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Development of a Transcriptional Amplification System Based on the PEG3 Promoter to Target Androgen Receptor-Positive and -Negative Prostate Cancer Cells. Int J Mol Sci 2019; 20:ijms20010216. [PMID: 30626088 PMCID: PMC6337121 DOI: 10.3390/ijms20010216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 12/21/2018] [Accepted: 12/31/2018] [Indexed: 12/17/2022] Open
Abstract
Localized prostate cancer (PCa) is often curable, whereas metastatic disease treated by castration inevitably progresses toward castration-resistant PCa (CRPC). Most CRPC treatments target androgen receptor (AR) signaling. However, not all CRPC cells rely on AR activity for survival and proliferation. With advances in immunotherapy and fluid biopsies for cancer management, expression systems specific for both AR-positive and -negative PCa are required for virus-based vaccines and cell imaging. To target both AR-responsive and non-responsive cells, we developed a three-step transcriptional amplification (3STA) system based on the progression elevated gene-3 (PEG3) promoter named PEG3AP1-3STA. Notably, we report on different genetic modifications that significantly improved PEG3 promoter's strength in PCa cells. Adenoviruses incorporating PEG3 promoter with and without transcriptional amplification systems were generated. The potential of PEG3AP1-3STA to target PCa cells was then evaluated in vitro and in vivo in androgen-responsive and non-responsive PCa cell lines. PEG3AP1-3STA was shown to be active in all PCa cell lines and not regulated by androgens, and its activity was amplified 97-fold compared to that of a non-amplified promoter. The PEG3AP1-3STA system can thus be used to target advanced AR+ and AR- cells for imaging or immunovirotherapy in advanced PCa.
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Padhani AR, Lecouvet FE, Tunariu N, Koh DM, De Keyzer F, Collins DJ, Sala E, Fanti S, Vargas HA, Petralia G, Schlemmer HP, Tombal B, de Bono J. Rationale for Modernising Imaging in Advanced Prostate Cancer. Eur Urol Focus 2017; 3:223-239. [PMID: 28753774 DOI: 10.1016/j.euf.2016.06.018] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 05/29/2016] [Accepted: 06/29/2016] [Indexed: 12/25/2022]
Abstract
CONTEXT To effectively manage patients with advanced prostate cancer (APC), it is essential to have accurate, reproducible, and validated methods for detecting and quantifying the burden of bone and soft tissue metastases and for assessing their response to therapy. Current standard of care imaging with bone and computed tomography (CT) scans have significant limitations for the assessment of bone metastases in particular. OBJECTIVE We aimed to undertake a critical comparative review of imaging methods used for diagnosis and disease monitoring of metastatic APC from the perspective of their availability and ability to assess disease presence, extent, and response of bone and soft tissue disease. EVIDENCE ACQUISITION An expert panel of radiologists, nuclear medicine physicians, and medical physicists with the greatest experience of imaging in advanced prostate cancer prepared a review of the practicalities, performance, merits, and limitations of currently available imaging methods. EVIDENCE SYNTHESIS Meta-analyses showed that positron emission tomography (PET)/CT with different radiotracers and whole-body magnetic resonance imaging (WB-MRI) are more accurate for bone lesion detection than CT and bone scans (BSs). At a patient level, the pooled sensitivities for bone disease by using choline (CH)-PET/CT, WB-MRI, and BS were 91% (95% confidence interval [CI], 83-96%), 97% (95% CI, 91-99%), and 79% (95% CI, 73-83%), respectively. The pooled specificities for bone metastases detection using CH-PET/CT, WB-MRI, and BS were 99% (95% CI, 93-100%), 95% (95% CI, 90-97%), and 82% (95% CI, 78-85%), respectively. The ability of PET/CT and WB-MRI to assess therapeutic benefits is promising but has not been comprehensively evaluated. There is variability in the cost, availability, and quality of PET/CT and WB-MRI. CONCLUSIONS Standardisation of acquisition, interpretation, and reporting of WB-MRI and PET/CT scans is required to assess the performance of these techniques in clinical trials of treatment approaches in APC. PATIENT SUMMARY PET/CT and whole-body MRI scans have the potential to improve detection and to assess response to treatment of all states of advanced prostate cancer. Consensus recommendations on quality standards, interpretation, and reporting are needed but will require validation in clinical trials of established and new treatment approaches.
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Affiliation(s)
- Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, Middlesex, UK.
| | - Frederic E Lecouvet
- Department of Radiology, Centre du Cancer and Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Nina Tunariu
- Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Dow-Mu Koh
- Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Frederik De Keyzer
- Department of Radiology, Medical Imaging Research Centre, University Hospitals Leuven, Leuven, Belgium
| | - David J Collins
- Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Evis Sala
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stefano Fanti
- Service of Nuclear Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - H Alberto Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Giuseppe Petralia
- Department of Radiology, European Institute of Oncology, Milan, Italy
| | - Heinz Peter Schlemmer
- Department of Radiology, German Cancer Research Center Heidelberg (DKFZ), Heidelberg, Germany
| | - Bertrand Tombal
- Department of Urology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Johann de Bono
- Drug Development Unit, Institute of Cancer Research and the Royal Marsden NHS Trust, Surrey, UK
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Morin F, Beauregard JM, Bergeron M, Nguile Makao M, Lacombe L, Fradet V, Fradet Y, Pouliot F. Metabolic Imaging of Prostate Cancer Reveals Intrapatient Intermetastasis Response Heterogeneity to Systemic Therapy. Eur Urol Focus 2017; 3:639-642. [PMID: 28753860 DOI: 10.1016/j.euf.2017.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/05/2017] [Accepted: 02/10/2017] [Indexed: 12/17/2022]
Abstract
Although intrapatient heterogeneity of prostate cancer (PCa) has recently been characterized via genomic and transcriptomic studies, the heterogeneity of systemic treatment responses has yet to be reported or imaged. Our objective was to evaluate the intrapatient intermetastasis response to systemic treatment among patients with metastatic PCa. We evaluated the metabolic response for each individual metastatic lesion (n=165) in 15 patients with metastatic PCa who underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography before and at least 3 mo after initiation of a systemic therapy that did not change in that period. Intermetastasis heterogeneity was defined as opposite metabolic responses for at least two metastases from the same compartment (bone or soft tissue) between the two time points. We found intrapatient intermetastasis response heterogeneity in 40% of the cases in our retrospective series. Our results suggest that systemic therapies can induce heterogeneous responses among individual metastases in patients with PCa, supporting the polyclonal evolution of PCa in advanced disease. Molecular imaging may thus be useful in identifying clinical resistance early after therapy initiation and could also allow targeted biopsy of resistant clones for molecular analysis. PATIENT SUMMARY Systemic therapies can lead to heterogeneous responses in individual metastases of prostate cancer in a patient. Molecular imaging may be useful for identifying heterogeneity and could allow targeted biopsy for molecular analysis or therapy.
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Affiliation(s)
- Fannie Morin
- Division of Urology, Department of Surgery and Cancer Research Center, Université Laval, Quebec City, Canada; Division of Urology, Department of Surgery and Oncology Axis of CHU de Québec Research Center, CHU de Québec-Université Laval, Quebec City, Canada
| | - Jean-Mathieu Beauregard
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine and Cancer Research Center, Université Laval, Quebec City, Canada; Division of Nuclear Medicine, Department of Medical Imaging and Oncology Axis of CHU de Québec Research Center, CHU de Québec-Université Laval, Quebec City, Canada
| | - Michelle Bergeron
- Division of Urology, Department of Surgery and Cancer Research Center, Université Laval, Quebec City, Canada; Division of Urology, Department of Surgery and Oncology Axis of CHU de Québec Research Center, CHU de Québec-Université Laval, Quebec City, Canada
| | - Molière Nguile Makao
- Division of Urology, Department of Surgery and Cancer Research Center, Université Laval, Quebec City, Canada; Division of Urology, Department of Surgery and Oncology Axis of CHU de Québec Research Center, CHU de Québec-Université Laval, Quebec City, Canada
| | - Louis Lacombe
- Division of Urology, Department of Surgery and Cancer Research Center, Université Laval, Quebec City, Canada; Division of Urology, Department of Surgery and Oncology Axis of CHU de Québec Research Center, CHU de Québec-Université Laval, Quebec City, Canada
| | - Vincent Fradet
- Division of Urology, Department of Surgery and Cancer Research Center, Université Laval, Quebec City, Canada; Division of Urology, Department of Surgery and Oncology Axis of CHU de Québec Research Center, CHU de Québec-Université Laval, Quebec City, Canada
| | - Yves Fradet
- Division of Urology, Department of Surgery and Cancer Research Center, Université Laval, Quebec City, Canada; Division of Urology, Department of Surgery and Oncology Axis of CHU de Québec Research Center, CHU de Québec-Université Laval, Quebec City, Canada
| | - Frédéric Pouliot
- Division of Urology, Department of Surgery and Cancer Research Center, Université Laval, Quebec City, Canada; Division of Urology, Department of Surgery and Oncology Axis of CHU de Québec Research Center, CHU de Québec-Université Laval, Quebec City, Canada.
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Beauregard JM, Beaulieu A. How we read FCH-PET/CT for prostate cancer. Cancer Imaging 2016; 16:41. [PMID: 27923396 PMCID: PMC5139043 DOI: 10.1186/s40644-016-0101-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 12/01/2016] [Indexed: 12/02/2022] Open
Abstract
Over the last decade, 18F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT) has gained in popularity for the staging and restaging of patients with prostate cancer (PCa). However, despite abundant literature on the topic, there is a lack of publications on how to actually interpret FCH-PET/CT in a clinical setting. Here we propose a practical, TNM-oriented approach to read FCH-PET/CT, with notes on procedure technique, image display, review sequence and report structure. The purpose of this article is to provide guidance to radiologists, nuclear medicine physicians and residents who are new to FCH-PET/CT, as well as to propose an alternate approach to more experienced physicians.
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Affiliation(s)
- Jean-Mathieu Beauregard
- Department of Medical Imaging, CHU de Québec - Université Laval, 11 côte du Palais, Quebec City (QC), G1R 2J6, Canada. .,Department of Radiology and Nuclear Medicine, Université Laval, Quebec City, Canada. .,Oncology Branch, CHU de Québec - Université Laval Research Center, Quebec City, Canada.
| | - Alexis Beaulieu
- Department of Medical Imaging, CHU de Québec - Université Laval, 11 côte du Palais, Quebec City (QC), G1R 2J6, Canada.,Department of Radiology and Nuclear Medicine, Université Laval, Quebec City, Canada
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Zustovich F, Pastorelli D. Therapeutic management of bone metastasis in prostate cancer: an update. Expert Rev Anticancer Ther 2016; 16:1199-1211. [PMID: 27666299 DOI: 10.1080/14737140.2016.1241148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Bone metastases affect the majority of patients with castration-resistant prostate cancer (CRPC), resulting in significant morbidity and mortality. This review describes the current therapies available for the management of CRPC patients with bone metastases. Areas covered: Studies on the use of currently available therapeutic approaches for palliating pain, delaying skeletal-related events (SREs) and prolonging survival in CRPC patients with bone metastases have been examined. PubMed database was searched in May 2016 starting with the following keywords: ('castration-resistant prostate cancer' OR 'CRPC') AND 'bone metastases', and approximately 270 results were retrieved. More specific searches were then performed on the epidemiology and molecular pathogenesis (in particular, 'vicious cycle' was used as a keyword), the management of pain, SREs and survival. The following keywords were also used individually: abiraterone, cabazitaxel, denosumab, docetaxel, enzalutamide, radium-223, sipuleucel-T, samarium-153, strontium-89, zoledronate. Randomized-controlled trials, observational studies, reviews, systematic reviews and meta-analyses were selected and articles were excluded if not in English. Expert commentary: Currently, clear recommendations on the optimal use of the agents available to treat mCRPC are lacking. Therefore, to ensure patients the best treatment, both their clinical characteristics and the features of each product have to be considered.
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Locke JA, Dal Pra A, Supiot S, Warde P, Bristow RG. Synergistic action of image-guided radiotherapy and androgen deprivation therapy. Nat Rev Urol 2015; 12:193-204. [PMID: 25800395 DOI: 10.1038/nrurol.2015.50] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The combined use of androgen deprivation therapy (ADT) and image-guided radiotherapy (IGRT) can improve overall survival in aggressive, localized prostate cancer. However, owing to the adverse effects of prolonged ADT, it is imperative to identify the patients who would benefit from this combined-modality therapy relative to the use of IGRT alone. Opportunities exist for more personalized approaches in treating aggressive, locally advanced prostate cancer. Biomarkers--such as disseminated tumour cells, circulating tumour cells, genomic signatures and molecular imaging techniques--could identify the patients who are at greatest risk for systemic metastases and who would benefit from the addition of systemic ADT. By contrast, when biomarkers of systemic disease are not present, treatment could proceed using local IGRT alone. The choice of drug, treatment duration and timing of ADT relative to IGRT could be predicated on these personalized approaches to prostate cancer medicine. These novel treatment intensification and reduction strategies could result in improved prostate-cancer-specific survival and overall survival, without incurring the added expense of metabolic syndrome and other adverse effects of ADT in all patients.
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Affiliation(s)
- Jennifer A Locke
- Department of Urologic Sciences, University of British Columbia, Gordon &Leslie Diamond Health Care Centre, Level 6, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Alan Dal Pra
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, CH-3010 Bern, Switzerland
| | - Stéphane Supiot
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes-St-Herblain, 8 quai Moncousu, BP 70721, 44000 Nantes, France
| | - Padraig Warde
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Robert G Bristow
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON M5G 2M9, Canada
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