Management of patients with castration-resistant disease

Healthy Long-Lived Human Beings—Working on Life Stages to Break the Limitation of Human Lifespans

The human lifespan has been increasing but will soon reach a plateau. A new direction based on the principal law of lifespan (PLOSP) may enable the human lifespan to be extremely healthy and long by the proper manipulation of the well-defined growing stages of the lifespan. The lifespan of creatures on earth from a single cell to animals can be elongated at different life stages including prenatal development, body growth, reproductivity, and aging. Each life stage has its own specific physiological and metabolic characteristics. Each life stage can be lengthened by either slowing its processes or continuously maintaining the activities of its function. Unfortunately, the current biomedical research on the extension of lifespans has mainly focused on the aging stage. Recognizing and clearly defining the periods of transition and the boundaries of life stages are essential for achieving the goal of long-lived healthy humans based on the PLOSP. The biomedical measures and pharmacological treatments for the extension of lifespans is life-stage-specific. The PLOSP can be tested with modified studies on longevity with a variety of technologies such as castration and ovariectomy. Sex differences in biological functions and the sequential order of the life stages requires different approaches for females and males.

Association of SLCO2B1 Genotypes With Time to Progression and Overall Survival in Patients Receiving Androgen-Deprivation Therapy for Prostate Cancer

PURPOSE

To validate the association of three previously demonstrated SLCO2B1 germline variants with time to progression (TTP) in patients receiving androgen-deprivation therapy (ADT), and to evaluate if the SLCO2B1 genetic variants impacted overall survival (OS) for prostate cancer (PC).

PATIENTS AND METHODS

Three single nucleotide polymorphisms (SNPs), exonic SNP rs12422149 and intronic SNPs rs1789693 and rs1077858, were genotyped in an independent validation cohort of 616 patients with PC who were treated with ADT at the Dana-Farber Cancer Institute from 1996 to 2013. Multivariable Cox proportional hazards regression adjusting for known prognostic factors estimated the association of these genetic variants with TTP and OS in patients receiving ADT. The expression of SLCO2B1 was examined in prostatectomy samples, and the impact of SLCO2B1 expression level on DHEAS (dehydroepiandrosterone sulfate) uptake was evaluated in cell lines.

RESULTS

The association between exonic SNP rs12422149 and TTP in patients treated with ADT was confirmed in univariable (P = .019) and multivariable analyses (adjusted hazard ratio, 1.31; 95% CI, 1.00 to 1.72 for GG v AA/AG; P = .049). Because OS had not been previously evaluated, we examined the association in the combined initial and validation cohorts (N = 1,094). The intronic SNP rs1077858 was associated with OS in both univariable (P = .009; Bonferroni's method adjusted P = .027) and multivariable analyses (adjusted hazard ratio, 1.35; 95% CI, 1.07 to 1.71 for GG v AA/AG; P = .012). SLCO2B1 expression in normal prostate tissue and in 22RV1 cells carrying the major allele of SNP rs1077858 was significantly lower than in cells carrying the risk allele. We show in vitro that SLCO2B1 expression levels correlated with DHEAS uptake by PC cells.

CONCLUSION

The association of SNP rs1077858 with OS may be a result of differential SLCO2B1 expression and the consequent increased uptake of DHEAS and subsequent resistance to ADT, which, in turn, may contribute to decreased OS.