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Arndt P, Turkowski K, Cekay M, Eul B, Grimminger F, Savai R. Endothelin and the tumor microenvironment: a finger in every pie. Clin Sci (Lond) 2024; 138:617-634. [PMID: 38785410 PMCID: PMC11130555 DOI: 10.1042/cs20240426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
The tumor microenvironment (TME) plays a central role in the development of cancer. Within this complex milieu, the endothelin (ET) system plays a key role by triggering epithelial-to-mesenchymal transition, causing degradation of the extracellular matrix and modulating hypoxia response, cell proliferation, composition, and activation. These multiple effects of the ET system on cancer progression have prompted numerous preclinical studies targeting the ET system with promising results, leading to considerable optimism for subsequent clinical trials. However, these clinical trials have not lived up to the high expectations; in fact, the clinical trials have failed to demonstrate any substantiated benefit of targeting the ET system in cancer patients. This review discusses the major and recent advances of the ET system with respect to TME and comments on past and ongoing clinical trials of the ET system.
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Affiliation(s)
- Philipp F. Arndt
- Lung Microenvironmental Niche in Cancerogenesis, Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Centre (UGMLC), Member of the Cardio-Pulmonary Institute (CPI), Member of the German Centre for Lung Research (DZL), Giessen, Germany
- Max Planck Institute for Heart and Lung Research, Member of the DZL, Member of the CPI, Bad Nauheim, Germany
| | - Kati Turkowski
- Lung Microenvironmental Niche in Cancerogenesis, Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
- Max Planck Institute for Heart and Lung Research, Member of the DZL, Member of the CPI, Bad Nauheim, Germany
| | - Michael J. Cekay
- Lung Microenvironmental Niche in Cancerogenesis, Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Centre (UGMLC), Member of the Cardio-Pulmonary Institute (CPI), Member of the German Centre for Lung Research (DZL), Giessen, Germany
| | - Bastian Eul
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Centre (UGMLC), Member of the Cardio-Pulmonary Institute (CPI), Member of the German Centre for Lung Research (DZL), Giessen, Germany
| | - Friedrich Grimminger
- Lung Microenvironmental Niche in Cancerogenesis, Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Centre (UGMLC), Member of the Cardio-Pulmonary Institute (CPI), Member of the German Centre for Lung Research (DZL), Giessen, Germany
| | - Rajkumar Savai
- Lung Microenvironmental Niche in Cancerogenesis, Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Centre (UGMLC), Member of the Cardio-Pulmonary Institute (CPI), Member of the German Centre for Lung Research (DZL), Giessen, Germany
- Max Planck Institute for Heart and Lung Research, Member of the DZL, Member of the CPI, Bad Nauheim, Germany
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Mahon KL, Sutherland SI, Lin HM, Stockler MR, Gurney H, Mallesara G, Briscoe K, Marx G, Higano CS, de Bono JS, Chi KN, Clark G, Breit SN, Brown DA, Horvath LG. Clinical validation of circulating GDF15/MIC-1 as a marker of response to docetaxel and survival in men with metastatic castration-resistant prostate cancer. Prostate 2024; 84:747-755. [PMID: 38544345 DOI: 10.1002/pros.24691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Elevated circulating growth differentiation factor (GDF15/MIC-1), interleukin 4 (IL4), and IL6 levels were associated with resistance to docetaxel in an exploratory cohort of men with metastatic castration-resistant prostate cancer (mCRPC). This study aimed to establish level 2 evidence of cytokine biomarker utility in mCRPC. METHODS IntVal: Plasma samples at baseline (BL) and Day 21 docetaxel (n = 120). ExtVal: Serum samples at BL and Day 42 of docetaxel (n = 430). IL4, IL6, and GDF15 levels were measured by ELISA. Monocytes and dendritic cells were treated with 10% plasma from men with high or low GDF15 or recombinant GDF15. RESULTS IntVal: Higher GDF15 levels at BL and Day 21 were associated with shorter overall survival (OS) (BL; p = 0.03 and Day 21; p = 0.004). IL4 and IL6 were not associated with outcomes. ExtVal: Higher GDF15 levels at BL and Day 42 predicted shorter OS (BL; p < 0.0001 and Day 42; p < 0.0001). Plasma from men with high GDF15 caused an increase in CD86 expression on monocytes (p = 0.03), but was not replicated by recombinant GDF15. CONCLUSIONS Elevated circulating GDF15 is associated with poor prognosis in men with mCRPC receiving docetaxel and may be a marker of changes in the innate immune system in response to docetaxel resistance. These findings provide a strong rationale to consider GDF15 as a biomarker to guide a therapeutic trial of drugs targeting the innate immune system in combination with docetaxel in mCRPC.
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Affiliation(s)
- Kate L Mahon
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Prostate Cancer Research Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Im Sutherland
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Prostate Cancer Research Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Cancer Research Group, The ANZAC Research Institute, Sydney, New South Wales, Australia
| | - Hui Ming Lin
- Prostate Cancer Research Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- School of Clinical Medicine, University of NSW, Sydney, New South Wales, Australia
| | - Martin R Stockler
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Westmead Hospital, Sydney, New South Wales, Australia
| | - Howard Gurney
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Calvary Mater, Newcastle, New South Wales, Australia
| | - Girish Mallesara
- Medical Oncology Department, Mid North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia
| | - Karen Briscoe
- Northern Haematology Oncology Group, Sydney, New South Wales, Australia
| | - Gavin Marx
- BC Cancer Agency, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Johann S de Bono
- St Vincent's Centre for Applied Medical Research, Sydney, New South Wales, Australia
| | - Kim N Chi
- Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - Georgina Clark
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Cancer Research Group, The ANZAC Research Institute, Sydney, New South Wales, Australia
| | - Samuel N Breit
- School of Clinical Medicine, University of NSW, Sydney, New South Wales, Australia
- Concord Hospital, Sydney, New South Wales, Australia
| | - David A Brown
- School of Clinical Medicine, University of NSW, Sydney, New South Wales, Australia
- Concord Hospital, Sydney, New South Wales, Australia
| | - Lisa G Horvath
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Prostate Cancer Research Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- School of Clinical Medicine, University of NSW, Sydney, New South Wales, Australia
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Lara PN, Mayerson E, Gertz E, Tangen C, Goldkorn A, van Loan M, Hussain M, Gupta S, Zhang J, Parikh M, Twardowski P, Quinn DI, LeBlanc M, Vogelzang NJ, Thompson I, Agarwal N. Bone Biomarkers and Subsequent Survival in Men with Hormone-sensitive Prostate Cancer: Results from the SWOG S1216 Phase 3 Trial of Androgen Deprivation Therapy with or Without Orteronel. Eur Urol 2024; 85:171-176. [PMID: 37085425 PMCID: PMC10662935 DOI: 10.1016/j.eururo.2023.03.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/30/2023] [Accepted: 03/29/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Bone biomarkers are strongly prognostic for overall survival (OS) in men with castration-resistant prostate cancer but not fully established for hormone-sensitive prostate cancer (HSPC). OBJECTIVE Bone biomarkers in HSPC were prospectively evaluated as part of a phase 3 study of androgen deprivation therapy ± the CYP17 inhibitor orteronel. DESIGN, SETTING, AND PARTICIPANTS Patients were randomly divided into training (n = 316) and validation (n = 633) sets. Recursive partitioning and Cox proportional hazard models were employed. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Bone resorption (C-telopeptide and pyridinoline) and bone formation markers (C-terminal collagen propeptide and bone alkaline phosphatase) were assessed from patient sera. RESULTS AND LIMITATIONS Of 1279 men, 949 had evaluable baseline bone biomarkers. Optimal cutoffs were identified to define elevated levels of each of the four biomarkers (all p < 0.05) that were associated with worse OS. After adjusting for clinical risk factors in the validation set, elevated bone biomarkers were statistically significantly associated with an increased risk of death (hazard ratios ranging from 1.37 to 1.92). Recursive partitioning algorithms applied to the training set identified three risk groups (low, intermediate, and poor) with differential OS outcomes (median OS: 8.2, 5.1, and 2.1 yr, respectively) based on combinations of bone biomarkers. These results were confirmed in the validation set. CONCLUSIONS In men with HSPC initiating androgen deprivation therapy, bone biomarkers are strongly and independently prognostic for OS. Bone biomarker levels alone or in combination with clinical covariates identify unique subsets of men with differential OS outcomes. These results validate the clinical value of bone biomarker assessment in the HSPC state, extending bone biomarker utility beyond the castration-resistant state. PATIENT SUMMARY In men with newly diagnosed metastatic prostate cancer, high levels of bone turnover biomarkers are associated with a shorter lifespan.
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Affiliation(s)
- Primo N Lara
- University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA.
| | | | - Erik Gertz
- US Department of Agriculture, Western Human Nutrition Research Center, University of California Davis, Davis, CA, USA
| | | | - Amir Goldkorn
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Marta van Loan
- US Department of Agriculture, Western Human Nutrition Research Center, University of California Davis, Davis, CA, USA
| | | | | | | | - Mamta Parikh
- University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | | | - David I Quinn
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | | | - Ian Thompson
- Christus Santa Rosa Health System, San Antonio, TX Health, San Antonio, TX, USA
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4
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Assayag J, Kim C, Chu H, Webster J. The prognostic value of Eastern Cooperative Oncology Group performance status on overall survival among patients with metastatic prostate cancer: a systematic review and meta-analysis. Front Oncol 2023; 13:1194718. [PMID: 38162494 PMCID: PMC10757350 DOI: 10.3389/fonc.2023.1194718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/15/2023] [Indexed: 01/03/2024] Open
Abstract
Background There is heterogeneity in the literature regarding the strength of association between Eastern Cooperative Oncology Group performance status (ECOG PS) and mortality. We conducted a systematic review and meta-analysis of studies reporting the prognostic value of ECOG PS on overall survival (OS) in metastatic prostate cancer (mPC). Methods PubMed was searched from inception to March 21, 2022. A meta-analysis pooling the effect of ECOG PS categories (≥2 vs. <2, 2 vs. <2, and ≥1 vs. <1) on OS was performed separately for studies including patients with metastatic castration-resistant prostate cancer (mCRPC) and metastatic castration-sensitive prostate cancer (mCSPC) using a random-effects model. Analyses were stratified by prior chemotherapy and study type. Results Overall, 75 studies, comprising 32,298 patients, were included. Most studies (72/75) included patients with mCRPC. Higher ECOG PS was associated with a significant increase in mortality risk, with the highest estimate observed among patients with mCRPC with an ECOG PS of ≥2 versus <2 (hazard ratio [HR]: 2.10, 95% confidence interval [CI]: 1.87-2.37). When stratifying by study type, there was a higher risk estimate of mortality among patients with mCRPC with an ECOG PS of ≥1 versus <1 in real-world data studies (HR: 1.98, 95% CI: 1.72-2.26) compared with clinical trials (HR: 1.32, 95% CI: 1.13-1.54; p < 0.001). There were no significant differences in the HR of OS stratified by previous chemotherapy. Conclusion ECOG PS was a significant predictor of OS regardless of category, previous chemotherapy, and mPC population. Additional studies are needed to better characterize the effect of ECOG PS on OS in mCSPC.
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Affiliation(s)
- Jonathan Assayag
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
| | - Chai Kim
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
| | - Haitao Chu
- Statistical Research and Data Science Center, Global Biometrics and Data Management, Pfizer Inc., New York, NY, United States
| | - Jennifer Webster
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
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Walia A, Tuia J, Prasad V. Progression-free survival, disease-free survival and other composite end points in oncology: improved reporting is needed. Nat Rev Clin Oncol 2023; 20:885-895. [PMID: 37828154 DOI: 10.1038/s41571-023-00823-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/14/2023]
Abstract
Composite outcome measures such as progression-free survival and disease-free survival are increasingly used as surrogate end points in oncology research, frequently serving as the primary end point of pivotal trials that form the basis for FDA and EMA approvals. Such outcome measures combine two or more distinct events (for example, tumour (re)growth, new lesions and/or death) into a single, time-to-event end point. The use of a composite end point can increase the statistical power of a clinical trial and decrease the follow-up period required to demonstrate efficacy, thus lowering costs; however, these end points have a number of limitations. Composite outcomes are often vaguely defined, with definitions that vary greatly between studies, complicating comparisons of results across trials. Altering the makeup of events included in a composite outcome can alter study conclusions, including whether treatment effects are statistically significant. Moreover, the events included in a composite outcome often vary in clinical significance, reflect distinct biological pathways and/or are affected differently by treatment. Therefore, knowing the precise breakdown of the component events is essential to accurately interpret trial results and gauge the true benefit of an intervention. In oncology clinical trials, however, such information is rarely provided. In this Perspective, we emphasize this deficiency through a review of 50 studies with progression-free survival as an outcome published in five top oncology journals, discuss the advantages and challenges of using composite end points, and highlight the need for transparent reporting of the component events.
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Affiliation(s)
- Anushka Walia
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - Jordan Tuia
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Vinay Prasad
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Sanchez-de-Diego C, Virumbrales-Muñoz M, Hermes B, Juang TD, Juang DS, Riendeau J, Guzman EC, Reed-McBain CA, Abizanda-Campo S, Patel J, Hess NJ, Skala MC, Beebe DJ, Ayuso JM. Griddient: a microfluidic array to generate reconfigurable gradients on-demand for spatial biology applications. Commun Biol 2023; 6:925. [PMID: 37689746 PMCID: PMC10492845 DOI: 10.1038/s42003-023-05282-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/24/2023] [Indexed: 09/11/2023] Open
Abstract
Biological tissues are highly organized structures where spatial-temporal gradients (e.g., nutrients, hypoxia, cytokines) modulate multiple physiological and pathological processes including inflammation, tissue regeneration, embryogenesis, and cancer progression. Current in vitro technologies struggle to capture the complexity of these transient microenvironmental gradients, do not provide dynamic control over the gradient profile, are complex and poorly suited for high throughput applications. Therefore, we have designed Griddent, a user-friendly platform with the capability of generating controllable and reversible gradients in a 3D microenvironment. Our platform consists of an array of 32 microfluidic chambers connected to a 384 well-array through a diffusion port at the bottom of each reservoir well. The diffusion ports are optimized to ensure gradient stability and facilitate manual micropipette loading. This platform is compatible with molecular and functional spatial biology as well as optical and fluorescence microscopy. In this work, we have used this platform to study cancer progression.
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Affiliation(s)
- Cristina Sanchez-de-Diego
- Department of Pathology & Laboratory Medicine, University of Wisconsin, Madison, WI, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - María Virumbrales-Muñoz
- Department of Pathology & Laboratory Medicine, University of Wisconsin, Madison, WI, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
- Department of Cell and Regenerative Biology, University of Wisconsin, Madison, WI, USA
| | - Brock Hermes
- Department of Pathology & Laboratory Medicine, University of Wisconsin, Madison, WI, USA
| | - Terry D Juang
- Department of Pathology & Laboratory Medicine, University of Wisconsin, Madison, WI, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Duane S Juang
- Department of Pathology & Laboratory Medicine, University of Wisconsin, Madison, WI, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Jeremiah Riendeau
- Morgridge Institute for Research, 330 N, Orchard street, Madison, WI, USA
| | | | - Catherine A Reed-McBain
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | - Sara Abizanda-Campo
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | - Janmesh Patel
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Nicholas J Hess
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
- Department of Medicine, Division of Hematology, Medical Oncology and Palliative Care, Madison, WI, USA
| | - Melissa C Skala
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
- Morgridge Institute for Research, 330 N, Orchard street, Madison, WI, USA
| | - David J Beebe
- Department of Pathology & Laboratory Medicine, University of Wisconsin, Madison, WI, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Jose M Ayuso
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA.
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI, USA.
- Department of Dermatology, University of Wisconsin, Madison, WI, USA.
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Archer Goode E, Wang N, Munkley J. Prostate cancer bone metastases biology and clinical management (Review). Oncol Lett 2023; 25:163. [PMID: 36960185 PMCID: PMC10028493 DOI: 10.3892/ol.2023.13749] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/09/2023] [Indexed: 03/25/2023] Open
Abstract
Prostate cancer (PCa) is one of the most prominent causes of cancer-related mortality in the male population. A highly impactful prognostic factor for patients diagnosed with PCa is the presence or absence of bone metastases. The formation of secondary tumours at the bone is the most commonly observed site for the establishment of PCa metastases and is associated with reduced survival of patients in addition to a cohort of life-debilitating symptoms, including mobility issues and chronic pain. Despite the prevalence of this disease presentation and the high medical relevance of bone metastases, the mechanisms underlying the formation of metastases to the bone and the understanding of what drives the osteotropism exhibited by prostate tumours remain to be fully elucidated. This lack of in-depth understanding manifests in limited effective treatment options for patients with advanced metastatic PCa and culminates in the low rate of survival observed for this sub-set of patients. The present review aims to summarise the most recent promising advances in the understanding of how and why prostate tumours metastasise to the bone, with the ultimate aim of highlighting novel treatment and prognostic targets, which may provide the opportunity to improve the diagnosis and treatment of patients with PCa with bone metastases.
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Affiliation(s)
- Emily Archer Goode
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, International Centre for Life, Newcastle NE1 3BZ, UK
| | - Ning Wang
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Sheffield S10 2RX, UK
| | - Jennifer Munkley
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, International Centre for Life, Newcastle NE1 3BZ, UK
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Hui D, Darke AK, Guthrie KA, Subbiah IM, Unger JM, Hershman DL, Krouse RS, Bakitas M, O'Rourke MA. Association Between Health-Related Quality of Life and Progression-Free Survival in Patients With Advanced Cancer: A Secondary Analysis of SWOG Clinical Trials. JCO Oncol Pract 2022; 18:e442-e451. [PMID: 34606328 PMCID: PMC9014467 DOI: 10.1200/op.21.00407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Health-related quality of life (HRQOL) is an established prognostic factor for mortality; however, it is unclear if HRQOL is predictive of time to disease progression, a particularly meaningful outcome for patients. We examined the association between HRQOL and progression-free survival (PFS) in SWOG Cancer Research Network clinical trials. METHODS For this secondary analysis, we reviewed all completed SWOG clinical trials to identify those for patients with advanced cancer that incorporated Functional Assessment of Cancer Therapy (FACT) questionnaires at baseline. FACT-Trial Outcome Index (FACT-TOI) was the primary independent variable. Associations between FACT-TOI and other FACT subscores with PFS and overall survival were evaluated via log-rank test and multivariable Cox regression analysis. RESULTS Three clinical trials met our inclusion criteria: S0027 and S9509 for advanced non-small-cell lung cancer and S0421 for hormone-refractory prostate cancer. Of the 1,527 enrolled patients, 1,295 (85%) had both HRQOL and survival outcomes data available and were included in this analysis. In univariable analysis, we observed a statistically significant gradient effect in all three trials, with higher baseline FACT-TOI scores corresponding to better PFS (S0027, P < .001; S9509, P = .02; and S0421, P < .001). In multivariable analysis, FACT-TOI was significantly associated with PFS in S0027 (hazard ratio [HR] = 0.64; 95% CI, 0.42 to 1.00) but not in S9509 (HR = 0.77; 95% CI, 0.56 to 1.05) or S042 (HR = 0.86; 95% CI, 0.73 to 1.01). FACT-TOI was significantly associated with overall survival in multivariable analysis (P < .005 in all three trials). CONCLUSION The association between baseline FACT-TOI scores and survival underscores their potential as a stratification factor in clinical trials.
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Affiliation(s)
- David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX
| | - Amy K Darke
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Katherine A Guthrie
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Ishwaria M Subbiah
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX
| | - Joseph M Unger
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Robert S Krouse
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marie Bakitas
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL
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9
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Sethakorn N, Heninger E, Sánchez-de-Diego C, Ding AB, Yada RC, Kerr SC, Kosoff D, Beebe DJ, Lang JM. Advancing Treatment of Bone Metastases through Novel Translational Approaches Targeting the Bone Microenvironment. Cancers (Basel) 2022; 14:757. [PMID: 35159026 PMCID: PMC8833657 DOI: 10.3390/cancers14030757] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/21/2022] [Accepted: 01/29/2022] [Indexed: 02/04/2023] Open
Abstract
Bone metastases represent a lethal condition that frequently occurs in solid tumors such as prostate, breast, lung, and renal cell carcinomas, and increase the risk of skeletal-related events (SREs) including pain, pathologic fractures, and spinal cord compression. This unique metastatic niche consists of a multicellular complex that cancer cells co-opt to engender bone remodeling, immune suppression, and stromal-mediated therapeutic resistance. This review comprehensively discusses clinical challenges of bone metastases, novel preclinical models of the bone and bone marrow microenviroment, and crucial signaling pathways active in bone homeostasis and metastatic niche. These studies establish the context to summarize the current state of investigational agents targeting BM, and approaches to improve BM-targeting therapies. Finally, we discuss opportunities to advance research in bone and bone marrow microenvironments by increasing complexity of humanized preclinical models and fostering interdisciplinary collaborations to translational research in this challenging metastatic niche.
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Affiliation(s)
- Nan Sethakorn
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (N.S.); (E.H.); (C.S.-d.-D.); (A.B.D.); (S.C.K.); (D.K.); (D.J.B.)
- Division of Hematology/Oncology, University of Wisconsin-Madison, 1111 Highland Ave., Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Erika Heninger
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (N.S.); (E.H.); (C.S.-d.-D.); (A.B.D.); (S.C.K.); (D.K.); (D.J.B.)
| | - Cristina Sánchez-de-Diego
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (N.S.); (E.H.); (C.S.-d.-D.); (A.B.D.); (S.C.K.); (D.K.); (D.J.B.)
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Adeline B. Ding
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (N.S.); (E.H.); (C.S.-d.-D.); (A.B.D.); (S.C.K.); (D.K.); (D.J.B.)
| | - Ravi Chandra Yada
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Sheena C. Kerr
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (N.S.); (E.H.); (C.S.-d.-D.); (A.B.D.); (S.C.K.); (D.K.); (D.J.B.)
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - David Kosoff
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (N.S.); (E.H.); (C.S.-d.-D.); (A.B.D.); (S.C.K.); (D.K.); (D.J.B.)
- Division of Hematology/Oncology, University of Wisconsin-Madison, 1111 Highland Ave., Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - David J. Beebe
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (N.S.); (E.H.); (C.S.-d.-D.); (A.B.D.); (S.C.K.); (D.K.); (D.J.B.)
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA;
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Joshua M. Lang
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (N.S.); (E.H.); (C.S.-d.-D.); (A.B.D.); (S.C.K.); (D.K.); (D.J.B.)
- Division of Hematology/Oncology, University of Wisconsin-Madison, 1111 Highland Ave., Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Wisconsin Institutes for Medical Research, 1111 Highland Ave., Madison, WI 53705, USA
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10
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Biomarkers for Treatment Response in Advanced Prostate Cancer. Cancers (Basel) 2021; 13:cancers13225723. [PMID: 34830878 PMCID: PMC8616385 DOI: 10.3390/cancers13225723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 01/05/2023] Open
Abstract
Simple Summary Prostate cancer is a leading cause of cancer-related death among males. Many treatments are available to manage the disease, but despite this, ultimately advanced prostate cancer is incurable and fatal. In order to improve survival and minimize side effects from these various treatments, the treatments need to be given in an optimal sequence or combination. This optimal use of therapies must be individualized, and biomarkers can be used for these decisions. Biomarkers can be useful in predicting whether a patient will respond to a treatment option and may help avoid use of therapies that are not expected to be effective. Many biomarkers are already in clinical use while many others are currently being investigated and may become part of clinical practice in future. In this review, we discuss both established and novel biomarkers with a role in management of advanced prostate cancer. Abstract Multiple treatment options with different mechanisms of action are currently available for the management of metastatic prostate cancer. However, the optimal use of these therapies—specifically, the sequencing of therapies—is not well defined. In order to obtain the best clinical outcomes, patients need to be treated with the therapies that are most likely to provide benefit and avoid toxic therapies that are unlikely to be effective. Ideally, predictive biomarkers that allow for the selection of the therapies most likely to be of benefit would be employed for each treatment decision. In practice, biomarkers including tumor molecular sequencing, circulating tumor DNA, circulating tumor cell enumeration and androgen receptor characteristics, and tumor cell surface expression (PSMA), all may have a role in therapy selection. In this review, we define the established prognostic and predictive biomarkers for therapy in advanced prostate cancer and explore emerging biomarkers.
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11
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Antognelli C, Marinucci L, Frosini R, Macchioni L, Talesa VN. Metastatic Prostate Cancer Cells Secrete Methylglyoxal-Derived MG-H1 to Reprogram Human Osteoblasts into a Dedifferentiated, Malignant-like Phenotype: A Possible Novel Player in Prostate Cancer Bone Metastases. Int J Mol Sci 2021; 22:ijms221910191. [PMID: 34638532 PMCID: PMC8508123 DOI: 10.3390/ijms221910191] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 02/07/2023] Open
Abstract
Bone metastases from prostate cancer (PCa) result from a complex cross-talk between PCa cells and osteoblasts (OB). Thus, targeting this interplay has become an attractive strategy to interfere with PCa bone dissemination. The agents currently used in clinical trials have proved ineffective, boosting research to identify additional mechanisms that may be involved in this two-directional talk. Here, we investigated whether and how 5-hydro-5-methylimidazolone (MG-H1), a specific methylglyoxal (MG)-derived advanced glycation end product (AGE), was a novel player in the dialogue between PCa and OB to drive PCa bone metastases. Conditioned medium from osteotropic PC3 PCa cells, pre-treated or not with a specific MG scavenger, was administrated to human primary OB and cell morphology, mesenchymal trans-differentiation, pro-osteogenic determinants, PCa-specific molecules, and migration/invasion were studied by phase-contrast microscopy, real-time PCR, western blot and specific assays, respectively. We found that PC3 cells were able to release MG-H1 that, by binding to the receptor for AGEs (RAGE) on OB, reprogrammed them into a less-differentiate phenotype, endowed with some PCa-specific molecular features and malignant properties, in a mechanism involving reactive oxidative species (ROS) production and NF-kB pathway activation. These findings provide novel insights into the mechanisms of PCa osteoblastic metastases and foster in vivo research toward new therapeutic strategies interfering with PCa/OB cross-talk.
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Affiliation(s)
- Cinzia Antognelli
- Department of Medicine and Surgery, Bioscience and Medical Embryology Division, University of Perugia, L. Severi Square, 06129 Perugia, Italy; (L.M.); (R.F.); (V.N.T.)
- Correspondence: ; Tel.: +39-075-585-8354
| | - Lorella Marinucci
- Department of Medicine and Surgery, Bioscience and Medical Embryology Division, University of Perugia, L. Severi Square, 06129 Perugia, Italy; (L.M.); (R.F.); (V.N.T.)
| | - Roberta Frosini
- Department of Medicine and Surgery, Bioscience and Medical Embryology Division, University of Perugia, L. Severi Square, 06129 Perugia, Italy; (L.M.); (R.F.); (V.N.T.)
| | - Lara Macchioni
- Department of Medicine and Surgery, Biochemistry and Physiology Division, University of Perugia, L. Severi Square, 06129 Perugia, Italy;
| | - Vincenzo Nicola Talesa
- Department of Medicine and Surgery, Bioscience and Medical Embryology Division, University of Perugia, L. Severi Square, 06129 Perugia, Italy; (L.M.); (R.F.); (V.N.T.)
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12
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Mo J, Darke AK, Guthrie KA, Sloan JA, Unger JM, Hershman DL, O'Rourke M, Bakitas M, Krouse RS. Association of Fatigue and Outcomes in Advanced Cancer: An Analysis of Four SWOG Treatment Trials. JCO Oncol Pract 2021; 17:e1246-e1257. [PMID: 34255538 DOI: 10.1200/op.20.01096] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Patient-reported outcomes may be associated with cancer outcomes. We evaluated clinically significant fatigue (CSF), overall survival, adverse events (AEs), and quality of life (QOL) during cancer treatment. METHODS We compared outcomes in four phase II or III chemotherapy trials, two advanced non-small-cell lung cancer and two advanced hormone-refractory prostate cancer, with or without baseline CSF. CSF was defined as a rating of two or greater on the Functional Assessment of Cancer Therapy fatigue question or a European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 fatigue symptom score of 50% or greater. Survival was compared according to CSF using Kaplan-Meier estimates and Cox regression models. Differences in AE rates by CSF were assessed via chi-squared tests, and QOL changes from baseline to 3 months via linear regression. RESULTS Of 1,994 participants, 1,907 (median age 69 years, range: 32-91) had complete baseline QOL survey data, with 52% reporting CSF at baseline. For the two hormone-refractory prostate cancer studies, baseline CSF was associated with higher mortality rates, with adjusted hazard ratios of (95% CI, P value) 1.32 (1.13 to 1.55, P < .001) and 1.31 (1.02 to 1.67, P = .03) and with increased incidence of grade 3-5 constitutional (16.5% v 9.4%, P = .002; 13.9% v 6.3%, P = .002) and neurologic (11.7% v 6.1%, P = .006; 9.0% v 3.9%, P = .01) AEs, respectively. Baseline CSF was associated with a higher mortality rate in one non-small-cell lung cancer study: hazard ratio 1.44 and 1.04 to 2.00, P = .03. CONCLUSION Oncology trial participants with baseline CSF had poorer survival and experienced more AEs than participants without CSF. This indicates fatigue as an important baseline prognostic factor in oncology treatment trials.
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Affiliation(s)
- Julia Mo
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Amy K Darke
- SWOG Cancer Research Network Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Katherine A Guthrie
- SWOG Cancer Research Network Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Joseph M Unger
- SWOG Cancer Research Network Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Mark O'Rourke
- Center for Integrative Oncology and Survivorship, Greenville Health System, Clemson, SC
| | - Marie Bakitas
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | - Robert S Krouse
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
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13
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Health-related Quality of Life in Patients with Advanced Prostate Cancer: A Systematic Review. Eur Urol Focus 2021; 7:742-751. [DOI: 10.1016/j.euf.2020.01.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 01/31/2020] [Indexed: 11/24/2022]
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14
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Petrylak DP, Ratta R, Gafanov R, Facchini G, Piulats JM, Kramer G, Flaig TW, Chandana SR, Li B, Burgents J, Fizazi K. KEYNOTE-921: Phase III study of pembrolizumab plus docetaxel for metastatic castration-resistant prostate cancer. Future Oncol 2021; 17:3291-3299. [PMID: 34098744 DOI: 10.2217/fon-2020-1133] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Despite recent advances, treatment options for men with metastatic castration-resistant prostate cancer (mCRPC) progressing after next-generation hormonal agents (NHAs) are limited and provide only modest survival benefit. Thus, an unmet need remains for mCRPC patients after treatment with targeted endocrine therapy or NHA therapy. Pembrolizumab, a humanized monoclonal antibody for PD-1, has been found to have activity as monotherapy in patients with mCRPC and as combination therapy in a Phase Ib/II study with docetaxel and prednisone/prednisolone for patients previously treated with enzalutamide or abiraterone acetate. The aim of the randomized, double-blind, Phase III KEYNOTE-921 study is to evaluate the efficacy and safety of pembrolizumab plus docetaxel in patients with mCRPC who were previously treated with an NHA. Clinical trial registration: NCT03834506 (ClinicalTrials.gov).
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Affiliation(s)
- Daniel P Petrylak
- Department of Internal Medicine, Smilow Cancer Hospital, Yale School of Medicine, New Haven, CT 06511, USA
| | - Raffaele Ratta
- Department of Medical Oncology, Foch Hospital, Suresnes, 92151, France
| | - Rustem Gafanov
- Department of Oncourology, Russian Scientific Center of Roentgen Radiology, Moscow, 117997, Russia
| | - Gaetano Facchini
- Departmental Unit of Experimental Uro-Androlo, Istituto Nazionale Tumori IRCCS, Fondazione G. Pascale, Naples, 80131, Italy
| | - Josep M Piulats
- Department of Medical Oncology, Catalan Institute of Oncology, Barcelona, 08908, Spain
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, 1090, Austria
| | - Thomas W Flaig
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Sreenivasa R Chandana
- Department of Medical Oncology, Cancer & Hematology Centers of Western Michigan, Grand Rapids, MI 49503, USA
| | - Ben Li
- Department of Clinical Research, Merck & Co., Inc., Kenilworth, NJ 07033, USA
| | - Joseph Burgents
- Department of Clinical Research, Merck & Co., Inc., Kenilworth, NJ 07033, USA
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy and University of Paris Saclay, Villejuif, 94800, France
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15
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Chen WJ, Kong DM, Li L. Prognostic value of ECOG performance status and Gleason score in the survival of castration-resistant prostate cancer: a systematic review. Asian J Androl 2021; 23:163-169. [PMID: 33159024 PMCID: PMC7991808 DOI: 10.4103/aja.aja_53_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/12/2020] [Indexed: 01/06/2023] Open
Abstract
Eastern Cooperative Oncology Group (ECOG) performance status and Gleason score are commonly investigated factors for overall survival (OS) in men with castration-resistant prostate cancer (CRPC). However, there is a lack of consistency regarding their prognostic or predictive value for OS. Therefore, we performed this meta-analysis to assess the associations of ECOG performance status and Gleason score with OS in CRPC patients and compare the two markers in patients under different treatment regimens or with different chemotherapy histories. A systematic literature review of monotherapy studies in CRPC patients was conducted in the PubMed database until May 2019. The data from 8247 patients in 34 studies, including clinical trials and real-world data, were included in our meta-analysis. Of these, twenty studies reported multivariate results and were included in our main analysis. CRPC patients with higher ECOG performance statuses (≥ 2) had a significantly increased mortality risk than those with lower ECOG performance statuses (<2), hazard ratio (HR): 2.10, 95% confidence interval (CI): 1.68-2.62, and P < 0.001. The synthesized HR of OS stratified by Gleason score was 1.01, with a 95% CI of 0.62-1.67 (Gleason score ≥ 8 vs <8). Subgroup analysis showed that there was no significant difference in pooled HRs for patients administered taxane chemotherapy (docetaxel and cabazitaxel) and androgen-targeting therapy (abiraterone acetate and enzalutamide) or for patients with different chemotherapy histories. ECOG performance status was identified as a significant prognostic factor in CRPC patients, while Gleason score showed a weak prognostic value for OS based on the available data in our meta-analysis.
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Affiliation(s)
- Wen-Jun Chen
- Center of Clinical Pharmacology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Da-Ming Kong
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery System, Department of Pharmaceutics, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Liang Li
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery System, Department of Pharmaceutics, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
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16
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Mallone F, Sacchetti M, Lambiase A, Moramarco A. Molecular Insights and Emerging Strategies for Treatment of Metastatic Uveal Melanoma. Cancers (Basel) 2020; 12:E2761. [PMID: 32992823 PMCID: PMC7600598 DOI: 10.3390/cancers12102761] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 09/14/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022] Open
Abstract
Uveal melanoma (UM) is the most common intraocular cancer. In recent decades, major advances have been achieved in the diagnosis and prognosis of UM allowing for tailored treatments. However, nearly 50% of patients still develop metastatic disease with survival rates of less than 1 year. There is currently no standard of adjuvant and metastatic treatment in UM, and available therapies are ineffective resulting from cutaneous melanoma protocols. Advances and novel treatment options including liver-directed therapies, immunotherapy, and targeted-therapy have been investigated in UM-dedicated clinical trials on single compounds or combinational therapies, with promising results. Therapies aimed at prolonging or targeting metastatic tumor dormancy provided encouraging results in other cancers, and need to be explored in UM. In this review, the latest progress in the diagnosis, prognosis, and treatment of UM in adjuvant and metastatic settings are discussed. In addition, novel insights into tumor genetics, biology and immunology, and the mechanisms underlying metastatic dormancy are discussed. As evident from the numerous studies discussed in this review, the increasing knowledge of this disease and the promising results from testing of novel individualized therapies could offer future perspectives for translating in clinical use.
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Affiliation(s)
| | | | - Alessandro Lambiase
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (M.S.); (A.M.)
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17
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Halabi S, Dutta S, Tangen CM, Rosenthal M, Petrylak DP, Thompson IM, Chi KN, De Bono JS, Araujo JC, Logothetis C, Eisenberger MA, Quinn DI, Fizazi K, Morris MJ, Higano CS, Tannock IF, Small EJ, Kelly WK. Comparative Survival of Asian and White Metastatic Castration-Resistant Prostate Cancer Men Treated With Docetaxel. JNCI Cancer Spectr 2020; 4:pkaa003. [PMID: 32368717 PMCID: PMC7190204 DOI: 10.1093/jncics/pkaa003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/16/2019] [Accepted: 01/21/2020] [Indexed: 01/02/2023] Open
Abstract
There are few data regarding disparities in overall survival (OS) between Asian and white men with metastatic castration-resistant prostate cancer (mCRPC). We compared OS of Asian and white mCRPC men treated in phase III clinical trials with docetaxel and prednisone (DP) or a DP-containing regimen. Individual participant data from 8820 men with mCRPC randomly assigned on nine phase III trials to receive DP or a DP-containing regimen were combined. Men enrolled in these trials had a diagnosis of prostate adenocarcinoma. The median overall survival was 18.8 months (95% confidence interval [CI] = 17.4 to 22.1 months) and 21.2 months (95% CI = 20.8 to 21.7 months) for Asian and white men, respectively. The pooled hazard ratio for death for Asian men compared with white men, adjusted for baseline prognostic factors, was 0.95 (95% CI = 0.84 to 1.09), indicating that Asian men were not at increased risk of death. This large analysis showed that Asian men did not have shorter OS duration than white men treated with docetaxel.
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Affiliation(s)
- Susan Halabi
- Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, NC, USA
| | - Sandipan Dutta
- Department of Mathematics and Statistics, Old Dominion University, Norfolk, VA, USA
| | - Catherine M Tangen
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Mark Rosenthal
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, Australia
| | | | - Ian M Thompson
- President, Christus San Rosa Hospital Medical Center, San Antonio, TX, USA
| | - Kim N Chi
- Medical Oncology, British Columbia Cancer Agency - Vancouver Centre, Vancouver, BC, USA
| | - Johann S De Bono
- Division of Clinical Studies, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - John C Araujo
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher Logothetis
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mario A Eisenberger
- Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, USA
| | - David I Quinn
- Genitourinary Oncology, Department of Medicine University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Karim Fizazi
- Medical Oncology, Gustave Roussy, Villejuif, France
| | - Michael J Morris
- Genitourinary Oncology Service, Department of Medicine. Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Celestia S Higano
- Department of Medicine, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ian F Tannock
- Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Eric J Small
- Department of Medicine, and University of California San Francisco Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - William Kevin Kelly
- Medical Oncology and Urology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA
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18
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Van Hemelrijck M, Sparano F, Moris L, Beyer K, Cottone F, Sprangers M, Efficace F. Harnessing the patient voice in prostate cancer research: Systematic review on the use of patient-reported outcomes in randomized controlled trials to support clinical decision-making. Cancer Med 2020; 9:4039-4058. [PMID: 32333639 PMCID: PMC7300413 DOI: 10.1002/cam4.3018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/31/2020] [Accepted: 03/10/2020] [Indexed: 02/06/2023] Open
Abstract
Background Given the growing importance of patient‐reported outcomes (PROs) as part of “big data” in improving patient care, there is a need to provide a state‐of‐the‐art picture of the added value of using PROs in prostate cancer (PCa) randomized controlled trials (RCTs). We aimed to synthetize the most recent high‐quality PRO evidence‐based knowledge from PCa RCTs and to examine whether quality of PRO reporting in PCa research improved over time. Methods We conducted a systematic literature search using PubMed, from April 2012 until February 2019. For benchmarking purposes, we also included RCTs identified in our previously published review of RCTs (2004‐2012). Methodology for study identification and evaluation followed standardized criteria and a predefined data extraction form was used to abstract information. PRO quality of the studies was evaluated using the International Society of Quality of Life Research (ISOQOL) recommended criteria. Results A total of 55 new RCTs were published between April 2012 and February 2019. About 24 (43.6%) RCTs were found to be of high‐quality regarding PRO assessments. Of these, 13 (54.2%) have been reported in the most recent European Association of Urology (EAU) PCa Guidelines. Overall QoL and sexual, urinary, and bowel function were the most commonly reported PROs. FACT‐P, EPIC‐26, and EORTC QLQ‐C30 and/or its module PR25 were most frequently used as measurement tools. An overall improvement in the completeness of PRO reporting was noted over time. Conclusion Many PRO trials are currently not included in the EAU guidelines. Our findings suggest that there has to be a better consensus on the use of PRO data for PCa patients, which will then be reflected in the PCa Guidelines and future data collection. Homogeneity in PROs collection and measurement tools will in turn enable “big data” Consortia to increase the patients’ voice in clinical research.
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Affiliation(s)
- Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), King's College London, London, UK
| | - Francesco Sparano
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Disease (GIMEMA), Rome, Italy
| | - Lisa Moris
- University Hospitals Leuven, Leuven, Belgium
| | - Katharina Beyer
- School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), King's College London, London, UK
| | - Francesco Cottone
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Disease (GIMEMA), Rome, Italy
| | - Mirjam Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Disease (GIMEMA), Rome, Italy
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19
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Intagliata S, Helal MA, Materia L, Pittalà V, Salerno L, Marrazzo A, Cagnotto A, Salmona M, Modica MN, Romeo G. Synthesis and Molecular Modelling Studies of New 1,3-Diaryl-5-Oxo-Proline Derivatives as Endothelin Receptor Ligands. Molecules 2020; 25:molecules25081851. [PMID: 32316541 PMCID: PMC7221592 DOI: 10.3390/molecules25081851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022] Open
Abstract
The synthesis of seventeen new 1,3-diaryl-5-oxo-proline derivatives as endothelin receptor (ETR) ligands is described. The structural configuration of the new molecules was determined by analyzing selected signals in proton NMR spectra. In vitro binding assays of the human ETA and ETB receptors allowed us to identify compound 31h as a selective ETAR ligand. The molecular docking of the selected compounds and the ETA antagonist atrasentan in the ETAR homology model provided insight into the structural elements required for the affinity and the selectivity of the ETAR subtype.
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Affiliation(s)
- Sebastiano Intagliata
- Department of Drug Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.I.); (V.P.); (L.S.); (A.M.); (G.R.)
| | - Mohamed A. Helal
- University of Science and Technology, Biomedical Sciences Program, Zewail City of Science and Technology, October Gardens, 6th of October, Giza 12578, Egypt;
- Medicinal Chemistry Department, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt
| | - Luisa Materia
- Department of Drug Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.I.); (V.P.); (L.S.); (A.M.); (G.R.)
| | - Valeria Pittalà
- Department of Drug Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.I.); (V.P.); (L.S.); (A.M.); (G.R.)
| | - Loredana Salerno
- Department of Drug Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.I.); (V.P.); (L.S.); (A.M.); (G.R.)
| | - Agostino Marrazzo
- Department of Drug Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.I.); (V.P.); (L.S.); (A.M.); (G.R.)
| | - Alfredo Cagnotto
- Istituto di Ricerche Farmacologiche “Mario Negri”, IRCCS. Via Mario Negri, 2, 20156 Milano, Italy; (A.C.); (M.S.)
| | - Mario Salmona
- Istituto di Ricerche Farmacologiche “Mario Negri”, IRCCS. Via Mario Negri, 2, 20156 Milano, Italy; (A.C.); (M.S.)
| | - Maria N. Modica
- Department of Drug Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.I.); (V.P.); (L.S.); (A.M.); (G.R.)
- Correspondence: ; Tel.: +39-095-738-6061
| | - Giuseppe Romeo
- Department of Drug Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.I.); (V.P.); (L.S.); (A.M.); (G.R.)
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20
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Halabi S, Dutta S, Tangen CM, Rosenthal M, Petrylak DP, Thompson IM, Chi KN, De Bono JS, Araujo JC, Logothetis C, Eisenberger MA, Quinn DI, Fizazi K, Morris MJ, Higano CS, Tannock IF, Small EJ, Kelly WK. Clinical outcomes in men of diverse ethnic backgrounds with metastatic castration-resistant prostate cancer. Ann Oncol 2020; 31:930-941. [PMID: 32289380 DOI: 10.1016/j.annonc.2020.03.309] [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] [Received: 12/23/2019] [Revised: 03/26/2020] [Accepted: 03/30/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND We have shown previously in multivariable analysis that black men had 19% lower risk of death than white men with metastatic castration-resistant prostate cancer (mCRPC) treated with a docetaxel and prednisone (DP)-based regimen. The primary goal of this analysis was to compare progression-free survival (PFS), biochemical PFS, ≥50% decline in prostate-specific antigen (PSA) from baseline and objective response rate (ORR) in white, black and Asian men with mCRPC treated with a DP-based regimen. PATIENTS AND METHODS Individual patient data from 8820 mCRPC men randomized on nine phase III trials to a DP-containing regimen were combined. Race used in the analysis was based on self-report. End points were PFS, biochemical PSA, ≥50% decline in PSA from baseline and ORR. The proportional hazards and the logistic regression models were employed to assess the prognostic importance of race in predicting outcomes adjusting for established prognostic factors. RESULTS Of 8820 patients, 7528 (85%) were white, 500 (6%) were black, 424 were Asian (5%) and 368 (4%) had race unspecified. Median PFS were 8.3 [95% confidence interval (CI) 8.2-8.5], 8.2 (95% CI 7.4-8.8) and 8.3 (95% CI 7.6-8.8) months in white, black and Asian men, respectively. Median PSA PFS were 9.9 (95% CI 9.7-10.4), 8.5 (95% CI 8.0-10.3) and 11.1 (95% CI 9.9-12.5) months in white, black and Asian men, respectively. CONCLUSIONS We observed no differences in clinical outcomes by race and ethnic groups in men with mCRPC enrolled on these phase III clinical trials with DP.
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Affiliation(s)
- S Halabi
- Duke University Medical Center and Duke University, Durham, USA.
| | - S Dutta
- Old Dominion University, Norfolk, USA
| | - C M Tangen
- Fred Hutchinson Cancer Research Center, Seattle, USA
| | - M Rosenthal
- The Royal Melbourne Hospital, Parkville, Australia
| | | | - I M Thompson
- Christus San Rosa Hospital Medical Center, San Antonio, USA
| | - K N Chi
- British Columbia Cancer Agency - Vancouver Centre, Vancouver, Canada
| | - J S De Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - J C Araujo
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - C Logothetis
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M A Eisenberger
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, USA
| | - D I Quinn
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, USA
| | - K Fizazi
- Gustave Roussy, Villejuif, France
| | - M J Morris
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - C S Higano
- University of Washington and Fred Hutchinson Cancer Research Center, Seattle, USA
| | - I F Tannock
- Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - E J Small
- University of California, San Francisco, San Francisco, USA
| | - W K Kelly
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, USA
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21
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Enevoldsen FC, Sahana J, Wehland M, Grimm D, Infanger M, Krüger M. Endothelin Receptor Antagonists: Status Quo and Future Perspectives for Targeted Therapy. J Clin Med 2020; 9:jcm9030824. [PMID: 32197449 PMCID: PMC7141375 DOI: 10.3390/jcm9030824] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 02/06/2023] Open
Abstract
The endothelin axis, recognized for its vasoconstrictive action, plays a central role in the pathology of pulmonary arterial hypertension (PAH). Treatment with approved endothelin receptor antagonists (ERAs), such as bosentan, ambrisentan, or macitentan, slow down PAH progression and relieves symptoms. Several findings have indicated that endothelin is further involved in the pathogenesis of certain other diseases, making ERAs potentially beneficial in the treatment of various conditions. In addition to PAH, this review summarizes the use and perspectives of ERAs in cancer, renal disease, fibrotic disorders, systemic scleroderma, vasospasm, and pain management. Bosentan has proven to be effective in systemic sclerosis PAH and in decreasing the development of vasospasm-related digital ulcers. The selective ERA clazosentan has been shown to be effective in preventing cerebral vasospasm and delaying ischemic neurological deficits and new infarcts. Furthermore, in the SONAR (Study Of Diabetic Nephropathy With Atrasentan) trial, the selective ERA atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease. These data suggest atrasentan as a new therapy in the treatment of diabetic nephropathy and possibly other renal diseases. Preclinical studies regarding heart failure, cancer, and fibrotic diseases have demonstrated promising effects, but clinical trials have not yet produced measurable results. Nevertheless, the potential benefits of ERAs may not be fully realized.
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Affiliation(s)
- Frederik C. Enevoldsen
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus C, Denmark; (F.C.E.); (J.S.); (D.G.)
| | - Jayashree Sahana
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus C, Denmark; (F.C.E.); (J.S.); (D.G.)
| | - Markus Wehland
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; (M.W.); (M.I.)
| | - Daniela Grimm
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus C, Denmark; (F.C.E.); (J.S.); (D.G.)
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; (M.W.); (M.I.)
| | - Manfred Infanger
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; (M.W.); (M.I.)
| | - Marcus Krüger
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; (M.W.); (M.I.)
- Correspondence: ; Tel.: +49-391-6721267
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22
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Zhao YQ, LeBlanc ML. Designing precision medicine trials to yield a greater population impact. Biometrics 2019; 76:643-653. [PMID: 31598964 DOI: 10.1111/biom.13161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 10/02/2019] [Indexed: 01/15/2023]
Abstract
Traditionally, a clinical trial is conducted comparing treatment to standard care for all patients. However, it could be inefficient given patients' heterogeneous responses to treatments, and rapid advances in the molecular understanding of diseases have made biomarker-based clinical trials increasingly popular. We propose a new targeted clinical trial design, termed as Max-Impact design, which selects the appropriate subpopulation for a clinical trial and aims to optimize population impact once the trial is completed. The proposed design not only gains insights on the patients who would be included in the trial but also considers the benefit to the excluded patients. We develop novel algorithms to construct enrollment rules for optimizing population impact, which are fairly general and can be applied to various types of outcomes. Simulation studies and a data example from the SWOG Cancer Research Network demonstrate the competitive performance of our proposed method compared to traditional untargeted and targeted designs.
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Affiliation(s)
- Ying-Qi Zhao
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Michael L LeBlanc
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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23
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Du S, Lin C, Tao YX. Updated mechanisms underlying sickle cell disease-associated pain. Neurosci Lett 2019; 712:134471. [PMID: 31505241 PMCID: PMC6815235 DOI: 10.1016/j.neulet.2019.134471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023]
Abstract
Sickle cell disease (SCD) is one of the most common severe genetic diseases around the world. A majority of SCD patients experience intense pain, leading to hospitalization, and poor quality of life. Opioids form the bedrock of pain management, but their long-term use is associated with severe side effects including hyperalgesia, tolerance and addiction. Recently, excellent research has shown some new potential mechanisms that underlie SCD-associated pain. This review focused on how transient receptor potential vanilloid 1, endothelin-1/endothelin type A receptor, and cannabinoid receptors contributed to the pathophysiology of SCD-associated pain. Understanding these mechanisms may open a new avenue in managing SCD-associated pain and improving quality of life for SCD patients.
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Affiliation(s)
- Shibin Du
- Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Corinna Lin
- Rutgers Graduate School of Biomedical Sciences, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Yuan-Xiang Tao
- Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA; Rutgers Graduate School of Biomedical Sciences, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA.
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24
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Moon HH, Clines KL, Cooks MA, Cialek CA, Esvelt MA, Clines GA. Castration Determines the Efficacy of ETAR Blockade in a Mouse Model of Prostate Cancer Bone Metastasis. Endocrinology 2019; 160:1786-1796. [PMID: 31173072 PMCID: PMC6610212 DOI: 10.1210/en.2019-00261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/24/2019] [Indexed: 02/08/2023]
Abstract
Bone metastasis is a painful complication of advanced prostate cancer. Endothelin-1 is a tumor-secreted factor that plays a central role in osteoblast activation and the osteosclerotic response of prostate cancer metastatic to bone. Antagonists that block the activation of the endothelin A receptor (ETAR), located on osteoblasts, reduce osteoblastic bone lesions in animal models of bone metastasis. However, ETAR antagonists demonstrated limited efficacy in clinical trials of men with advanced prostate cancer who also received standard androgen deprivation therapy (ADT). Previous data from our group suggested that, in a mouse model, ETAR antagonists might only be efficacious when androgen signaling in the osteoblast is lowered beyond the ability of standard ADT. This notion was tested in a mouse model of prostate cancer bone metastasis. Castrated and sham-operated male athymic nude mice underwent intracardiac inoculation of the ARCaPM castration-resistant prostate cancer cell line. The mice were then treated with either the ETAR antagonist zibotentan or a vehicle control to generate four experimental groups: vehicle+sham (Veh+Sham), vehicle+castrate (Veh+Castr), zibotentan+sham (Zibo+Sham), and zibotentan+castrate (Zibo+Castr). The mice were monitored radiographically for the development of skeletal lesions. The Zibo+Castr group had significantly longer survival and a single incidental lesion. Mice in the Zibo+Sham group had the shortest survival and the largest number of skeletal lesions. Survival and skeletal lesions of the Veh+Sham and Veh+Castr groups were intermediate compared with the zibotentan-treated groups. We report a complex interaction between ETAR and androgen signaling, whereby ETAR blockade was most efficacious when combined with complete androgen deprivation.
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Affiliation(s)
- Henry H Moon
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Katrina L Clines
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Mark A Cooks
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Charlotte A Cialek
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Marian A Esvelt
- Unit for Laboratory Medicine, University of Michigan, Ann Arbor, Michigan
| | - Gregory A Clines
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan
- Veterans Affairs Medical Center, Ann Arbor, Michigan
- Correspondence: Gregory A. Clines, MD, PhD, Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan, Endocrinology Section, Ann Arbor VA Medical Center, 2215 Fuller Road, Research 151, Ann Arbor, Michigan 48105. E-mail:
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25
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Gómez Rivas J, Carrion DM, Alvarez-Maestro M, Cathelineau X, Sanchez-Salas R, Di Lorenzo G, Di Maio M, Paul A, Martinez-Piñeiro L, Sartor O, Saad F, Debruyne F. Bone-targeted therapy in castration-resistant prostate cancer: where do we stand? MINERVA UROL NEFROL 2019; 71:445-456. [PMID: 31353876 DOI: 10.23736/s0393-2249.19.03420-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION In the last years, there have been significant developments in the therapeutic armamentarium of metastatic castration-resistant prostate cancer (mCRPC). New evidence shows that the addition of bone-targeted agents (BTA) to "life-prolonging agents" result in improved clinical benefit. This review aims to give an overview of data for the use of BTAs in a new era of mCRPC where new agents are used in daily practice. EVIDENCE ACQUISITION A non-systematic review of the literature was performed combining the keywords: "castration-resistant prostate cancer" and "bone-targeted therapy". The primary objective was to provide a critical assessment of data for the use of BTAs in mCRPC, and the secondary objective was to assess novel targeted therapy. EVIDENCE SYNTHESIS Zoledronic acid and denosumab have shown to be effective in reducing the risk of SREs in patients with mCRPC. The point at which treatment with bisphosphonates or denosumab should be initiated during PCa evolution has yet to be determined. The EMA has restricted the usage of Ra-223 to patients who have had two previous treatments for mCRPC to the bone or who cannot receive other treatments. Ra-223 should only be used as monotherapy or in combination with ADT for the treatment of mCRPC, symptomatic bone metastases and without visceral metastases. With recent developments in PSMA-targeted radiopharmaceuticals, PSMA RLT agents are now under investigation for the treatment of mCRPC. CONCLUSIONS Reducing skeletal-related morbidity remains a crucial goal of palliative life-extending therapy in mCRPC. New data about dosing schedules and combinations of different treatments will continue to refine the optimal strategy for incorporating BTAs into the new treatment paradigms for PCa. Novel molecules such as PSMA-targeted small molecules promise theranostic agents in the management of PCa patients.
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Affiliation(s)
- Juan Gómez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain - .,Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain -
| | - Diego M Carrion
- Department of Urology, La Paz University Hospital, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Mario Alvarez-Maestro
- Department of Urology, La Paz University Hospital, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | | | | | | | - Massimo Di Maio
- Division of Medical Oncology, Mauriziano Hospital, Turin, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Asit Paul
- Virginia Commonwealth University, Richmond, VA, USA
| | - Luis Martinez-Piñeiro
- Department of Urology, La Paz University Hospital, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Oliver Sartor
- Tulane Cancer Center, Tulane University Medical School, New Orleans, LA, USA
| | - Fred Saad
- Unit of Cancer Prognostics and Health Outcomes, University of Montreal Health Center, Montreal, QC, Canada
| | - Francis Debruyne
- Department of Urology, Andros Men's and Gynos Women's Health Institutes, Arnhem, the Netherlands
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26
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Marandino L, De Luca E, Zichi C, Lombardi P, Reale ML, Pignataro D, Di Stefano RF, Ghisoni E, Mariniello A, Trevisi E, Leone G, Muratori L, La Salvia A, Sonetto C, Buttigliero C, Tucci M, Aglietta M, Novello S, Scagliotti GV, Perrone F, Di Maio M. Quality-of-Life Assessment and Reporting in Prostate Cancer: Systematic Review of Phase 3 Trials Testing Anticancer Drugs Published Between 2012 and 2018. Clin Genitourin Cancer 2019; 17:332-347.e2. [PMID: 31416754 DOI: 10.1016/j.clgc.2019.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/06/2019] [Accepted: 07/15/2019] [Indexed: 01/20/2023]
Abstract
Quality of life (QoL) is not included among the end points in many studies, and QoL results are underreported in many phase 3 oncology trials. We performed a systematic review to describe QoL prevalence and heterogeneity in QoL reporting in recently published prostate cancer phase 3 trials. A PubMed search was performed to identify primary publications of randomized phase 3 trials testing anticancer drugs in prostate cancer, issued between 2012 and 2018. We analyzed QoL inclusion among end points, presence of QoL results, and methodology of QoL analysis. Seventy-two publications were identified (15 early-stage, 20 advanced hormone-sensitive, and 37 castration-resistant prostate cancer [CRPC]). QoL was not listed among study end points in 23 studies (31.9%) (40.0% early stage, 40.0% advanced hormone sensitive, and 24.3% CRPC). QoL results were absent in 15 (30.6%) of 49 primary publications of trials that included QoL among end points. Overall, as a result of absent end point or unpublished results, QoL data were lacking in 38 (52.8%) primary publications (53.3% early stage, 55.0% in advanced hormone sensitive, and 51.4% in CRPC). The most commonly used QoL tools were Functional Assessment of Cancer Therapy-Prostate (FACT-P) (21, 53.8%) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) (14, 35.9%); most common methods of analysis were mean changes or mean scores (28, 71.8%), time to deterioration (14, 35.9%), and proportion of patients with response (10, 25.6%). In conclusion, QoL data are lacking in a not negligible proportion of recently published phase 3 trials in prostate cancer, although the presence of QoL results is better in positive trials, especially in CRPC. The methodology of QoL analysis is heterogeneous for type of instruments, analysis, and presentation of results.
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Affiliation(s)
- Laura Marandino
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Emmanuele De Luca
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy
| | - Clizia Zichi
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy
| | - Pasquale Lombardi
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Maria Lucia Reale
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Daniele Pignataro
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Rosario F Di Stefano
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Eleonora Ghisoni
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Annapaola Mariniello
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Elena Trevisi
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Leonardo Muratori
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Anna La Salvia
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Consuelo Buttigliero
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Marcello Tucci
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Massimo Aglietta
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Giorgio V Scagliotti
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Francesco Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale"-IRCCS, Naples, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy.
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Abstract
Bone metastases are the main driver of morbidity and mortality in advanced prostate cancer. Targeting the bone microenvironment, a key player in the pathogenesis of bone metastasis, has become one of the mainstays of therapy in men with advanced prostate cancer. This review will evaluate the data supporting the use of bone-targeted therapy, including (1) bisphosphonates such as zoledronic acid, which directly target osteoclasts, (2) denosumab, a receptor activator of nuclear factor-kappa B (RANK) ligand inhibitor, which targets a key component of bone stromal interaction, and (3) radium-223, an alpha-emitting calcium mimetic, which hones to the metabolically active areas of osteoblastic metastasis and induces double-strand breaks in the DNA. Denosumab has shown enhanced delay in skeletal-related events compared to zoledronic acid in patients with metastatic castration-resistant prostate cancer (mCRPC). Data are mixed with regard to pain control as a primary measure of efficacy. New data call into question dosing frequency, with quarterly dosing strategy potentially achieving similar effect compared to monthly dosing for zoledronic acid. In the case of radium-223, there are data for both pain palliation and improved overall survival in mCRPC. Further studies are needed to optimize timing and combination strategies for bone-targeted therapies. Ongoing studies will explore the impact of combining bone-targeted therapy with investigational therapeutic agents such as immunotherapy, for advanced prostate cancer. Future studies should strive to develop biomarkers of response, in order to improve efficacy and cost-effectiveness of these agents.
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Affiliation(s)
- Tanya B Dorff
- USC Keck School of Medicine, USC Norris Comprehensive Cancer Center, Genitourinary Oncology, Los Angeles, CA 90033, USA
| | - Neeraj Agarwal
- Hunts Man Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USA
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28
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Heath E, Heilbrun L, Mannuel H, Liu G, Lara P, Monk JP, Flaig T, Zurita A, Mack P, Vaishampayan U, Stella P, Smith D, Bolton S, Hussain A, Al-Janadi A, Silbiger D, Usman M, Ivy SP. Phase II, Multicenter, Randomized Trial of Docetaxel plus Prednisone with or Without Cediranib in Men with Chemotherapy-Naive Metastatic Castrate-Resistant Prostate Cancer. Oncologist 2019; 24:1149-e807. [PMID: 31152080 PMCID: PMC6738301 DOI: 10.1634/theoncologist.2019-0331] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 04/23/2019] [Indexed: 02/06/2023] Open
Abstract
Lessons Learned. The negative results are consistent with the negative results of large phase III trials in which docetaxel plus antiangiogenic agents were used in patients with metastatic castrate‐resistant prostate cancer (mCRPC). The negative data underscore that, despite a sound biological rationale and supportive early‐phase clinical results, adding antiangiogenic agents to docetaxel for mCRPC is a great challenge.
Background. Inhibition of vascular endothelial growth factor (VEGF) signaling abrogates tumor‐induced angiogenesis to constrain tumor growth, and can be exploited therapeutically by using cediranib, an oral tyrosine kinase inhibitor of VEGF receptor signaling. Our preliminary phase I trial data showed that adding cediranib to docetaxel plus prednisone (DP) was safe and feasible, with early evidence for efficacy in patients with metastatic castrate‐resistant prostate cancer (mCRPC). Methods. This multicenter phase II trial assessed whether adding cediranib to DP improves efficacy of DP in patients with mCRPC. Chemotherapy‐naive patients with mCRPC were randomly assigned to receive either docetaxel (75 mg/m2 intravenously every 3 weeks) with prednisone (5 mg twice daily) plus cediranib (30 mg once daily; the DP+C arm) or DP only (the DP arm). The primary endpoint was to compare 6‐month progression‐free survival (PFS) rate between the two arms. Secondary endpoints included 6‐month overall survival (OS), objective tumor and prostate‐specific antigen (PSA) response rates, biomarkers, and adverse events. Results. The 6‐month PFS rate in a total of 58 patients was only numerically higher in the DP+C arm (61%) compared with the DP arm (57%). Similarly, the 6‐month OS rate, objective tumor and PSA response rates, and biomarkers were not significantly different between the two arms. Increased baseline levels of interleukin 6 (IL‐6), however, were significantly associated with increased risk of progression. Neutropenia was the only grade 4 toxicity (38% in the DP+C arm vs. 18% in the DP arm). Conclusion. Combining cediranib with docetaxel + prednisone failed to demonstrate superior efficacy, compared with docetaxel + prednisone, and added toxicity. Our data do not support pursuing the combination further in patients with mCRPC.
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Affiliation(s)
- Elisabeth Heath
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Lance Heilbrun
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Heather Mannuel
- Division of Hematology/Oncology, University of Maryland School of Medicine and Greenebaum Cancer Center, Baltimore, Maryland, USA
| | - Glenn Liu
- Division of Hematology/Oncology, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, Wisconsin, USA
| | - Primo Lara
- Division of Hematology/Oncology, University of California Davis School of Medicine and Cancer Center, Sacramento, California, USA
| | - J Paul Monk
- Division of Medical Oncology, Ohio State University School of Medicine and Cancer Center - James, Columbus, Ohio, USA
| | - Thomas Flaig
- Division of Medical Oncology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Amado Zurita
- Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Philip Mack
- Division of Hematology/Oncology, University of California Davis School of Medicine and Cancer Center, Sacramento, California, USA
| | - Ulka Vaishampayan
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan, USA
| | | | - Daryn Smith
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Susan Bolton
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Arif Hussain
- Division of Hematology/Oncology, University of Maryland School of Medicine and Greenebaum Cancer Center, Baltimore, Maryland, USA
| | - Anas Al-Janadi
- Michigan State University Breslin Cancer Center, Lansing, Michigan, USA
| | - Daniel Silbiger
- Case Western Reserve University School of Medicine University Hospitals, Cleveland, Ohio, USA
| | - Muhammad Usman
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan, USA
| | - S Percy Ivy
- National Institutes of Health National Cancer Institute, Bethesda, Maryland, USA
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29
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Zhao YQ, Zeng D, Tangen CM, LeBlanc ML. Robustifying Trial-Derived Optimal Treatment Rules for A Target Population. Electron J Stat 2019; 13:1717-1743. [PMID: 31440323 DOI: 10.1214/19-ejs1540] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Treatment rules based on individual patient characteristics that are easy to interpret and disseminate are important in clinical practice. Properly planned and conducted randomized clinical trials are used to construct individualized treatment rules. However, it is often a concern that trial participants lack representativeness, so it limits the applicability of the derived rules to a target population. In this work, we use data from a single trial study to propose a two-stage procedure to derive a robust and parsimonious rule to maximize the benefit in the target population. The procedure allows a wide range of possible covariate distributions in the target population, with minimal assumptions on the first two moments of the covariate distribution. The practical utility and favorable performance of the methodology are demonstrated using extensive simulations and a real data application.
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Affiliation(s)
- Ying-Qi Zhao
- Associate Member, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109
| | - Donglin Zeng
- Professor, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599
| | - Catherine M Tangen
- Member, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109
| | - Michael L LeBlanc
- Member, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109
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30
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Shevach J, Sydes MR, Hussain M. Revisiting Intermittent Therapy in Metastatic Prostate Cancer: Can Less Be More in the "New World Order"? Eur Urol Focus 2019; 5:125-133. [PMID: 30803926 DOI: 10.1016/j.euf.2019.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/24/2019] [Accepted: 02/04/2019] [Indexed: 01/23/2023]
Abstract
CONTEXT Androgen deprivation therapy (ADT) is the standard of care for men with metastatic hormone-sensitive prostate cancer (HSPC) and a potential treatment option in those with prostate-specific antigen relapse after local therapy. Based on promising biological and preclinical data, several clinical trials compared the efficacy of intermittent androgen deprivation (IAD) versus continuous androgen deprivation (CAD) with the objective of delaying disease progression and improving survival and quality of life (QoL). OBJECTIVE The objective of this review is to revisit the concept of IAD in the "new world order" and reconsider whether it has a potential clinical role in an era where we have seen unprecedented progress in the management of patients with metastatic HSPC. EVIDENCE ACQUISITION MEDLINE, Embase, and the Cochrane Library databases were searched for randomized controlled trials comparing IAD and CAD therapies. References of retrieved articles were also searched. Articles with at least 100 randomized patients, which were published in 2008 or later and had data on overall survival or QoL outcomes, were included. EVIDENCE SYNTHESIS The evidence to date cannot exclude inferiority of IAD compared with CAD with respect to survival outcomes. The hazard ratios in metastatic disease indicate less favorable survival with IAD. No superiority trial conclusively favored IAD or CAD. Two trials demonstrated noninferiority of IAD, although the noninferiority margins (NIMs) are clinically concerning. Another trial could not exclude noninferiority. A modest but temporary QoL and symptom benefit generally favoring IAD was observed. CONCLUSIONS IAD has not conclusively demonstrated an impact on disease progression or survival, and has only modest effects on QoL and symptoms measured in the short term. As such, it is not the standard of care, particularly in the era where we have seen unprecedented survival impact with combination ADT+docetaxel or abiraterone +prednisone. IAD may need to be reassessed in the context of current therapies, ideally driven by biological rationale, with the goal of minimizing physical and financial toxicities with appropriately designed informative clinical trials. PATIENT SUMMARY In this report, we looked at two hormone therapy approaches for prostate cancer that is still sensitive to castration: one with treatment breaks and one without. Patients may tolerate therapy with breaks more easily, but this effect is not sustained and is not associated with better longevity. The best longevity is seen in patients who receive newer hormone therapies or chemotherapy in addition to continuous hormone therapy. Whether these newer therapies would be as effective if given intermittently is an important but unanswered question.
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Affiliation(s)
- Jeffrey Shevach
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Maha Hussain
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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31
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Halabi S, Dutta S, Tangen CM, Rosenthal M, Petrylak DP, Thompson IM, Chi KN, Araujo JC, Logothetis C, Quinn DI, Fizazi K, Morris MJ, Eisenberger MA, George DJ, De Bono JS, Higano CS, Tannock IF, Small EJ, Kelly WK. Overall Survival of Black and White Men With Metastatic Castration-Resistant Prostate Cancer Treated With Docetaxel. J Clin Oncol 2018; 37:403-410. [PMID: 30576268 DOI: 10.1200/jco.18.01279] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Several studies have reported that among patients with localized prostate cancer, black men have a shorter overall survival (OS) time than white men, but few data exist for men with advanced prostate cancer. The primary goal of this analysis was to compare the OS in black and white men with metastatic castration-resistant prostate cancer (mCRPC) who were treated in phase III clinical trials with docetaxel plus prednisone (DP) or a DP-containing regimen. METHODS Individual participant data from 8,820 men with mCRPC randomly assigned in nine phase III trials to DP or a DP-containing regimen were combined. Race was based on self-report. The primary end point was OS. The Cox proportional hazards regression model was used to assess the prognostic importance of race (black v white) adjusted for established risk factors common across the trials (age, prostate-specific antigen, performance status, alkaline phosphatase, hemoglobin, and sites of metastases). RESULTS Of 8,820 men, 7,528 (85%) were white, 500 (6%) were black, 424 (5%) were Asian, and 368 (4%) were of unknown race. Black men were younger and had worse performance status, higher testosterone and prostate-specific antigen, and lower hemoglobin than white men. Despite these differences, the median OS was 21.0 months (95% CI, 19.4 to 22.5 months) versus 21.2 months (95% CI, 20.8 to 21.7 months) in black and white men, respectively. The pooled multivariable hazard ratio of 0.81 (95% CI, 0.72 to 0.91) demonstrates that overall, black men have a statistically significant decreased risk of death compared with white men ( P < .001). CONCLUSION When adjusted for known prognostic factors, we observed a statistically significant increased OS in black versus white men with mCRPC who were enrolled in these clinical trials. The mechanism for these differences is not known.
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Affiliation(s)
| | | | | | - Mark Rosenthal
- 3 The Royal Melbourne Hospital, Parkville, VIC, Australia
| | | | | | - Kim N Chi
- 6 BC Cancer Agency Vancouver Centre, Vancouver, BC
| | - John C Araujo
- 7 The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - David I Quinn
- 8 University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | | | - Mario A Eisenberger
- 11 The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | | | - Johann S De Bono
- 12 The Institute of Cancer Research and The Royal Marsden National Health Service Foundation Trust, Sutton, United Kingdom
| | | | - Ian F Tannock
- 13 Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Eric J Small
- 14 University of California San Francisco, San Francisco, CA
| | - William Kevin Kelly
- 15 Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA
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32
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Liu F, Sun D, Zhou X, Ding Y, Ma Y, Hou Y, Kong X, Wang Z. Effect of adjuvant hormone therapy in patients with prostate cancer: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e13145. [PMID: 30557966 PMCID: PMC6319968 DOI: 10.1097/md.0000000000013145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To summarize the evidence regarding the treatment effect of adjuvant hormone therapy (AHT) in patients with prostate cancer (PCa). AHT following radiotherapy, chemotherapy, or surgery is widely used in patients with PCa. However, the treatment effect is inconsistent in individual trials. METHODS The electronic databases including PubMed, EmBase, and Cochrane Library were searched to identify randomized controlled trials (RCTs) in September 2016. RCTs that evaluated the effects of AHT in patients with PCa were included. Hazard ratio (HR) and relative risks (RR) were used to measure the treatment effects of AHT using a random effects model. The analyses were further stratified by factors that could affect the treatment efficacy. RESULTS A total of 14,594 potential studies were identified, and 27 RCTs were included. Compared with the control group, patients who received AHT were associated with a significant improvement in overall survival (OS) (HR: 0.78; 95% confidence interval [CI]: 0.71-0.85; P <.001), disease-free survival (DFS) (HR: 0.50; 95% CI: 0.39-0.65; P <.001), total mortality (RR: 0.90; 95% CI: 0.85-0.96; P = .001), recurrence (RR: 0.70; 95% CI: 0.60-0.81; P <.001), and disease-specific mortality (RR: 0.70; 95% CI: 0.56-0.87; P <.001). However, no significant difference was observed between AHT and control for response rate (RR: 1.75; 95% CI: 0.91-3.37; P = .095). CONCLUSIONS The findings of this meta-analysis confirmed that patients who received AHT had a significant improvement in OS, DFS, total mortality, recurrence, and disease-specific mortality. Further, large-scale RCTs are required to evaluate the treatment effect in specific subpopulations.
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Affiliation(s)
| | | | | | - Youpeng Ding
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, P.R.China
| | - Yanan Ma
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, P.R.China
| | - Yi Hou
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, P.R.China
| | - Xiangbo Kong
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, P.R.China
| | - Zhixin Wang
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, P.R.China
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33
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N��ez-Iglesias M, Novio S, Garc�a-Santiago C, Cartea M, Soengas P, Velasco P, Freire-Garabal M. Effects of 3-butenyl isothiocyanate on phenotypically different prostate cancer cells. Int J Oncol 2018; 53:2213-2223. [DOI: 10.3892/ijo.2018.4545] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 06/27/2018] [Indexed: 11/05/2022] Open
Affiliation(s)
- M.j. N��ez-Iglesias
- Screening of New Libraries Laboratory, School of Medicine and Dentistry, University of Santiago de Compostela, 15782 A Coru�a, Spain
| | - S. Novio
- Screening of New Libraries Laboratory, School of Medicine and Dentistry, University of Santiago de Compostela, 15782 A Coru�a, Spain
| | - C. Garc�a-Santiago
- Screening of New Libraries Laboratory, School of Medicine and Dentistry, University of Santiago de Compostela, 15782 A Coru�a, Spain
| | - M.e. Cartea
- Group of Genetics, Breeding and Biochemistry of Brassicas, Biological Mission of Galicia, CSIC, 36143 Pontevedra, Spain
| | - P. Soengas
- Group of Genetics, Breeding and Biochemistry of Brassicas, Biological Mission of Galicia, CSIC, 36143 Pontevedra, Spain
| | - P. Velasco
- Group of Genetics, Breeding and Biochemistry of Brassicas, Biological Mission of Galicia, CSIC, 36143 Pontevedra, Spain
| | - M. Freire-Garabal
- Screening of New Libraries Laboratory, School of Medicine and Dentistry, University of Santiago de Compostela, 15782 A Coru�a, Spain
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34
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Ganaie AA, Beigh FH, Astone M, Ferrari MG, Maqbool R, Umbreen S, Parray AS, Siddique HR, Hussain T, Murugan P, Morrissey C, Koochekpour S, Deng Y, Konety BR, Hoeppner LH, Saleem M. BMI1 Drives Metastasis of Prostate Cancer in Caucasian and African-American Men and Is A Potential Therapeutic Target: Hypothesis Tested in Race-specific Models. Clin Cancer Res 2018; 24:6421-6432. [PMID: 30087142 DOI: 10.1158/1078-0432.ccr-18-1394] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/11/2018] [Accepted: 08/01/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Metastasis is the major cause of mortality in prostate cancer patients. Factors such as genetic makeup and race play critical role in the outcome of therapies. This study was conducted to investigate the relevance of BMI1 in metastatic prostate cancer disease in Caucasian and African-Americans. EXPERIMENTAL DESIGN We employed race-specific prostate cancer models, clinical specimens, clinical data mining, gene-microarray, transcription-reporter assay, chromatin-immunoprecipitation (ChIP), IHC, transgenic-(tgfl/fl) zebrafish, and mouse metastasis models. RESULTS BMI1 expression was observed to be elevated in metastatic tumors (lymph nodes, lungs, bones, liver) of Caucasian and African-American prostate cancer patients. The comparative analysis of stage III/IV tumors showed an increased BMI1 expression in African-Americans than Caucasians. TCGA and NIH/GEO clinical data corroborated to our findings. We show that BMI1 expression (i) positively correlates to metastatic (MYC, VEGF, cyclin D1) and (ii) negative correlates to tumor suppressor (INKF4A/p16, PTEN) levels in tumors. The correlation was prominent in African-American tumors. We show that BMI1 regulates the transcriptional activation of MYC, VEGF, INKF4A/p16, and PTEN. We show the effect of pharmacological inhibition of BMI1 on the metastatic genome and invasiveness of tumor cells. Next, we show the anti-metastatic efficacy of BMI1-inhibitor in transgenic zebrafish and mouse metastasis models. Docetaxel as monotherapy has poor outcome on the growth of metastatic tumors. BMI1 inhibitor as an adjuvant improved the taxane therapy in race-based in vitro and in vivo models. CONCLUSIONS BMI1, a major driver of metastasis, represents a promising therapeutic target for treating advanced prostate cancer in patients (including those belonging to high-risk group).
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Affiliation(s)
- Arsheed A Ganaie
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Firdous H Beigh
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Matteo Astone
- Department of Molecular Biology and Translational Cancer Research, Hormel Institute, Austin, Minnesota
| | - Marina G Ferrari
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Raihana Maqbool
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Syed Umbreen
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Aijaz S Parray
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Institute of Neurosciences, Academic Health Systems Hamad Medical Corporation, Doha, Qatar
| | - Hifzur R Siddique
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Aligarh University, Aligarh, Uttar Pradesh, India
| | - Tabish Hussain
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Paari Murugan
- Department of Lab Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Colm Morrissey
- Department of Urology, University of Washington, Seattle, Washington
| | - Shahriar Koochekpour
- Department of Cancer Genetics and Genomics, Roswell Park Cancer Center, Buffalo, New York
| | - Yibin Deng
- Department of Mouse Genetics, Hormel Institute, Austin, Minnesota
| | - Badrinath R Konety
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Luke H Hoeppner
- Department of Molecular Biology and Translational Cancer Research, Hormel Institute, Austin, Minnesota
| | - Mohammad Saleem
- Department of Urology, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
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35
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Heinrich D, Bruland Ø, Guise TA, Suzuki H, Sartor O. Alkaline phosphatase in metastatic castration-resistant prostate cancer: reassessment of an older biomarker. Future Oncol 2018; 14:2543-2556. [PMID: 29925281 DOI: 10.2217/fon-2018-0087] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Since most patients with metastatic castration-resistant prostate cancer (mCRPC) have bone metastases, it is important to understand the potential impact of therapies on prognostic biomarkers, such as ALP. Clinical studies involving mCRPC life-prolonging agents (i.e., sipuleucel-T, abiraterone, enzalutamide, docetaxel, cabazitaxel, and radium-223) have shown that baseline ALP level is prognostic for overall survival, and may be a better prognostic marker for overall survival than prostate-specific antigen in patients with bone-dominant mCRPC. Mechanism of action differences between therapies may partly explain ALP dynamics during treatment. ALP changes can be interpreted within the context of other parameters while monitoring disease activity to better understand the underlying pathology. This review evaluates the current role of ALP in mCRPC.
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Affiliation(s)
- Daniel Heinrich
- Department of Oncology, Akershus University Hospital, Sykehusveien 25, 1478 Lørenskog, Norway
| | - Øyvind Bruland
- Department of Oncology, Oslo University Hospital-Norwegian Radium Hospital, Ullernchausseen 70, 0379 Oslo, Norway
| | - Theresa A Guise
- Department of Medicine, Indiana University School of Medicine, 980 W. Walnut St, Walther Hall, R3, Room C130 Indianapolis, IN 46202, USA
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimazu, Sakura-shi, Chiba 285-8741, Japan
| | - Oliver Sartor
- Departments of Medicine & Urology, Tulane Cancer Center, 1430 Tulane Ave., SL-42, New Orleans, LA 70112, USA
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36
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Unger JM, Griffin K, Donaldson GW, Baranowski KM, Good MJ, Reburiano E, Hussain M, Monk PJ, Van Veldhuizen PJ, Carducci MA, Higano CS, Lara PN, Tangen CM, Quinn DI, Wade JL, Vogelzang NJ, Thompson IM, Moinpour CM. Patient-reported outcomes for patients with metastatic castration-resistant prostate cancer receiving docetaxel and Atrasentan versus docetaxel and placebo in a randomized phase III clinical trial (SWOG S0421). J Patient Rep Outcomes 2018; 2:27. [PMID: 29951640 PMCID: PMC5997724 DOI: 10.1186/s41687-018-0054-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/21/2018] [Indexed: 01/22/2023] Open
Abstract
Background SWOG S0421 was a large randomized trial comparing docetaxel/prednisone plus placebo (DPP) to docetaxel/prednisone plus atrasentan over 12 cycles for patients with metastatic castration-resistant prostate cancer (mCRPC). The current report presents the PRO results for this trial, an important secondary endpoint. Methods The trial specified two primary PRO endpoints. Palliation of worst pain was based on the Brief Pain Inventory (BPI), where a 2 point difference is defined as clinically meaningful. Improvement of functional status was based on the Functional Assessment of Cancer Therapy – Prostate Cancer Trial Outcome Index (FACT-P TOI); a 5-point difference has been defined as clinically meaningful. We compared rates by arm using chi-square tests. Longitudinal analyses using linear mixed models addressed changes by arm over time. Results Four-hundred eighty-nine patients on each arm were evaluable for PRO endpoint data. There were no differences by arm in clinically meaningful pain palliation (41.7% for DPP vs. 44.0% for DPA, p = .70) or functional status (24.2% for DPP vs. 28.7% for DPA, p = .13). Longitudinal comparisons indicated no differences over time by arm for BPI Worst Pain scores (0.13 points, p = .23). Patients on the DPA arm had improved functional status of 1.78 points on average, a statistically significant (p = .02) but not clinically meaningful difference. Conclusions The SWOG S0421 PRO data showed little evidence of clinically meaningful differences by arm in either pain palliation or functional status. Electronic supplementary material The online version of this article (10.1186/s41687-018-0054-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joseph M Unger
- 1SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA USA.,17Fred Hutchinson Cancer Research Center, M3-C102/P.O. Box 19024, 1100 Fairview Avenue North, Seattle, WA 98109-1024 USA
| | - Katherine Griffin
- 1SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | | | | | | | | | - Maha Hussain
- 6Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL USA
| | - Paul J Monk
- 7The Ohio State University James Cancer Hospital, Columbus, OH USA
| | | | | | - Celestia S Higano
- 10Pacific Cancer Research Consortium NCORP, Seattle Cancer Care Alliance, University of Washington, Seattle, WA USA
| | - Primo N Lara
- 11University of California at Davis, Sacramento, CA USA
| | - Catherine M Tangen
- 1SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - David I Quinn
- 12University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA USA
| | - James L Wade
- 1SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA USA.,2University of Utah, Salt Lake City, UT USA.,3Karmanos Cancer Center, Farmington Hills, MI USA.,4National Cancer Institute, Washington, DC USA.,ICON PLCC, Philadelphia, PA USA.,6Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL USA.,7The Ohio State University James Cancer Hospital, Columbus, OH USA.,Sarah Cannon Cancer Center, Kansas City, KS USA.,9Johns Hopkins University School of Medicine, Baltimore, MD USA.,10Pacific Cancer Research Consortium NCORP, Seattle Cancer Care Alliance, University of Washington, Seattle, WA USA.,11University of California at Davis, Sacramento, CA USA.,12University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA USA.,Heartland NCORP, Decatur, IL USA.,US Oncology Research Comprehensive Cancer Centers, Las Vegas, NV USA.,15CHRISTUS Santa Rosa Hospital Medical Center, San Antonio, TX USA.,16Fred Hutchinson Cancer Research Center, Seattle, WA USA.,17Fred Hutchinson Cancer Research Center, M3-C102/P.O. Box 19024, 1100 Fairview Avenue North, Seattle, WA 98109-1024 USA
| | | | - Ian M Thompson
- 1SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA USA.,2University of Utah, Salt Lake City, UT USA.,3Karmanos Cancer Center, Farmington Hills, MI USA.,4National Cancer Institute, Washington, DC USA.,ICON PLCC, Philadelphia, PA USA.,6Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL USA.,7The Ohio State University James Cancer Hospital, Columbus, OH USA.,Sarah Cannon Cancer Center, Kansas City, KS USA.,9Johns Hopkins University School of Medicine, Baltimore, MD USA.,10Pacific Cancer Research Consortium NCORP, Seattle Cancer Care Alliance, University of Washington, Seattle, WA USA.,11University of California at Davis, Sacramento, CA USA.,12University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA USA.,Heartland NCORP, Decatur, IL USA.,US Oncology Research Comprehensive Cancer Centers, Las Vegas, NV USA.,15CHRISTUS Santa Rosa Hospital Medical Center, San Antonio, TX USA.,16Fred Hutchinson Cancer Research Center, Seattle, WA USA.,17Fred Hutchinson Cancer Research Center, M3-C102/P.O. Box 19024, 1100 Fairview Avenue North, Seattle, WA 98109-1024 USA
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Shupp AB, Kolb AD, Mukhopadhyay D, Bussard KM. Cancer Metastases to Bone: Concepts, Mechanisms, and Interactions with Bone Osteoblasts. Cancers (Basel) 2018; 10:E182. [PMID: 29867053 PMCID: PMC6025347 DOI: 10.3390/cancers10060182] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/29/2018] [Accepted: 05/31/2018] [Indexed: 12/31/2022] Open
Abstract
The skeleton is a unique structure capable of providing support for the body. Bone resorption and deposition are controlled in a tightly regulated balance between osteoblasts and osteoclasts with no net bone gain or loss. However, under conditions of disease, the balance between bone resorption and deposition is upset. Osteoblasts play an important role in bone homeostasis by depositing new bone osteoid into resorption pits. It is becoming increasingly evident that osteoblasts additionally play key roles in cancer cell dissemination to bone and subsequent metastasis. Our laboratory has evidence that when osteoblasts come into contact with disseminated breast cancer cells, the osteoblasts produce factors that initially reduce breast cancer cell proliferation, yet promote cancer cell survival in bone. Other laboratories have demonstrated that osteoblasts both directly and indirectly contribute to dormant cancer cell reactivation in bone. Moreover, we have demonstrated that osteoblasts undergo an inflammatory stress response in late stages of breast cancer, and produce inflammatory cytokines that are maintenance and survival factors for breast cancer cells and osteoclasts. Advances in understanding interactions between osteoblasts, osteoclasts, and bone metastatic cancer cells will aid in controlling and ultimately preventing cancer cell metastasis to bone.
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Affiliation(s)
- Alison B Shupp
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
| | - Alexus D Kolb
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
| | - Dimpi Mukhopadhyay
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
| | - Karen M Bussard
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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38
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Brown LC, Sonpavde G, Armstrong AJ. Can RECIST response predict success in phase 3 trials in men with metastatic castration-resistant prostate cancer? Prostate Cancer Prostatic Dis 2018; 21:419-430. [PMID: 29858595 DOI: 10.1038/s41391-018-0049-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/11/2018] [Accepted: 03/19/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Intermediate endpoints are needed in early phase studies of men with metastatic castration-resistant prostate cancer (mCRPC) that can reliably predict success in phase 3 trials. Among men with measurable disease, objective response may provide information as to whether a treatment is likely to be successful. METHODS We conducted a systematic review of systemic agents that have proceeded to phase 3 trials in men with mCRPC and examined the relationship between improvements in measurable disease response in phase 2 trials and successful phase 3 trials leading to regulatory approval. Only trials that included men with radiographically measurable disease were included. RESULTS We examined 31 eligible mCRPC phase 3 trials between 1992 and 2017 and 29 of the preceding phase 2 trials for RECIST responses. Measurable tumor responses in phase 2 trials were higher for successful therapies in phase 3 trials in chemotherapy-naive men with mCRPC, but were less correlated with success in trials investigating docetaxel combination regimens or the post chemotherapy mCRPC setting. Many failed agents did not produce higher than expected response rates over control arms; however, several agents such as anti-angiogenic therapies or orteronel produced higher than expected responses without survival benefit. CONCLUSIONS Objective responses in men with mCRPC may be associated with prolonged survival, but this association is mechanism dependent and inconsistent across trials or disease states. These data support considering RECIST response as a supportive but not sole endpoint in phase 2 trials to support launching phase 3 trials.
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Affiliation(s)
- Landon C Brown
- Department of Medicine, School of Medicine, Duke University, Durham, NC, USA
| | | | - Andrew J Armstrong
- Department of Medicine, School of Medicine, Duke University, Durham, NC, USA. .,Duke Cancer Institute and the Duke Prostate and Urologic Cancer Center, Duke University, Durham, NC, USA.
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39
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Wang Y, Zhang H, Shen W, He P, Zhou Z. Effectiveness and tolerability of targeted drugs for the treatment of metastatic castration-resistant prostate cancer: a network meta-analysis of randomized controlled trials. J Cancer Res Clin Oncol 2018; 144:1751-1768. [PMID: 29797220 DOI: 10.1007/s00432-018-2664-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 05/08/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE Castration-resistant prostate cancer (CRPC) refers to prostate cancer that has progressed after initial androgen deprivation therapy (ADT). Over the years, treatment strategies for metastatic CRPC (mCRPC) have undergone considerable changes. We performed a network meta-analysis to assess the effectiveness and tolerability of targeted agents for mCRPC. METHODS We search databases including MEDLINE, EMBASE, and the Cochrane Library through Sep 5, 2017. The major effectiveness outcomes were progression-free survival (PFS) and overall survival (OS). The tolerability outcome was severe adverse events (AEs) of grade ≥ 3. RESULTS Twenty-six articles assessing a total of 20,314 patients were included in this study. A random-effect analysis showed that targeted agents could significant prolong PFS in mCRPC patients (I2 = 94.3%; hazard ratio (HR): 0.74; 95% confidence interval (CI): 0.65-0.84; p < 0.001). In addition, the surface under the cumulative ranking curve (SUCRA) ranking from the network analysis showed that enzalutamide was the most effective in improving the PFS of mCRPC patients (100%), followed by abiraterone (90.1%) and tasquinimod (84.2%). Additionally, targeted agents could clearly prolong OS in mCRPC patients (I2 = 71.6%; HR: 0.91; 95% CI: 0.85-0.97; p < 0.001). Furthermore, based on SUCRA ranking, enzalutamide was the most effective in improving the OS of mCRPC patients (97.2%), followed by abiraterone (91.1%) and zibotentan (65.8%). Intetumumab was associated with the lowest incidence of severe AEs (94.9%), followed by atrasentan (85.1%) and placebo (79.3%). CONCLUSION In patients with mCRPC, enzalutamide, abiraterone and tasquinimod can prolong PFS, and enzalutamide and abiraterone can prolong OS. Additionally, enzalutamide and abiraterone can improve both PFS and OS with a low risk of causing severe AEs.
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Affiliation(s)
- Yongquan Wang
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Heng Zhang
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Wenhao Shen
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Peng He
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Zhansong Zhou
- Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
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Lara PN, Plets M, Tangen C, Gertz E, Vogelzang NJ, Hussain M, Twardowski PW, Garzotto MG, Monk JP, Carducci M, Goldkorn A, Mack PC, Thompson I, Van Loan M, Quinn DI. Bone turnover biomarkers identify unique prognostic risk groups in men with castration resistant prostate cancer and skeletal metastases: Results from SWOG S0421. Cancer Treat Res Commun 2018; 16:18-23. [PMID: 31298998 DOI: 10.1016/j.ctarc.2018.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/19/2018] [Accepted: 04/26/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Skeletal metastases often occur in men with castration-resistant prostate cancer (CRPC) where bone biomarkers are prognostic for overall survival (OS). In those with highly elevated markers, there is preferential benefit from bone-targeted therapy. In the phase IIIS0421 docetaxel +/- atrasentan trial, clinical covariates and bone biomarkers were analyzed to identify CRPC subsets with differential outcomes. SUBJECTS AND METHODS Markers of bone resorption [N-telopeptide-NTx; pyridinoline-PYD] and formation [C-terminal collagen propeptide-CICP; bone alkaline phosphatase-BAP] were measured in pre-treatment sera. Bone biomarkers and clinical covariates were included in a Cox model for OS; bone markers were added in a stepwise selection process. Receiver operating characteristic (ROC) curves were constructed for risk factor models +/- bone markers. Significant variables were allowed to compete in a classification and regression tree (CART) analysis. Hazard ratios(HR) were calculated by comparing OS in each of the terminal nodes to a reference group in a Cox model. RESULTS 750 patients were included. Each bone marker significantly contributed to the risk factor-adjusted OS Cox model, with higher levels associated with worse OS. BAP (HR = 1.15, p = 0.008), CICP (HR = 1.27, p < 0.001), and PYD (HR = 1.21, p = 0.047) in combination were significantly associated with OS. Prognostic accuracy was improved by addition of bone markers to clinical covariates. CART analysis selected CICP, BAP, hemoglobin, and pain score for the final OS model, identifying five prognostic groups. CONCLUSIONS Elevated serum bone biomarker levels are associated with worse OS in bone-metastatic CRPC. Bone biomarkers can identify unique prognostic subgroups. These results further define the role of bone biomarkers in the design of CRPC trials.
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Affiliation(s)
- P N Lara
- University of California Davis Comprehensive Cancer Center, Sacramento, CA, United States.
| | - M Plets
- SWOG Statistical Center, Seattle, WA, United States
| | - C Tangen
- SWOG Statistical Center, Seattle, WA, United States
| | - E Gertz
- US Department of Agriculture, Western Human Nutrition Research Center, University of California Davis, Davis, CA, United States
| | | | - M Hussain
- Northwestern University, Chicago, IL, United States
| | - P W Twardowski
- City of Hope National Medical Center, Duarte, CA, United States
| | - M G Garzotto
- Oregon Health & Science University, Portland, OR, United States
| | - J P Monk
- Ohio State University, Columbus, OH, United States
| | - M Carducci
- Johns Hopkins University, Baltimore, MD, United States
| | - A Goldkorn
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, United States
| | - P C Mack
- University of California Davis Comprehensive Cancer Center, Sacramento, CA, United States
| | - I Thompson
- Cancer Therapy and Research Center, UTHSC, San Antonio, TX, United States
| | - M Van Loan
- US Department of Agriculture, Western Human Nutrition Research Center, University of California Davis, Davis, CA, United States
| | - D I Quinn
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, United States
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Lutz BM, Wu S, Gu X, Atianjoh FE, Li Z, Fox BM, Pollock DM, Tao YX. Endothelin type A receptors mediate pain in a mouse model of sickle cell disease. Haematologica 2018; 103:1124-1135. [PMID: 29545351 PMCID: PMC6029538 DOI: 10.3324/haematol.2017.187013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 03/13/2018] [Indexed: 12/12/2022] Open
Abstract
Sickle cell disease is associated with acute painful episodes and chronic intractable pain. Endothelin-1, a known pain inducer, is elevated in the blood plasma of both sickle cell patients and mouse models of sickle cell disease. We show here that the levels of endothelin-1 and its endothelin type A receptor are increased in the dorsal root ganglia of a mouse model of sickle cell disease. Pharmacologic inhibition or neuron-specific knockdown of endothelin type A receptors in primary sensory neurons of dorsal root ganglia alleviated basal and post-hypoxia evoked pain hypersensitivities in sickle cell mice. Mechanistically, endothelin type A receptors contribute to sickle cell disease-associated pain likely through the activation of NF-κB-induced Nav1.8 channel upregulation in primary sensory neurons of sickle cell mice. Our findings suggest that endothelin type A receptor is a potential target for the management of sickle cell disease-associated pain, although this expectation needs to be further verified in clinical settings.
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Affiliation(s)
- Brianna Marie Lutz
- Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA.,Rutgers Graduate School of Biomedical Sciences, New Jersey Medical School, The State University of New Jersey, Newark, NJ, USA
| | - Shaogen Wu
- Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Xiyao Gu
- Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Fidelis E Atianjoh
- Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA.,Intensive Care Unit, MedStar Southern Maryland Hospital Center, Clinton, MD, USA
| | - Zhen Li
- Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Brandon M Fox
- Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham, AL, USA
| | - David M Pollock
- Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham, AL, USA
| | - Yuan-Xiang Tao
- Rutgers Graduate School of Biomedical Sciences, New Jersey Medical School, The State University of New Jersey, Newark, NJ, USA.,Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
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42
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Foucher Y, Lorent M, Tessier P, Supiot S, Sébille V, Dantan E. A mini-review of quality of life as an outcome in prostate cancer trials: patient-centered approaches are needed to propose appropriate treatments on behalf of patients. Health Qual Life Outcomes 2018; 16:40. [PMID: 29506537 PMCID: PMC5836440 DOI: 10.1186/s12955-018-0870-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 02/26/2018] [Indexed: 12/18/2022] Open
Abstract
Background Patients with prostate cancer (PC) may be ready to make trade-offs between their quantity and their quality of life. For instance, elderly patients may prefer the absence of treatment if it is associated with a low-risk of disease progression, compared to treatments aiming at preventing disease progression but with a substantial deterioration of their Health-Related Quality of Life (HRQoL). Therefore, it seems relevant to compare the treatments by considering both survival and HRQoL. In this mini-review, the aim was to question whether the potential trade-offs between survival and HRQoL are considered in high impact factor journals. Methods The study was conducted from the PubMed database for recent papers published between May 01, 2013, and May 01, 2015. We also restricted our search to nine medical journals with 2013 impact factor > 15. Results Among the 30 selected studies, only six collected individual HRQoL as a secondary endpoint by using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire. In four studies, the time to HRQoL change was analyzed, but its definitions varied. In two studies, the mean changes in HRQoL between the baseline and the 12- or 16-week follow-up were analyzed. None of the six studies reported in a single endpoint both the quantity and the quality of life. Conclusions Our mini-review, which only focused on recent publications in journals with high-impact, suggests moving PC clinical research towards patient-centered outcomes-based studies. This may help physicians to propose the most appropriate treatment on behalf of patients. We recommend the use of indicators such as Quality-Adjusted Life-Years (QALYs) as principal endpoint in future clinical trials. Electronic supplementary material The online version of this article (10.1186/s12955-018-0870-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yohann Foucher
- SPHERE (MethodS for Patients-centered outcomes and HEalth Research), INSERM UMR 1246, Nantes University, IRS2 - 22 boulevard Bénoni Goullin, 44200, Nantes, France. .,CHU Nantes University Hospital, Nantes, France.
| | - Marine Lorent
- SPHERE (MethodS for Patients-centered outcomes and HEalth Research), INSERM UMR 1246, Nantes University, IRS2 - 22 boulevard Bénoni Goullin, 44200, Nantes, France
| | - Philippe Tessier
- SPHERE (MethodS for Patients-centered outcomes and HEalth Research), INSERM UMR 1246, Nantes University, IRS2 - 22 boulevard Bénoni Goullin, 44200, Nantes, France.,CHU Nantes University Hospital, Nantes, France
| | - Stéphane Supiot
- ICO - Institut de Cancérologie de l'Ouest - Centre René Gauducheau, Boulevard Jacques Monod, 44805, Saint-Herblain, France
| | - Véronique Sébille
- SPHERE (MethodS for Patients-centered outcomes and HEalth Research), INSERM UMR 1246, Nantes University, IRS2 - 22 boulevard Bénoni Goullin, 44200, Nantes, France.,CHU Nantes University Hospital, Nantes, France
| | - Etienne Dantan
- SPHERE (MethodS for Patients-centered outcomes and HEalth Research), INSERM UMR 1246, Nantes University, IRS2 - 22 boulevard Bénoni Goullin, 44200, Nantes, France
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Treatment with docetaxel in combination with Aneustat leads to potent inhibition of metastasis in a patient-derived xenograft model of advanced prostate cancer. Br J Cancer 2018; 118:802-812. [PMID: 29381682 PMCID: PMC5877435 DOI: 10.1038/bjc.2017.474] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 01/09/2023] Open
Abstract
Background: Docetaxel used for first-line treatment of advanced prostate cancer (PCa) is only marginally effective. We previously showed, using the LTL-313H subrenal capsule patient-derived metastatic PCa xenograft model, that docetaxel combined with Aneustat (OMN54), a multivalent plant-derived therapeutic, led to marked synergistic tumour growth inhibition. Here, we investigated the effect of docetaxel+Aneustat on metastasis. Methods: C4-2 cells were incubated with docetaxel, Aneustat and docetaxel+Aneustat to assess effects on cell migration. The LTL-313H model, similarly treated, was analysed for effects on lung micro-metastasis and kidney invasion. The LTL-313H gene expression profile was compared with profiles of PCa patients (obtained from Oncomine) and subjected to IPA to determine involvement of cancer driver genes. Results: Docetaxel+Aneustat markedly inhibited C4-2 cell migration and LTL-313H lung micro-metastasis/kidney invasion. Oncomine analysis indicated that treatment with docetaxel+Aneustat was associated with improved patient outcome. The drug combination markedly downregulated expression of cancer driver genes such as FOXM1 (and FOXM1-target genes). FOXM1 overexpression reduced the anti-metastatic activity of docetaxel+Aneustat. Conclusions: Docetaxel+Aneustat can inhibit PCa tissue invasion and metastasis. This activity appears to be based on reduced expression of cancer driver genes such as FOXM1. Use of docetaxel+Aneustat may provide a new, more effective regimen for therapy of metastatic PCa.
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Corn PG, Agarwal N, Araujo JC, Sonpavde G. Taxane-based Combination Therapies for Metastatic Prostate Cancer. Eur Urol Focus 2017; 5:369-380. [PMID: 29275145 DOI: 10.1016/j.euf.2017.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/10/2017] [Accepted: 11/15/2017] [Indexed: 12/19/2022]
Abstract
CONTEXT Multiple single-agent therapies improving survival are approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC), including two chemotherapies, two androgen-signaling axis-targeting agents, an immunotherapeutic vaccine, and a radiopharmaceutical. Combination therapy can target multiple oncogenic pathways simultaneously, while potentially curbing the development of treatment resistance. OBJECTIVE To provide a succinct overview of taxane-based combination therapies currently being evaluated for the treatment of metastatic prostate cancer. EVIDENCE ACQUISITION We searched MEDLINE/PubMed® and relevant congress databases for literature focused on taxane-based combination therapies being evaluated for the treatment of metastatic prostate cancer. In addition, a systematic search of www.clinicaltrials.gov was performed to gather information regarding ongoing taxane-based combination trials in prostate cancer. This search included phase II or III trials starting after January 1, 2010, which included the terms "docetaxel" or "cabazitaxel" and "prostate", and was then manually filtered for combination studies. EVIDENCE SYNTHESIS Single-agent therapy yields modest increments in survival. The success of combining docetaxel with androgen deprivation to improve overall survival (OS) for metastatic hormone-sensitive disease suggests the potential of similar approaches in mCRPC. Several classes of biological drugs have previously been combined with docetaxel for mCRPC in clinical trials without improvement in OS. However, combining docetaxel or cabazitaxel with newer agents with established single-agent benefit, such as radium-223, second-generation androgen pathway-targeted agents, or other chemotherapies, has the potential to benefit patients when compared with taxane chemotherapy alone. Our search revealed that the majority of trials currently assessing taxanes are focused on combination therapies: a combination approach is being evaluated in 37 of 47 trials assessing docetaxel and in 18 of 34 trials assessing cabazitaxel. CONCLUSIONS Despite prior failures, novel taxane-based combination therapies have the potential to improve outcomes in mCRPC. Challenges include the absence of validated predictive biomarkers for the selection of suitable patients and the potential for enhanced toxicity. PATIENT SUMMARY Patients with metastatic prostate cancer have access to multiple therapies improving survival. Many advanced epithelial cancers are treated with combinations of drugs; however, prostate cancer has remained an exception. A number of clinical studies have shown that combining chemotherapy with other classes of therapy may improve patient outcomes in prostate cancer. Here, we summarize the various combinations that are tested in the clinic and review the results.
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Affiliation(s)
- Paul G Corn
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Neeraj Agarwal
- Department of Medicine, Section of Medical Oncology, University of Utah Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - John Charles Araujo
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guru Sonpavde
- Genitourinary Oncology Section, Dana Farber Cancer Institute, Boston, MA, USA.
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Sonpavde G, Pond GR, Plets M, Tangen CM, Hussain MHA, Lara PN, Goldkorn A, Garzotto MG, Mack PC, Higano CS, Vogelzang NJ, Thompson IM, Twardowski PW, Van Veldhuizen PJ, Agarwal N, Carducci MA, Monk JP, Quinn DI. Validation of the Association of RECIST Changes With Survival in Men With Metastatic Castration-Resistant Prostate Cancer Treated on SWOG Study S0421. Clin Genitourin Cancer 2017; 15:635-641. [PMID: 28579151 PMCID: PMC5734863 DOI: 10.1016/j.clgc.2017.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 04/17/2017] [Accepted: 05/03/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Phase 2 trials evaluating new agents for metastatic castration-resistant prostate cancer (mCRPC) have relied on bone scan and prostate-specific antigen changes to assess activity. Given the increasing detection of measurable disease, Response Evaluation Criteria in Solid Tumors (RECIST) changes warrant consideration to evaluate activity. We validated the association of RECIST 1.0 changes with survival in men with mCRPC receiving docetaxel. PATIENTS AND METHODS Data for men with measurable disease from the Southwest Oncology Group (SWOG) S0421, a phase 3 trial in men with mCRPC receiving docetaxel and prednisone plus placebo or atrasentan, were used. Cox proportional hazards regression was used to evaluate the association of RECIST 1.0 outcomes within 120 days, ie, unconfirmed partial response (uPR), stable disease, and progressive disease (PD), with overall survival (OS) from day 120, adjusted for prognostic factors. RESULTS Overall, 326 men were evaluable for landmark analysis, of whom 23 had PD, 230 stable disease, and 73 uPR. OS beyond day 120 was significantly different (P = .004) among these subgroups, with median (95% confidence interval) OS of 7.1 (3.5-8.8), 13.4 (11.4-15.6), and 16.3 (10.0-19.6) months for those with PD, stable disease, and uPR, respectively. In a multivariable model, the hazard ratio (95% confidence interval) for patients with PD was 2.47 (1.42-4.29) compared to patients with an uPR (P = .002). CONCLUSION The association of RECIST 1.0 changes with OS in men with mCRPC receiving docetaxel was validated. Given limitations of bone scan and prostate-specific antigen alterations, improvements in objective RECIST 1.0 changes should be reported in phase 2 trials before launching phase 3 trials.
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Affiliation(s)
- Guru Sonpavde
- University of Alabama at Birmingham, Birmingham, AL.
| | | | | | | | | | | | - Amir Goldkorn
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | | | | | | | - Ian M Thompson
- University of Texas Health Science Center at San Antonio, San Antonio, TX
| | | | | | | | | | | | - David I Quinn
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
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46
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Xia H, Luo X, Yin W. Inhibition of prostate cancer growth by immunization with a GM-CSF-modified mouse prostate cancer RM-1 cell vaccine in a novel murine model. Oncol Lett 2017; 15:538-544. [PMID: 29387233 DOI: 10.3892/ol.2017.7332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/01/2017] [Indexed: 01/01/2023] Open
Abstract
Advanced prostate cancer is difficult to treat owing to a lack of effective approaches for disrupting immune tolerance. C57BL/6 male and female mice implanted with viable RM-1 cells represent a novel murine model of advanced prostate cancer for studying antitumor effects following immunization with a granulocyte-macrophage colony-stimulating factor (GM-CSF)-modified RM-1 cell vaccine, which has been described previously. In vitro cytotoxic activity and cytokine secretion experiments were conducted to investigate the antitumor response. The cytotoxicity profile of splenocytes from female mice immunized against RM-1 cells primarily involved cytotoxic T lymphocyte (CTL) lysis and, to a lesser extent, natural killer (NK) cell lysis. NK cell lysis was also observed in males, which exhibited no evidence of CTL lysis. The secretion of interferon-γ in the GM-CSF-modified cell vaccine group was significantly increased compared with the other groups. The level of interleukin-4 was low. To investigate the antitumor immune response further, cluster of differentiation 4 (CD4) T cells and CD8 T cells were analyzed in the spleens and tumors of female mice receiving the GM-CSF-modified RM-1 cell vaccine. Unlike female mice, males exhibited the highest proportion of NK cells in the spleen. NK cells were not detected in the tumor tissue in any of the groups. The difference between the sexes may explain the specificity of the immune response, as females are intolerant to prostate antigens whereas males are. This model is clinically relevant as it translates to human immunology and offers an effective and convenient method for studying immunotherapy for prostate cancer.
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Affiliation(s)
- Hongmei Xia
- Department of Oncology, The People's Hospital of Yichun Affiliated to Clinical Medicine School of Yichun University in Jiangxi Province, Yichun, Jiangxi 336000, P.R. China
| | - Xiaojing Luo
- Department of Oncology, The People's Hospital of Yichun Affiliated to Clinical Medicine School of Yichun University in Jiangxi Province, Yichun, Jiangxi 336000, P.R. China
| | - Weihua Yin
- Department of Oncology, The People's Hospital of Yichun Affiliated to Clinical Medicine School of Yichun University in Jiangxi Province, Yichun, Jiangxi 336000, P.R. China
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Mohanty SK, Yagiz K, Pradhan D, Luthringer DJ, Amin MB, Alkan S, Cinar B. STAT3 and STAT5A are potential therapeutic targets in castration-resistant prostate cancer. Oncotarget 2017; 8:85997-86010. [PMID: 29156772 PMCID: PMC5689662 DOI: 10.18632/oncotarget.20844] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/03/2017] [Indexed: 11/25/2022] Open
Abstract
Mechanisms of castration-resistant prostate cancer (CRPC) are not well understood, thus hindering rational-based drug design. Activation of STAT3/5A, key components of the JAK/STAT pathway, is implicated in aggressive PC, yet their clinical relevance in CRPC remains elusive. Here, we evaluated the possible role of STAT3/5A in CRPC using immunological, quantitative mRNA expression profiling, and pharmacological methods. We observed a strong nuclear immunoreactivity for STAT3 and STAT5A in 93% (n=14/15) and 80% (n=12/15) of CRPC cases, respectively, compared with benign prostatic hyperplasia (BPH). We demonstrated that PC cells express varying levels of STAT3 and STAT5A transcripts. In addition, we demonstrate that pimozide, a psychotropic drug and an indirect inhibitor of STAT5, attenuated PC cells growth, and induced apoptosis in a dose-dependent manner. Furthermore, our analysis of the PC public data revealed that the STAT3/5A genes were frequently amplified in metastatic CRPC. These findings suggest that STAT3/5A potentially serves as a predictive biomarker to evaluate the therapeutic efficacy of a cancer drug targeting the JAK/STAT pathway. Since the JAK/STAT and AR pathways are suggested to be functionally synergistic, inhibition of the JAK/STAT signaling alone or together with AR may lead to a novel treatment modality for patients with advanced PC.
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Affiliation(s)
- Sambit K. Mohanty
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Kader Yagiz
- Department of Hematology and Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Dinesh Pradhan
- University of Pittsburgh Medical Center, Pittsburgh, PA 15238, USA
| | - Daniel J. Luthringer
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Mahul B. Amin
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
| | - Serhan Alkan
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Bekir Cinar
- Department of Biological Sciences, The Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA 30314, USA
- Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
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48
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Soekmadji C, Corcoran NM, Oleinikova I, Jovanovic L, Ramm GA, Nelson CC, Jenster G, Russell PJ. Extracellular vesicles for personalized therapy decision support in advanced metastatic cancers and its potential impact for prostate cancer. Prostate 2017; 77:1416-1423. [PMID: 28856701 DOI: 10.1002/pros.23403] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/03/2017] [Indexed: 12/31/2022]
Abstract
The use of circulating tumor cells (CTCs) and circulating extracellular vesicles (EVs), such as exosomes, as liquid biopsy-derived biomarkers for cancers have been investigated. CTC enumeration using the CellSearch based platform provides an accurate insight on overall survival where higher CTC counts indicate poor prognosis for patients with advanced metastatic cancer. EVs provide information based on their lipid, protein, and nucleic acid content and can be isolated from biofluids and analyzed from a relatively small volume, providing a routine and non-invasive modality to monitor disease progression. Our pilot experiment by assessing the level of two subpopulations of small EVs, the CD9 positive and CD63 positive EVs, showed that the CD9 positive EV level is higher in plasma from patients with advanced metastatic prostate cancer with detectable CTCs. These data show the potential utility of a particular EV subpopulation to serve as biomarkers for advanced metastatic prostate cancer. EVs can potentially be utilized as biomarkers to provide accurate genotypic and phenotypic information for advanced prostate cancer, where new strategies to design a more personalized therapy is currently the focus of considerable investigation.
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Affiliation(s)
- Carolina Soekmadji
- Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Niall M Corcoran
- Australian Prostate Cancer Research Centre Epworth, and Department of Surgery, University of Melbourne, Australia
| | - Irina Oleinikova
- Department of Urology, Queensland Health, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lidija Jovanovic
- Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | - Grant A Ramm
- Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Colleen C Nelson
- Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | - Guido Jenster
- Department of Urology, Erasmus Medical Centre, R,otterdam, The Netherlands
| | - Pamela J Russell
- Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
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Wong SE, North SA, Sweeney CJ, Stockler MR, Sridhar SS. Screen Failure Rates in Contemporary Randomized Clinical Phase II/III Therapeutic Trials in Genitourinary Malignancies. Clin Genitourin Cancer 2017; 16:S1558-7673(17)30274-4. [PMID: 28993132 DOI: 10.1016/j.clgc.2017.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 08/28/2017] [Accepted: 08/31/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Screen failures, defined as individuals who undergo screening but are not enrolled in a clinical trial, incur significant costs without contributing valuable data to the study. Despite these costs, there are few published data about the rate or reasons for screen failures in advanced genitourinary cancer clinical trials. MATERIALS AND METHODS We reviewed 50 phase II and III trials in advanced genitourinary cancers conducted between 1999 and 2016. RESULTS Of the 50 trials, only 48% (24 of 50) published screen failure rates: 68% (13 of 19) of those in prostate cancer, 33% (6 of 18) in kidney cancer, and 58% (5 of 13) in bladder cancer. Among the phase III trials in prostate cancer, the mean screen failure rate was 26% (range, 12%-45%). The main reason for screen failure was reported as ineligibility. Among the phase III trials in kidney cancer, the mean screen failure rate was 25% (range, 21%-29%), with the most frequent reasons being ineligibility and patient refusal. Among the phase II/III trials in bladder cancer, the mean screen failure rate was 19% (range, 4%-28%), with the main reasons being ineligibility and patient refusal. CONCLUSION Contemporary trials in genitourinary cancer reported screen failure rates of approximately 20% to 30%. Many trials did not report on the numbers of, and reasons for, screen failures. Greater standardization of definitions, methods, and reporting are needed to better understand and decrease screen failure rates in genitourinary cancer clinical trials.
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Affiliation(s)
- Sarah E Wong
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | | | | | - Martin R Stockler
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Sydney, Australia
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50
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Gross ME, Dorff TB, Quinn DI, Diaz PM, Castellanos OO, Agus DB. Safety and Efficacy of Docetaxel, Bevacizumab, and Everolimus for Castration-resistant Prostate Cancer (CRPC). Clin Genitourin Cancer 2017; 16:S1558-7673(17)30200-8. [PMID: 28826933 PMCID: PMC7444943 DOI: 10.1016/j.clgc.2017.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/16/2017] [Accepted: 07/09/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous data suggests that co-targeting mammalian target of rapamycin and angiogenic pathways may potentiate effects of cytotoxic chemotherapy. We studied combining mammalian target of rapamycin and vascular endothelial growth factor inhibition with docetaxel in castrate-resistant prostate cancer (CRPC). METHODS Eligible patients had progressive, metastatic, chemotherapy-naive CRPC. Docetaxel and bevacizumab were given intravenously day 1 with everolimus orally daily on a 21-day cycle across 3 dose levels (75:15:2.5, 75:15:5, and 65:15:5; docetaxel mg/m2, mg/kg bevacizumab, and mg everolimus, respectively). Maintenance therapy with bevacizumab/everolimus without docetaxel was allowed after ≥ 6 cycles. RESULTS Forty-three subjects were treated across all dose levels. Maximal tolerated doses for the combined therapies observed in the phase 1B portion of the trial were: docetaxel 75 mg/m2, bevacizumab 15 mg/kg, and everolimus 2.5 mg. Maximal prostate-specific antigen decline ≥ 30% and ≥ 50% was achieved in 33 (79%) and 31 (74%) of patients, respectively. Best response by modified Response Evaluation Criteria In Solid Tumors criteria in 25 subjects with measurable disease at baseline included complete or partial response in 20 (80%) patients. The median progression-free and overall survival were 8.9 months (95% confidence interval, 7.4-10.6 months) and 21.9 months (95% confidence interval, 18.4-30.3 months), respectively. Hematologic toxicities were the most common treatment-related grade ≥ 3 adverse events including: febrile neutropenia (12; 28%), lymphopenia (12; 28%), leukocytes (10; 23%), neutrophils (9; 21%), and hemoglobin (2; 5%). Nonhematologic grade ≥ 3 adverse events included: hypertension (8; 19%), fatigue (3; 7%), pneumonia (3; 7%), and mucositis (4; 5%). There was 1 treatment-related death owing to neutropenic fever and pneumonia in a patient treated at dose level 3 despite dose modifications and prophylactic growth factor support. CONCLUSIONS Docetaxel, bevacizumab, and everolimus can be safely administered in CRPC and demonstrate a significant level of anticancer activity, meeting the predetermined response criteria. However, any potential benefit of combined therapy must be balanced against increased risk for toxicities. Our results do not support the hypothesis that this combination of agents improves upon the results obtained with docetaxel monotherapy in an unselected population of chemotherapy-naive patients with CRPC.
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Affiliation(s)
- Mitchell E Gross
- Lawrence J. Ellison Institute for Transformative Medicine, University of Southern California, Los Angeles, CA; Department of Medicine/Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Tanya B Dorff
- Department of Medicine/Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - David I Quinn
- Department of Medicine/Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA; USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Patricia M Diaz
- Department of Medicine/Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Olga O Castellanos
- Department of Medicine/Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - David B Agus
- Lawrence J. Ellison Institute for Transformative Medicine, University of Southern California, Los Angeles, CA; Department of Medicine/Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA
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