Treatment of locally advanced prostate cancer (Stage T3)

Prostate Cancer, Pathophysiology and Recent Developments in Management: A Narrative Review

PURPOSE OF REVIEW

Prostate cancer is the second most common cancer in men. The different stages of prostate cancer which include localised (low, intermediate, and high risk) disease, locally advanced, non-metastatic castration-resistant prostate cancer (M0 CRPCa), and metastatic disease. The main treatment of locally advanced disease is external beam radiotherapy with hormonal therapy which are associated with good prognosis.

RECENT FINDINGS

Current treatments for M0 CRPCa include androgen deprivation therapy in combination with apalutamide, darolutamide or enzalutamide, all of which are associated with good metastatic-free survival rates in clinical trials. Hormone-naive metastatic prostate cancer comprises the same treatments as M0 CRPCa, whereas further treatment includes docetaxel and abiraterone. Metastatic castration-resistant prostate cancer treatments include sipuleucel-T, radium-223, abiraterone, enzalutamide and cabazitaxel, which aim to slow down the progression of the disease and to prolong life. This article also provides insight into the development of new drugs recently approved for metastatic castration prostate cancer, which include PARP inhibitors and Lutetium-177 which have shown to have significantly good overall survival and to improve radiographic progression-free survival. In addition, new clinical trials are ongoing to test new medications such as cabozantinb and chimeric-antigen receptor T-cell therapy for the treatment of advanced prostate cancer. With the aim to slow down the progression of the disease and to prolong life, new drug developments are underway to hopefully provide a positive impact on overall survival and improve progression-free survival, especially in advanced prostate cancer.

Increased expression of CD81 is associated with poor prognosis of prostate cancer and increases the progression of prostate cancer cells in vitro

CD81, a member of the tetraspanin family, has been revealed to be upregulated and associated with prognosis in several types of cancer; however, this relationship has not been explored in prostate cancer. The present study aimed to investigate the prognostic significance and functional role of CD81 in prostate cancer. The expression of CD81 in prostate cancer tissues and cell lines was evaluated using qRT-PCR analysis. Kaplan-Meier survival analysis and Cox regression analysis were conducted to explore the prognostic significance of CD81. Cell experiments were used to explore the effects of CD81 on cell proliferation, migration, and invasion in prostate cell lines in vitro. The expression of CD81 was increased in both prostate cancer tissues and cell lines. Upregulation of CD81 was significantly associated with lymph node metastasis and TNM stage. Moreover, patients with high CD81 levels had poorer overall survival than those with lower levels. Additionally, tumor cell proliferation, migration, and invasion were inhibited by knockdown of CD81. The present results indicated that CD81 plays an oncogenic role in prostate cancer. Overexpression of CD81 may serve as a prognostic biomarker and therapeutic target and is involved in the progression of prostate cancer.

[Targeting of the AKT/m-TOR Pathway: Biomarkers of Resistance to Cancer Therapy-- AKT/m-TOR Pathway and Resistance to Cancer Therapy]

Resistance to cancer therapy continues to be a major limitation for the successful treatment of cancer. There are many published studies on therapy resistance in breast and prostate cancers; however, there are currently no data on molecular markers associated with resistance. The conflicting data were reported regarding the AKT/m-TOR signaling pathway components as markers predicting resistance. The AKT/m-TOR signaling pathway is involved in the development of many human cancers; its activation is related to cell proliferation, angiogenesis, apoptosis, as well as to therapy resistance. Molecular alterations in the AKT/m-TOR signaling pathway provide a platform to identify universal markers associated with the development of resistance to cancer therapy.