Long-term prostate cancer control using palladium-103 brachytherapy and external beam radiotherapy in patients with a high likelihood of extracapsular cancer extension

Cytotoxic Action of Palladium-Based Compound on Prostate Stem Cells, Primary Prostate Epithelial Cells, Prostate Epithelial Cells, and Prostate Cell Lines

Objective

Prostate cancer is one of the most common types of cancer found to occur in males and is ranked as the second-highest cause of cancer-associated deaths among male patients. In this study, we have shown the influence of a new palladium-based anticancer agent in contrast to the six distinct prostate cancer lines and the primary cultures.

Methods

In this study, we have used six distinct prostate cell lines, that is, PNT2-C2, LNCaP, BPH-1, PC-3, PNT1A, and P4E6. The MTP and ATP assay were performed to evaluate the growth of the cell and the flow cytometry to investigate the status of the cell cycle. The antigrowth effect of the palladium complex was evaluated against different cell lines at three time zones 24 h, 48 h, and 72 h. [PdCl(terpy)] (capsule)-2H2O is synthesized by direct encapsulation of equimolar amounts of capsule ions into [Pd (terpy) Cl] Cl-2H2O.

Results

A comparative analysis was done on 25 mM etoposide and 12 mM cisplatin, cytotoxic agents. The lowest IC50 value at 72 hours was 0.128 mM for BPH-1 cell lines with 0.139 mM, whereas PNT2-C2 cells were found to be most resistant with IC50 values of 0.829 mM. The antigrowth effect of palladium complex on cell lines was measured using the MTS assay at 24, 48, and 72 hours. BPH-1, PNT2-C2, and PNT1A either possess normal tissues or have benign prostatic hyperplasia tissues whereas P4E6, PC-3, and LNCaP cell lines possess malignant origin. The Pd complex exhibited significant cytotoxic action in stem cells when compared against etoposide. An antigrowth effect was reported for Pd complex at lower concentration, but it was more cytotoxic than etoposide with significant cytotoxicity (P=0.001).

Conclusion

The palladium complex experienced a substantial antigrowth influence over most of the prostate tumor cell lines and the primary cultures, eventually, leading to the implementation of this Pd complex in the treating procedure of metastatic prostate cancer, which is tremendously resistant to the traditional treatment.

Prostate epithelial genes define therapy-relevant prostate cancer molecular subtype

Background and objectives

Transcriptomic landscape of prostate cancer (PCa) shows multidimensional variability, potentially arising from the cell-of-origin, reflected in serum markers, and most importantly related to drug sensitivities. For example, Aggressive Variant Prostate Cancer (AVPC) presents low PSA per tumor burden, and characterized by de novo resistance to androgen receptor signaling inhibitors (ARIs). Understanding PCa transcriptomic complexity can provide biological insight and therapeutic guidance. However, unsupervised clustering analysis is hindered by potential confounding factors such as stromal contamination and stress-related material degradation.

Materials and methods

To focus on prostate epithelial cell-relevant heterogeneity, we defined 1,629 genes expressed by prostate epithelial cells by analyzing publicly available bulk and single- cell RNA sequencing data. Consensus clustering and CIBERSORT deconvolution were used for class discovery and proportion estimate analysis. The Cancer Genome Atlas Prostate Adenocarcinoma dataset served as a training set. The resulting clusters were analyzed in association with clinical, pathologic, and genomic characteristics and impact on survival. Serum markers PSA and PAP was analyzed to predict response to docetaxel chemotherapy in metastatic setting.

Results

We identified two luminal subtypes and two aggressive variant subtypes of PCa: luminal A (Adipogenic/AR-active/PSA-high) (30.0%); luminal S (Secretory/PAP-high) (26.0%); AVPC-I (Immune-infiltrative) (14.7%), AVPC-M (Myc-active) (4.2%), and mixed (25.0%). AVPC-I and AVPC-M subtypes predicted to be resistant to ARI and have low PSA per tumor burden. Luminal A and AVPC-M predicted to be resistant to docetaxel and have high PSA/PAP Ratio. Metastatic PCa patients with high PSA/PAP ratio (>20) had significantly shorter progression-free survival than those with low ratio (≤20) following docetaxel chemotherapy.

Conclusion

We propose four prostate adenocarcinoma subtypes with distinct transcriptomic, genomic, and pathologic characteristics. PSA/PAP ratio in advanced cancer may aid in determining which patients would benefit from maximized androgen receptor inhibition or early use of antimicrotubule agents.

Brachytherapy for prostate cancer: a systematic review

Low-dose rate brachytherapy has become a mainstream treatment option for men diagnosed with prostate cancer because of excellent long-term treatment outcomes in low-, intermediate-, and high-risk patients. To a great extend due to patient lead advocacy for minimally invasive treatment options, high-quality prostate implants have become widely available in the US, Europe, and Japan. High-dose-rate (HDR) afterloading brachytherapy in the management of localised prostate cancer has practical, physical, and biological advantages over low-dose-rate seed brachytherapy. There are no free live sources used, no risk of source loss, and since the implant is a temporary procedure following discharge no issues with regard to radioprotection use of existing facilities exist. Patients with localized prostate cancer may benefit from high-dose-rate brachytherapy, which may be used alone in certain circumstances or in combination with external-beam radiotherapy in other settings. The purpose of this paper is to present the essentials of brachytherapies techniques along with the most important studies that support their effectiveness in the treatment of prostate cancer.

Permanent prostate seed brachytherapy: a current perspective on the evolution of the technique and its application

This Review highlights current areas of controversy and development in the field of transperineal permanent prostate seed implantation brachytherapy (PPI), in particular the technological evolution of PPI treatment planning that has led to intra-operative treatment planning and execution, the use of MRI spectroscopy and ultrasonography to target intraprostatic tumor foci, and the introduction of (131)Cs as a new PPI isotope. Here we present a comprehensive review of mature data for PPI monotherapy and PPI combined with supplemental external beam radiation therapy, and a critical discussion of issues pertinent to supplemental EBRT. We also present our current policies in the treatment of prostate cancer at the University of California, San Francisco.