sensitive prostate cancer. Can Urol Assoc J 2019; 14:17-23. [PMID: 31999544 DOI: 10.5489/cuaj.6384] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Alan I So
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Kim N Chi
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Brita Danielson
- Department of Oncology, Division of Radiation Oncology, University of Alberta, Edmonton, AB, Canada
| | - Neil E Fleshner
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Anil Kapoor
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Tamim Niazi
- Department of Oncology, Division of Radiation Oncology, McGill University, Montreal QC, Canada
| | - Frederic Pouliot
- Division of Urology, Department of Surgery, Université Laval, Quebec City, QC, Canada
| | - Ricardo A Rendon
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Bobby Shayegan
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Srikala Sridhar
- Division of Hematology and Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Eric Vigneault
- Department of Radiation Oncology, CHUQ, Université Laval, Quebec City, QC, Canada
| | - Fred Saad
- Department of Surgery, Université de Montréal, Montreal, QC, Canada
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47
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Prognostic value of alkaline phosphatase in hormone-sensitive prostate cancer: a systematic review and meta-analysis. Int J Clin Oncol 2019; 25:247-257. [PMID: 31768692 PMCID: PMC6989419 DOI: 10.1007/s10147-019-01578-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/07/2019] [Indexed: 12/11/2022]
Abstract
Purpose To assess the prognostic value of alkaline phosphatase in patients with hormone-sensitive prostate cancer. Methods A systematic review and meta-analysis was performed using the PUBMED, Web of Science, Cochrane Library, and Scopus in April 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared hormone-sensitive prostate cancer patients with high vs. low alkaline phosphatase to determine its predictive value for overall survival, cancer-specific survival, and progression-free survival. We performed a formal meta-analysis of these outcomes. Results 42 articles with 7938 patients were included in the systematic review and 28 studies with 5849 patients for the qualitative assessment. High alkaline phosphatase was associated with worse overall survival (pooled HR 1.72; 95% CI 1.37−2.14) and progression-free survival (pooled HR 1.30; 95% CI 1.10−1.54). In subgroup analyses of patients with “high-volume” and “low-volume”, alkaline phosphatase was associated with the overall survival (pooled HR 1.41; 95% CI 1.21−1.64 and pooled HR 1.64; 95% CI, 1.06−2.52, respectively). Conclusions In this meta-analysis, elevated serum levels of alkaline phosphatase were associated with an increased risk of overall mortality and disease progression in patients with hormone-sensitive prostate cancer. In contrast, those were not associated with an increased risk of cancer-specific mortality. Alkaline phosphatase was independently associated with overall survival in both patients with “high-volume” and “low-volume” hormone-sensitive prostate cancer. Alkaline phosphatase may be useful for being integrated into prognostic tools that help guide treatment strategy, thereby facilitating the shared decision making process.
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48
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Prognostic impact of C-reactive protein-albumin ratio for the lethality in castration-resistant prostate cancer. Med Oncol 2019; 37:9. [PMID: 31754918 DOI: 10.1007/s12032-019-1332-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/11/2019] [Indexed: 12/11/2022]
Abstract
This study aimed to assess the clinical value of C-reactive protein-albumin ratio (CAR) at the initiation of first-line treatment for castration-resistant prostate cancer (CRPC). We identified 221 CRPC patients treated with either androgen-signaling inhibitors (ASIs: abiraterone and enzalutamide) or docetaxel as the first-line treatment. The value of CAR was evaluated at the initiation of first-line treatment. The optimal cutoff value of CAR for the prediction of lethality was defined by the receiver operating characteristic curve and the Youden Index. The primary endpoints of the study included overall survival (OS) and cancer-specific survival (CSS). The median age was 74 years. The optimal cutoff value of CAR in newly diagnosed CRPC patients was 0.5 (CAR > 0.5: n = 77 and CAR ≤ 0.5: n = 144). The 3-year OS and CSS rate in patients with CAR > 0.5 were significantly lower than those with CAR ≤ 0.5 (OS: 30.9% vs 55.5%, p < 0.001) (CSS: 42.5% vs 65.4%, p < 0.001). A multivariate analysis consistently demonstrated that CAR was an independent predictor for both OS and CSS. When stratified by the first-line treatments, patients with CAR > 0.5 has significantly shorter CSS than those with CAR ≤ 0.5 in abiraterone (median of 23 vs 49 months, p < 0.001) and enzalutamide (median of 23 vs 41 months, p = 0.0016), whereas no difference was observed in patients treated with docetaxel as the first-line treatment (median of 34 and 37 months, p = 0.7708). Despite the limited cohort size and retrospective design, increased CAR seemed to serve as an independent predictor of OS and CSS for patients newly diagnosed with CRPC.
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49
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Current Treatment Options for Metastatic Hormone-Sensitive Prostate Cancer. Cancers (Basel) 2019; 11:cancers11091355. [PMID: 31547436 PMCID: PMC6770296 DOI: 10.3390/cancers11091355] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/05/2019] [Accepted: 09/10/2019] [Indexed: 02/08/2023] Open
Abstract
The possible treatments options for metastatic hormone-sensitive prostate cancer (mHSPC) have dramatically increased during the last years. The old backbone, which androgen-deprivation therapy (ADT) is the exclusive approach for hormone-naïve patients, has been disrupted. Despite the fact that several high-quality, randomized, controlled phase 3 trials have been conducted in this setting, no direct comparison is currently available among the different strategies. Inadequate power, absence of preplanning and small sample size frequently affect the subgroup analyses according to disease volume or patient's risk. The choice between ADT alone and ADT combined with docetaxel, abiraterone acetate, enzalutamide, apalutamide or radiotherapy to the primary tumor remains challenging. Factors that are related to the tumor, patient or drug side effects, currently guide these clinical decisions. This comprehensive review aims to indirectly compare the phase 3 trials in the mHSPC setting, in order to extrapolate data useful for treatment selection, providing also perspectives on future biomarkers.
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50
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Narita S, Nomura K, Hatakeyama S, Takahashi M, Sakurai T, Kawamura S, Hoshi S, Ishida M, Kawaguchi T, Ishidoya S, Shimoda J, Sato H, Mitsuzuka K, Tochigi T, Tsuchiya N, Ohyama C, Arai Y, Nagashima K, Habuchi T. Changes in conditional net survival and dynamic prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy. Cancer Med 2019; 8:6566-6577. [PMID: 31508900 PMCID: PMC6825980 DOI: 10.1002/cam4.2502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to identify predictive factors associated with conditional net survival in patients with metastatic hormone-naive prostate cancer (mHNPC) initially treated with androgen deprivation therapy (ADT). METHODS At nine hospitals in Tohoku, Japan, the medical records of 605 consecutive patients with mHNPC who initially received ADT were retrospectively reviewed. The Pohar Perme estimator was used to calculate conditional net cancer-specific survival (CSS) and overall survival (OS) for up to 5 years subsequent to the diagnosis. Using multiple imputation, proportional hazard ratios for conditional CSS and OS were calculated with adjusted Cox regression models. RESULTS During a median follow up of 2.95 years, 208 patients died, of which 169 died due to progressive prostate cancer. At baseline, the 5-year CSS and OS rates were 65.5% and 58.2%, respectively. Conditional 5-year net CSS and OS survival gradually increased for all the patients. In patients given a 5-year survivorship, the conditional 5-year net CSS and OS rates improved to 0.906 and 0.811, respectively. Only the extent of disease score (EOD) ≥2 remained a prognostic factor for CSS and OS up to 5 years; as survival time increased, other variables were no longer independent prognostic factors. CONCLUSIONS The conditional 5-year net CSS and OS in patients with mHNPC gradually increased; thus, the risk of mortality decreased with increasing survival. The patient's risk profile changed over time. EOD remained an independent prognostic factor for CSS and OS after 5-year follow-up. Conditional net survival can play a role in clinical decision-making, providing intriguing information for cancer survivors.
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Affiliation(s)
- Shintaro Narita
- Department of Urology, Akita University School of Medicine, Akita, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Kyoko Nomura
- Department of Public Health, Akita University School of Medicine, Akita, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Masahiro Takahashi
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Toshihiko Sakurai
- Department of Urology, Yamagata University School of Medicine, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Sadafumi Kawamura
- Department of Urology, Miyagi Cancer Center, Natori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Senji Hoshi
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Masanori Ishida
- Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Toshiaki Kawaguchi
- Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Shigeto Ishidoya
- Department of Urology, Sendai City Hospital, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Jiro Shimoda
- Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Hiromi Sato
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Tatsuo Tochigi
- Department of Urology, Miyagi Cancer Center, Natori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Yamagata University School of Medicine, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Yoichi Arai
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Kengo Nagashima
- Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Minato-ku, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, Akita, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
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