1
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Tosoian JJ, Zhang Y, Xiao L, Xie C, Samora NL, Niknafs YS, Chopra Z, Siddiqui J, Zheng H, Herron G, Vaishampayan N, Robinson HS, Arivoli K, Trock BJ, Ross AE, Morgan TM, Palapattu GS, Salami SS, Kunju LP, Tomlins SA, Sokoll LJ, Chan DW, Srivastava S, Feng Z, Sanda MG, Zheng Y, Wei JT, Chinnaiyan AM. Development and Validation of an 18-Gene Urine Test for High-Grade Prostate Cancer. JAMA Oncol 2024; 10:726-736. [PMID: 38635241 PMCID: PMC11190811 DOI: 10.1001/jamaoncol.2024.0455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/06/2023] [Indexed: 04/19/2024]
Abstract
Importance Benefits of prostate cancer (PCa) screening with prostate-specific antigen (PSA) alone are largely offset by excess negative biopsies and overdetection of indolent cancers resulting from the poor specificity of PSA for high-grade PCa (ie, grade group [GG] 2 or greater). Objective To develop a multiplex urinary panel for high-grade PCa and validate its external performance relative to current guideline-endorsed biomarkers. Design, Setting, and Participants RNA sequencing analysis of 58 724 genes identified 54 markers of PCa, including 17 markers uniquely overexpressed by high-grade cancers. Gene expression and clinical factors were modeled in a new urinary test for high-grade PCa (MyProstateScore 2.0 [MPS2]). Optimal models were developed in parallel without prostate volume (MPS2) and with prostate volume (MPS2+). The locked models underwent blinded external validation in a prospective National Cancer Institute trial cohort. Data were collected from January 2008 to December 2020, and data were analyzed from November 2022 to November 2023. Exposure Protocolized blood and urine collection and transrectal ultrasound-guided systematic prostate biopsy. Main Outcomes and Measures Multiple biomarker tests were assessed in the validation cohort, including serum PSA alone, the Prostate Cancer Prevention Trial risk calculator, and the Prostate Health Index (PHI) as well as derived multiplex 2-gene and 3-gene models, the original 2-gene MPS test, and the 18-gene MPS2 models. Under a testing approach with 95% sensitivity for PCa of GG 2 or greater, measures of diagnostic accuracy and clinical consequences of testing were calculated. Cancers of GG 3 or greater were assessed secondarily. Results Of 761 men included in the development cohort, the median (IQR) age was 63 (58-68) years, and the median (IQR) PSA level was 5.6 (4.6-7.2) ng/mL; of 743 men included in the validation cohort, the median (IQR) age was 62 (57-68) years, and the median (IQR) PSA level was 5.6 (4.1-8.0) ng/mL. In the validation cohort, 151 (20.3%) had high-grade PCa on biopsy. Area under the receiver operating characteristic curve values were 0.60 using PSA alone, 0.66 using the risk calculator, 0.77 using PHI, 0.76 using the derived multiplex 2-gene model, 0.72 using the derived multiplex 3-gene model, and 0.74 using the original MPS model compared with 0.81 using the MPS2 model and 0.82 using the MPS2+ model. At 95% sensitivity, the MPS2 model would have reduced unnecessary biopsies performed in the initial biopsy population (range for other tests, 15% to 30%; range for MPS2, 35% to 42%) and repeat biopsy population (range for other tests, 9% to 21%; range for MPS2, 46% to 51%). Across pertinent subgroups, the MPS2 models had negative predictive values of 95% to 99% for cancers of GG 2 or greater and of 99% for cancers of GG 3 or greater. Conclusions and Relevance In this study, a new 18-gene PCa test had higher diagnostic accuracy for high-grade PCa relative to existing biomarker tests. Clinically, use of this test would have meaningfully reduced unnecessary biopsies performed while maintaining highly sensitive detection of high-grade cancers. These data support use of this new PCa biomarker test in patients with elevated PSA levels to reduce the potential harms of PCa screening while preserving its long-term benefits.
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Affiliation(s)
- Jeffrey J. Tosoian
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee
| | - Yuping Zhang
- Department of Pathology, University of Michigan, Ann Arbor
| | - Lanbo Xiao
- Department of Pathology, University of Michigan, Ann Arbor
| | - Cassie Xie
- Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Nathan L. Samora
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Zoey Chopra
- Department of Pathology, University of Michigan, Ann Arbor
| | - Javed Siddiqui
- Department of Pathology, University of Michigan, Ann Arbor
| | - Heng Zheng
- Department of Pathology, University of Michigan, Ann Arbor
| | - Grace Herron
- Department of Pathology, University of Michigan, Ann Arbor
| | | | - Hunter S. Robinson
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Bruce J. Trock
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley E. Ross
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Todd M. Morgan
- Department of Urology, University of Michigan, Ann Arbor
| | | | | | | | - Scott A. Tomlins
- Department of Urology, University of Michigan, Ann Arbor
- Strata Oncology, Ann Arbor, Michigan
| | - Lori J. Sokoll
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel W. Chan
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sudhir Srivastava
- Division of Cancer Prevention, National Institutes of Health, Bethesda, Maryland
| | - Ziding Feng
- Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Yingye Zheng
- Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - John T. Wei
- Department of Urology, University of Michigan, Ann Arbor
| | - Arul M. Chinnaiyan
- Department of Pathology, University of Michigan, Ann Arbor
- Department of Urology, University of Michigan, Ann Arbor
- Howard Hughes Medical Institute, Chevy Chase, Maryland
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2
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Pernigoni N, Guo C, Gallagher L, Yuan W, Colucci M, Troiani M, Liu L, Maraccani L, Guccini I, Migliorini D, de Bono J, Alimonti A. The potential role of the microbiota in prostate cancer pathogenesis and treatment. Nat Rev Urol 2023; 20:706-718. [PMID: 37491512 DOI: 10.1038/s41585-023-00795-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2023] [Indexed: 07/27/2023]
Abstract
The human body hosts a complex and dynamic population of trillions of microorganisms - the microbiota - which influences the body in homeostasis and disease, including cancer. Several epidemiological studies have associated specific urinary and gut microbial species with increased risk of prostate cancer; however, causal mechanistic data remain elusive. Studies have associated bacterial generation of genotoxins with the occurrence of TMPRSS2-ERG gene fusions, a common, early oncogenic event during prostate carcinogenesis. A subsequent study demonstrated the role of the gut microbiota in prostate cancer endocrine resistance, which occurs, at least partially, through the generation of androgenic steroids fuelling oncogenic signalling via the androgen receptor. These studies present mechanistic evidence of how the host microbiota might be implicated in prostate carcinogenesis and tumour progression. Importantly, these findings also reveal potential avenues for the detection and treatment of prostate cancer through the profiling and modulation of the host microbiota. The latter could involve approaches such as the use of faecal microbiota transplantation, prebiotics, probiotics, postbiotics or antibiotics, which can be used independently or combined with existing treatments to reverse therapeutic resistance and improve clinical outcomes in patients with prostate cancer.
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Affiliation(s)
- Nicolò Pernigoni
- Institute of Oncology Research, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Christina Guo
- Institute of Cancer Research, London, UK
- Royal Marsden Hospital, London, UK
| | | | - Wei Yuan
- Institute of Cancer Research, London, UK
| | - Manuel Colucci
- Institute of Oncology Research, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Martina Troiani
- Institute of Oncology Research, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Lei Liu
- Institute of Oncology Research, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Luisa Maraccani
- Institute of Oncology Research, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
- Veneto Institute of Molecular Medicine, Padova, Italy
| | - Ilaria Guccini
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Denis Migliorini
- Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
- Center for Translational Research in Onco-Hematology, University of Geneva, Geneva, Switzerland
- Swiss Cancer Center Léman, Lausanne and Geneva, Geneva, Switzerland
- AGORA Cancer Research Center, Lausanne, Switzerland
| | - Johann de Bono
- Institute of Cancer Research, London, UK
- Royal Marsden Hospital, London, UK
| | - Andrea Alimonti
- Institute of Oncology Research, Bellinzona, Switzerland.
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
- Veneto Institute of Molecular Medicine, Padova, Italy.
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland.
- Department of Medicine, University of Padova, Padova, Italy.
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
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3
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Varaprasad GL, Gupta VK, Prasad K, Kim E, Tej MB, Mohanty P, Verma HK, Raju GSR, Bhaskar L, Huh YS. Recent advances and future perspectives in the therapeutics of prostate cancer. Exp Hematol Oncol 2023; 12:80. [PMID: 37740236 PMCID: PMC10517568 DOI: 10.1186/s40164-023-00444-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 09/10/2023] [Indexed: 09/24/2023] Open
Abstract
Prostate cancer (PC) is one of the most common cancers in males and the fifth leading reason of death. Age, ethnicity, family history, and genetic defects are major factors that determine the aggressiveness and lethality of PC. The African population is at the highest risk of developing high-grade PC. It can be challenging to distinguish between low-risk and high-risk patients due to the slow progression of PC. Prostate-specific antigen (PSA) is a revolutionary discovery for the identification of PC. However, it has led to an increase in over diagnosis and over treatment of PC in the past few decades. Even if modifications are made to the standard PSA testing, the specificity has not been found to be significant. Our understanding of PC genetics and proteomics has improved due to advances in different fields. New serum, urine, and tissue biomarkers, such as PC antigen 3 (PCA3), have led to various new diagnostic tests, such as the prostate health index, 4K score, and PCA3. These tests significantly reduce the number of unnecessary and repeat biopsies performed. Chemotherapy, radiotherapy, and prostatectomy are standard treatment options. However, newer novel hormone therapy drugs with a better response have been identified. Androgen deprivation and hormonal therapy are evolving as new and better options for managing hormone-sensitive and castration-resistant PC. This review aimed to highlight and discuss epidemiology, various risk factors, and developments in PC diagnosis and treatment regimens.
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Affiliation(s)
- Ganji Lakshmi Varaprasad
- Department of Biological Sciences and Bioengineering, Biohybrid Systems Research Center (BSRC), Inha University, Incheon, 22212, Republic of Korea
| | - Vivek Kumar Gupta
- Department of Biological Sciences and Bioengineering, Biohybrid Systems Research Center (BSRC), Inha University, Incheon, 22212, Republic of Korea
| | - Kiran Prasad
- Department of Zoology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | - Eunsu Kim
- Department of Biological Sciences and Bioengineering, Biohybrid Systems Research Center (BSRC), Inha University, Incheon, 22212, Republic of Korea
| | - Mandava Bhuvan Tej
- Department of Health Care Informatics, Sacred Heart University, 5151 Park Avenue, Fair Fields, CT, 06825, USA
| | - Pratik Mohanty
- Department of Zoology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | - Henu Kumar Verma
- Department of Immunopathology, Institute of Lungs Health and Immunity, Helmholtz Zentrum, 85764, Neuherberg, Munich, Germany
| | - Ganji Seeta Rama Raju
- Department of Energy and Materials Engineering, Dongguk University-Seoul, Seoul, 04620, Republic of Korea.
| | - Lvks Bhaskar
- Department of Zoology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India.
| | - Yun Suk Huh
- Department of Biological Sciences and Bioengineering, Biohybrid Systems Research Center (BSRC), Inha University, Incheon, 22212, Republic of Korea.
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4
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Gene-Transcript Expression in Urine Supernatant and Urine Cell-Sediment Are Different but Equally Useful for Detecting Prostate Cancer. Cancers (Basel) 2023; 15:cancers15030789. [PMID: 36765747 PMCID: PMC9913640 DOI: 10.3390/cancers15030789] [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: 12/22/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 02/02/2023] Open
Abstract
There is considerable interest in urine as a non-invasive liquid biopsy to detect prostate cancer (PCa). PCa-specific transcripts such as the TMPRSS2:ERG fusion gene can be found in both urine extracellular vesicles (EVs) and urine cell-sediment (Cell) but the relative usefulness of these and other genes in each fraction in PCa detection has not been fully elucidated. Urine samples from 76 men (PCa n = 40, non-cancer n = 36) were analysed by NanoString for 154 PCa-associated genes-probes, 11 tissue-specific, and six housekeeping. Comparison to qRT-PCR data for four genes (PCA3, OR51E2, FOLH1, and RPLP2) was strong (r = 0.51-0.95, Spearman p < 0.00001). Comparing EV to Cells, differential gene expression analysis found 57 gene-probes significantly more highly expressed in 100 ng of amplified cDNA products from the EV fraction, and 26 in Cells (p < 0.05; edgeR). Expression levels of prostate-specific genes (KLK2, KLK3) measured were ~20× higher in EVs, while PTPRC (white-blood Cells) was ~1000× higher in Cells. Boruta analysis identified 11 gene-probes as useful in detecting PCa: two were useful in both fractions (PCA3, HOXC6), five in EVs alone (GJB1, RPS10, TMPRSS2:ERG, ERG_Exons_4-5, HPN) and four from Cell (ERG_Exons_6-7, OR51E2, SPINK1, IMPDH2), suggesting that it is beneficial to fractionate whole urine prior to analysis. The five housekeeping genes were not significantly differentially expressed between PCa and non-cancer samples. Expression signatures from Cell, EV and combined data did not show evidence for one fraction providing superior information over the other.
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5
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Cotter K, Rubin MA. The evolving landscape of prostate cancer somatic mutations. Prostate 2022; 82 Suppl 1:S13-S24. [PMID: 35657155 PMCID: PMC9328313 DOI: 10.1002/pros.24353] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/17/2022] [Accepted: 03/28/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The landscape of somatic mutations in prostate cancer (PCa) has quickly evolved over the past years. RESULTS This evolution was in part due to the improved quality and lower cost of genomic sequencing platforms available to an ever-larger group of clinicians and researchers. The result of these efforts is a better understanding of early and late mutations that are enriched or nearly exclusive to treated PCa. There are, however, some important limitations to the current knowledge. The expanding variety of next-generation sequencing (NGS) assays either capture a wide spectrum of mutations but at low coverage or are focused panels that cover a select number of genes, most often cancer-related, at a deep coverage. Both of these approaches have their advantages, but ultimately miss low-frequency mutations or fail to cover the spectrum of potential mutations. Additionally, some alterations, such as the common ETS gene fusions, require a mixture of DNA and RNA analysis to capture the true frequency. Finally, almost all studies rely on bulk PCa tumor samples, which fail to consider tumor heterogeneity. Given all these caveats, the true picture of the somatic landscape of PCa continues to develop. SUMMARY In this review, the focus will be on how the landscape of mutations evolves during disease progression considering therapy. It will focus on a select group of early and late mutations and utilize SPOP mutations to illustrate recurrent alterations that may have clinical implications.
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Affiliation(s)
- Kellie Cotter
- Department for BioMedical ResearchUniversity of BernBernSwitzerland
| | - Mark A. Rubin
- Department for BioMedical ResearchUniversity of BernBernSwitzerland
- Bern Center for Precision MedicineUniversity of BernBernSwitzerland
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6
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Oncogenic gene fusions in nonneoplastic precursors as evidence that bacterial infection can initiate prostate cancer. Proc Natl Acad Sci U S A 2021; 118:2018976118. [PMID: 34341114 DOI: 10.1073/pnas.2018976118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Prostate adenocarcinoma is the second most commonly diagnosed cancer in men worldwide, and the initiating factors are unknown. Oncogenic TMPRSS2:ERG (ERG+) gene fusions are facilitated by DNA breaks and occur in up to 50% of prostate cancers. Infection-driven inflammation is implicated in the formation of ERG+ fusions, and we hypothesized that these fusions initiate in early inflammation-associated prostate cancer precursor lesions, such as proliferative inflammatory atrophy (PIA), prior to cancer development. We investigated whether bacterial prostatitis is associated with ERG+ precancerous lesions in unique cases with active bacterial infections at the time of radical prostatectomy. We identified a high frequency of ERG+ non-neoplastic-appearing glands in these cases, including ERG+ PIA transitioning to early invasive cancer. These lesions were positive for ERG protein by immunohistochemistry and ERG messenger RNA by in situ hybridization. We additionally verified TMPRSS2:ERG genomic rearrangements in precursor lesions using tricolor fluorescence in situ hybridization. Identification of rearrangement patterns combined with whole-prostate mapping in three dimensions confirmed multiple (up to eight) distinct ERG+ precancerous lesions in infected cases. We further identified the pathogen-derived genotoxin colibactin as a potential source of DNA breaks in clinical cases as well as cultured prostate cells. Overall, we provide evidence that bacterial infections can initiate driver gene alterations in prostate cancer. In addition, our observations indicate that infection-induced ERG+ fusions are an early alteration in the carcinogenic process and that PIA may serve as a direct precursor to prostate cancer.
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7
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Tosoian JJ, Dunn RL, Niknafs YS, Saha A, Vince RA, St Sauver JL, Jacobson DJ, McGree ME, Siddiqui J, Groskopf J, Jacobsen SJ, Tomlins SA, Kunju LP, Morgan TM, Salami SS, Wei JT, Chinnaiyan AM, Sarma AV. Association of Urinary MyProstateScore, Age, and Prostate Volume in a Longitudinal Cohort of Healthy Men: Long-term Findings from the Olmsted County Study. EUR UROL SUPPL 2021; 29:30-35. [PMID: 34337531 PMCID: PMC8317796 DOI: 10.1016/j.euros.2021.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 11/02/2022] Open
Abstract
Background Serum prostate-specific antigen (PSA), used in prostate cancer screening, is nonspecific for cancer and is affected by age and prostate volume. More specific biomarkers could be more accurate for early detection of prostate cancer and reduce unnecessary prostate biopsies. Objective To evaluate the association of age and prostate volume with urinary MyProstateScore (MPS) in a screened, longitudinal cohort without evidence of prostate cancer. Design setting and participants The Olmsted County Study included men aged 40-79 yr who underwent biennial prostate cancer screening. PSA ≥4.0 ng/ml or abnormal rectal examination triggered prostate biopsy, and patients with cancer were excluded. The remaining men submitted urinary specimens for PCA3 and TMPRSS2:ERG testing. Outcome measurements and statistical analysis MPS was calculated using the validated, locked model for grade group ≥2 cancer that includes serum PSA, urinary PCA3, and urinary TMPRSS2:ERG. The associations of age and volume with biomarkers were assessed in multivariable regression models. The t statistic was used to quantify the strength of associations independent of the unit of measurement, and R 2 values were used to estimate the proportion of biomarker variance explained by each factor. Results and limitations The study included 314 screened men without evidence of cancer. In multivariable models including age and volume, PCA3 score was significantly associated with age (t = 7.51; p < 0.001), while T2:ERG score was not associated with age or volume. MPS was significantly associated with both age (t = 7.45; p < 0.001) and volume (t = 3.56; p < 0.001), but accounting for age alone explained the variability observed (R 2 = 0.29) in a similar way to the model including age and volume (R 2 = 0.31). The variability of PCA3, T2:ERG, and MPS was less dependent on age and volume than the variability for PSA (R 2 = 0.45). Conclusions In a cohort of longitudinally screened men without evidence of cancer, we found that MPS demonstrated less variability with noncancer factors (age, prostate volume) than PSA did. These findings support the biology of these markers as more cancer-specific than PSA and highlight their promise in reducing the morbidity associated with PSA-based screening. Patient summary In a group of men with no evidence of prostate cancer, we found that each of three urine-based markers of cancer-PCA3, T2:ERG, and the commercially available MyProstateScore test-showed less variability with noncancer factors (age and prostate volume) than serum PSA (prostate-specific antigen) did. These findings support their proposed use as noninvasive markers of prostate cancer that could improve the accuracy of early detection.
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Affiliation(s)
- Jeffrey J Tosoian
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Rodney L Dunn
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Yashar S Niknafs
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Anjan Saha
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Randy A Vince
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Debra J Jacobson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Michaela E McGree
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Javed Siddiqui
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | | | - Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, CA, USA
| | - Scott A Tomlins
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Lakshmi P Kunju
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Todd M Morgan
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Simpa S Salami
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - John T Wei
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Arul M Chinnaiyan
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA.,Department of Pathology, University of Michigan, Ann Arbor, MI, USA.,Howard Hughes Medical Institute, University of Michigan, Ann Arbor, MI, USA
| | - Aruna V Sarma
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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8
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Merging new-age biomarkers and nanodiagnostics for precision prostate cancer management. Nat Rev Urol 2020; 16:302-317. [PMID: 30962568 DOI: 10.1038/s41585-019-0178-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The accurate identification and stratified treatment of clinically significant early-stage prostate cancer have been ongoing concerns since the outcomes of large international prostate cancer screening trials were reported. The controversy surrounding clinical and cost benefits of prostate cancer screening has highlighted the lack of strategies for discriminating high-risk disease (that requires early treatment) from low-risk disease (that could be managed using watchful waiting or active surveillance). Advances in molecular subtyping and multiomics nanotechnology-based prostate cancer risk delineation can enable refinement of prostate cancer molecular taxonomy into clinically meaningful and treatable subtypes. Furthermore, the presence of intertumoural and intratumoural heterogeneity in prostate cancer warrants the development of novel nanodiagnostic technologies to identify clinically significant prostate cancer in a rapid, cost-effective and accurate manner. Circulating and urinary next-generation prostate cancer biomarkers for disease molecular subtyping and the newest complementary nanodiagnostic platforms for enhanced biomarker detection are promising tools for precision prostate cancer management. However, challenges in merging both aspects and clinical translation still need to be overcome.
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9
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Abstract
The genomics of prostate cancer (PCA) has been difficult to study compared with some other cancer types for a multitude of reasons, despite significant efforts since the early 1980s. Overcoming some of these obstacles has paved the way for greater insight into the genomics of PCA. The advent of high-throughput technologies coming from the initial use of microsatellite and oligonucleotide probes gave rise to techniques like comparative genomic hybridization (CGH). With the introduction of massively parallel genomic sequencing, referred to as next-generation sequencing (NGS), a deeper understanding of cancer genomics in general has occurred. Along with these technologic advances, there has been the development of computational biology and statistical approaches to address novel large data sets characterized by single base resolution. This review will provide a historic perspective of PCA genomics with an emphasis on the cardinal mutations and alterations observed to be consistently seen in PCA for both hormone-naïve localized PCA and castration-resistant prostate cancer (CRPC). There will be a focus on alterations that have the greatest potential to play a role in disease progression and therapy management.
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Affiliation(s)
- Mark A Rubin
- Englander Institute for Precision Medicine, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York 10065
- Sandra and Edward Meyer Cancer Center at Weill Cornell Medical College, New York, New York 10021
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York 10021
- Department of BioMedical Research, University of Bern, 3012 Bern, Switzerland
| | - Francesca Demichelis
- Englander Institute for Precision Medicine, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York 10065
- Centre for Integrative Biology, University of Trento, 38123 Trento, Italy
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10
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Song C, Chen H. Predictive significance of TMRPSS2- ERG fusion in prostate cancer: a meta-analysis. Cancer Cell Int 2018; 18:177. [PMID: 30459527 PMCID: PMC6233278 DOI: 10.1186/s12935-018-0672-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/31/2018] [Indexed: 11/23/2022] Open
Abstract
Background Prostate cancer is a major malignancy in males. TMPRSS2-ERG is a high-frequency fusion gene expressed in prostate cancer and plays a vital role in carcinogenesis. Recent studies showed that TMPRSS2-ERG is a potential predictive biomarker for prostate cancer. However, the predictive value of TMPRSS2-ERG fusion is yet unclear. Methods A total of 76 relevant articles, published from 2015 to 2017, were obtained from PubMed, Web of Science, EMBASE, Scopus, the Cochrane Library, and CNKI databases to investigate the predictive significance of TMPRSS2-ERG fusion in prostate cancer. Pooled odds ratio (ORs) with 95% confidence intervals (CIs) were calculated to estimate the correlation between TMPRSS2-ERG fusion gene and tumor features. Results The pooled or stratified analysis showed that the TMPRSS2-ERG fusion gene had a highly predictive potential. First, TMPRSS2-ERG fusion was associated with T-stage at diagnosis (T3–4 vs. T1–2 OR: 1.40; 95% CI 1.33–1.48) and metastasis (M1 vs. M0 OR: 1.35; 95% CI 1.02–1.78) but not with biochemical recurrence or prostate cancer-specific mortality. Furthermore, the subgroup analysis found that the TMPRSS2-ERG fusion gene was correlated with Gleason (G) scores, and the fusion was common in prostate cancer with G ≤ 7. Additionally, the meta-analysis demonstrated that the fusion was likely to occur in young patients (> 65 vs. ≤ 65 OR: 0.68; 95% CI 0.52–0.89), in patients with high PSA levels (> 10 vs. ≤ 10 OR: 1.30; 95% CI 1.21–1.38), and in patients with peripheral involvement (positive vs. negative OR: 1.17; 95% CI 1.08–1.28), while not associated with tumor volume. Finally, the subgroup analysis of different fusion types demonstrated that the deletion-type fusion was significantly associated with the malignant degree of prostate cancer (pooled OR: 5.67; 95% CI 2.85–11.28). Moreover, the deletion-type was common in Africa patients, followed by Caucasian patients, and no significant difference was observed in the incidence of different fusion types in the Asian population. Conclusions The meta-analysis findings suggested that the TMPRSS2-ERG fusion gene might be a predictive marker for prostate cancer patients, and might be valuable for assessing the characteristics of prostate cancer for individualized treatment and prognosis evaluation. Electronic supplementary material The online version of this article (10.1186/s12935-018-0672-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chunjiao Song
- 1Medical Research Center, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), No. 568 Zhongxing Bei Road, Shaoxing, 312000 Zhejiang People's Republic of China
| | - Huan Chen
- 2Zhejiang Institute of Microbiology (Key Laboratory of Microorganism Technology and Bioinformatics Research of Zhejiang Province), Hangzhou, Zhejiang China
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11
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Rubin MA, Demichelis F. The Genomics of Prostate Cancer: emerging understanding with technologic advances. Mod Pathol 2018; 31:S1-11. [PMID: 29297493 DOI: 10.1038/modpathol.2017.166] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 01/06/2023]
Abstract
With the advent of next-generation sequencing technologies and large whole-exome and genome studies in prostate and other cancers, our understanding of the landscape of genomic alterations has dramatically been refined. In additional to well-known alterations in genomic regions involving 8p, 8q, 10q23, common ETS translocations and androgen receptor amplifications, newer technology have uncovered recurrent mutations in SPOP, FOXA1, MED12, IDH and complex large scale genomic alterations (eg, chromoplexy). This review surveys the enhanced landscape of genomic alterations in clinically localized and advanced prostate cancer.
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Affiliation(s)
- Mark A Rubin
- Institute for Precision Medicine, Weill Cornell Medical College-New York Presbyterian Hospital, New York, NY, USA.,Sandra and Edward Meyer Cancer Center at Weill Cornell Medical College, New York, NY, USA.,Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.,Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Francesca Demichelis
- Institute for Precision Medicine, Weill Cornell Medical College-New York Presbyterian Hospital, New York, NY, USA.,Centre of Integrative Biology, University of Trento, Trento, Italy
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12
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Wu D, Ni J, Beretov J, Cozzi P, Willcox M, Wasinger V, Walsh B, Graham P, Li Y. Urinary biomarkers in prostate cancer detection and monitoring progression. Crit Rev Oncol Hematol 2017; 118:15-26. [DOI: 10.1016/j.critrevonc.2017.08.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/08/2017] [Accepted: 08/11/2017] [Indexed: 12/21/2022] Open
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13
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Sanda MG, Feng Z, Howard DH, Tomlins SA, Sokoll LJ, Chan DW, Regan MM, Groskopf J, Chipman J, Patil DH, Salami SS, Scherr DS, Kagan J, Srivastava S, Thompson IM, Siddiqui J, Fan J, Joon AY, Bantis LE, Rubin MA, Chinnayian AM, Wei JT, Bidair M, Kibel A, Lin DW, Lotan Y, Partin A, Taneja S. Association Between Combined TMPRSS2:ERG and PCA3 RNA Urinary Testing and Detection of Aggressive Prostate Cancer. JAMA Oncol 2017; 3:1085-1093. [PMID: 28520829 DOI: 10.1001/jamaoncol.2017.0177] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Importance Potential survival benefits from treating aggressive (Gleason score, ≥7) early-stage prostate cancer are undermined by harms from unnecessary prostate biopsy and overdiagnosis of indolent disease. Objective To evaluate the a priori primary hypothesis that combined measurement of PCA3 and TMPRSS2:ERG (T2:ERG) RNA in the urine after digital rectal examination would improve specificity over measurement of prostate-specific antigen alone for detecting cancer with Gleason score of 7 or higher. As a secondary objective, to evaluate the potential effect of such urine RNA testing on health care costs. Design, Setting, and Participants Prospective, multicenter diagnostic evaluation and validation in academic and community-based ambulatory urology clinics. Participants were a referred sample of men presenting for first-time prostate biopsy without preexisting prostate cancer: 516 eligible participants from among 748 prospective cohort participants in the developmental cohort and 561 eligible participants from 928 in the validation cohort. Interventions/Exposures Urinary PCA3 and T2:ERG RNA measurement before prostate biopsy. Main Outcomes and Measures Presence of prostate cancer having Gleason score of 7 or higher on prostate biopsy. Pathology testing was blinded to urine assay results. In the developmental cohort, a multiplex decision algorithm was constructed using urine RNA assays to optimize specificity while maintaining 95% sensitivity for predicting aggressive prostate cancer at initial biopsy. Findings were validated in a separate multicenter cohort via prespecified analysis, blinded per prospective-specimen-collection, retrospective-blinded-evaluation (PRoBE) criteria. Cost effects of the urinary testing strategy were evaluated by modeling observed biopsy results and previously reported treatment outcomes. Results Among the 516 men in the developmental cohort (mean age, 62 years; range, 33-85 years) combining testing of urinary T2:ERG and PCA3 at thresholds that preserved 95% sensitivity for detecting aggressive prostate cancer improved specificity from 18% to 39%. Among the 561 men in the validation cohort (mean age, 62 years; range, 27-86 years), analysis confirmed improvement in specificity (from 17% to 33%; lower bound of 1-sided 95% CI, 0.73%; prespecified 1-sided P = .04), while high sensitivity (93%) was preserved for aggressive prostate cancer detection. Forty-two percent of unnecessary prostate biopsies would have been averted by using the urine assay results to select men for biopsy. Cost analysis suggested that this urinary testing algorithm to restrict prostate biopsy has greater potential cost-benefit in younger men. Conclusions and Relevance Combined urinary testing for T2:ERG and PCA3 can avert unnecessary biopsy while retaining robust sensitivity for detecting aggressive prostate cancer with consequent potential health care cost savings.
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Affiliation(s)
- Martin G Sanda
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia
| | - Ziding Feng
- Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - David H Howard
- Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Scott A Tomlins
- Department of Urology, University of Michigan, Ann Arbor, Michigan.,Michigan Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Lori J Sokoll
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Daniel W Chan
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Meredith M Regan
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | - Jonathan Chipman
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Dattatraya H Patil
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia
| | - Simpa S Salami
- Hofstra North Shore-LIJ School of Medicine, The Arthur Smith Institute for Urology, New Hyde Park, New York
| | - Douglas S Scherr
- Department of Urology, Weill-Cornell Medical Center, New York, New York
| | - Jacob Kagan
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Sudhir Srivastava
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Ian M Thompson
- University of Texas Health Sciences Center - San Antonio, Texas
| | - Javed Siddiqui
- Michigan Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Jing Fan
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, California
| | - Aron Y Joon
- Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Leonidas E Bantis
- Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Mark A Rubin
- Department of Pathology, Weill-Cornell Medical Center, New York, New York
| | - Arul M Chinnayian
- Department of Urology, University of Michigan, Ann Arbor, Michigan.,Michigan Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - John T Wei
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | | | | | - Adam Kibel
- Brigham and Women's Hospital, Boston, Massachusetts
| | - Daniel W Lin
- University of Washington Medical Center, Seattle
| | - Yair Lotan
- University of Texas Southwestern Medical Center, Dallas
| | | | - Samir Taneja
- New York University School of Medicine, New York
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14
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Wang Z, Wang Y, Zhang J, Hu Q, Zhi F, Zhang S, Mao D, Zhang Y, Liang H. Significance of the TMPRSS2:ERG gene fusion in prostate cancer. Mol Med Rep 2017; 16:5450-5458. [PMID: 28849022 PMCID: PMC5647090 DOI: 10.3892/mmr.2017.7281] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 06/28/2017] [Indexed: 12/31/2022] Open
Abstract
The transmembrane protease serine 2:v-ets erythroblastosis virus E26 oncogene homolog (TMPRSS2:ERG) gene fusion is common in prostate cancer, while its functional role is not fully understood. The present study aimed to investigate the significance of the TMPRSS2:ERG gene fusion in human prostate cancers using bioinformatics tools. Comprehensive alteration analysis of TMPRSS2 and ERG in 148 different human cancer studies was performed by cBioPortal, and the mRNA expression level of the ERG gene was evaluated using Oncomine analysis. Furthermore, lentiviral short hairpin (sh)RNA-mediated knockdown of TMPRSS2:ERG was performed to study the impact of ERG silencing on cell proliferation and cell cycle distribution in prostate cancer cells. The results demonstrated that the TMPRSS2 and ERG genes were mostly altered in prostate cancer, and the most frequent alteration was gene fusion. Oncomine analysis demonstrated that the ERG gene was significantly upregulated in prostate clinical samples compared with the normal prostate gland in four independent datasets, and a positive association was observed between potassium inwardly-rectifying channel subfamily J member 15, down syndrome critical region gene 4, potassium inwardly-rectifying channel subfamily J member 6 and ERG gene expression. There were 272 mutations of the ERG gene identified in the cBioPortal database; among the mutations, 2 missense mutations (R367C and P401H) were regarded as functional mutations (functional impact score >1.938). Furthermore, the present study successfully knocked down ERG gene expression through a lentiviral-mediated gene silencing approach in VCaP prostate cancer cells. The ERG mRNA and protein expression levels were both suppressed significantly, and a cell-cycle arrest at G0/G1 phase was observed after ERG gene silencing. In conclusion, these bioinformatics analyses provide novel insights for TMPRSS2:ERG fusion gene study in prostate cancer. Target inhibition of ERG expression could significantly cause cell growth arrest in prostate cancer cells, which could be a potentially valuable target for prostate cancer treatment. However, the precise mechanism of these results remains unclear; therefore, further studies are required.
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Affiliation(s)
- Zhu Wang
- Department of Urology, People's Hospital of Longhua New District of Shenzhen and Affiliated Shenzhen Longhua Hospital of Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Yuliang Wang
- Department of Urology, Peking University People's Hospital, Beijing 100044, P.R. China
| | - Jianwen Zhang
- Department of Urology, People's Hospital of Longhua New District of Shenzhen and Affiliated Shenzhen Longhua Hospital of Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Qiyi Hu
- Department of Urology, People's Hospital of Longhua New District of Shenzhen and Affiliated Shenzhen Longhua Hospital of Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Fan Zhi
- Department of Urology, People's Hospital of Longhua New District of Shenzhen and Affiliated Shenzhen Longhua Hospital of Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Shengping Zhang
- Department of Urology, People's Hospital of Longhua New District of Shenzhen and Affiliated Shenzhen Longhua Hospital of Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Dengqi Mao
- Department of Urology, People's Hospital of Longhua New District of Shenzhen and Affiliated Shenzhen Longhua Hospital of Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Ying Zhang
- Department of Urology, People's Hospital of Longhua New District of Shenzhen and Affiliated Shenzhen Longhua Hospital of Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
| | - Hui Liang
- Department of Urology, People's Hospital of Longhua New District of Shenzhen and Affiliated Shenzhen Longhua Hospital of Southern Medical University, Shenzhen, Guangdong 518109, P.R. China
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15
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Barnett CL, Tomlins SA, Underwood DJ, Wei JT, Morgan TM, Montie JE, Denton BT. Two-Stage Biomarker Protocols for Improving the Precision of Early Detection of Prostate Cancer. Med Decis Making 2017; 37:815-826. [DOI: 10.1177/0272989x17696996] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. New cancer biomarkers are being discovered at a rapid pace; however, these tests vary in their predictive performance characteristics, and it is unclear how best to use them. Methods. We investigated 2-stage biomarker-based screening strategies in the context of prostate cancer using a partially observable Markov model to simulate patients’ progression through prostate cancer states to mortality from prostate cancer or other causes. Patients were screened every 2 years from ages 55 to 69. If the patient’s serum prostate-specific antigen (PSA) was over a specified threshold in the first stage, a second stage biomarker test was administered. We evaluated design characteristics for these 2-stage strategies using 7 newly discovered biomarkers as examples. Monte Carlo simulation was used to estimate the number of screening biopsies, prostate cancer deaths, and quality-adjusted life-years (QALYs) per 1000 men. Results. The all-cancer biomarkers significantly underperformed the high-grade cancer biomarkers in terms of QALYs. The screening strategy that used a PSA threshold of 2 ng/mL and a second biomarker test with high-grade sensitivity and specificity of 0.86 and 0.62, respectively, maximized QALYs. This strategy resulted in a prostate cancer death rate within 1% of using PSA alone with a threshold of 2 ng/mL, while reducing the number of biopsies by 20%. Sensitivity analysis suggests that the results are robust with respect to variation in model parameters. Conclusions. Two-stage biomarker screening strategies using new biomarkers with risk thresholds optimized for high-grade cancer detection may increase quality-adjusted survival and reduce unnecessary biopsies.
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Affiliation(s)
- Christine L. Barnett
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI (CLB, BTD)
- Department of Urology, University of Michigan, Ann Arbor, MI (SAT, JTW, TMM, JEM, BTD)
- Department of Pathology, University of Michigan, Ann Arbor, MI (SAT)
- Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC (DJU)
| | - Scott A. Tomlins
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI (CLB, BTD)
- Department of Urology, University of Michigan, Ann Arbor, MI (SAT, JTW, TMM, JEM, BTD)
- Department of Pathology, University of Michigan, Ann Arbor, MI (SAT)
- Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC (DJU)
| | - Daniel J. Underwood
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI (CLB, BTD)
- Department of Urology, University of Michigan, Ann Arbor, MI (SAT, JTW, TMM, JEM, BTD)
- Department of Pathology, University of Michigan, Ann Arbor, MI (SAT)
- Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC (DJU)
| | - John T. Wei
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI (CLB, BTD)
- Department of Urology, University of Michigan, Ann Arbor, MI (SAT, JTW, TMM, JEM, BTD)
- Department of Pathology, University of Michigan, Ann Arbor, MI (SAT)
- Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC (DJU)
| | - Todd M. Morgan
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI (CLB, BTD)
- Department of Urology, University of Michigan, Ann Arbor, MI (SAT, JTW, TMM, JEM, BTD)
- Department of Pathology, University of Michigan, Ann Arbor, MI (SAT)
- Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC (DJU)
| | - James E. Montie
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI (CLB, BTD)
- Department of Urology, University of Michigan, Ann Arbor, MI (SAT, JTW, TMM, JEM, BTD)
- Department of Pathology, University of Michigan, Ann Arbor, MI (SAT)
- Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC (DJU)
| | - Brian T. Denton
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI (CLB, BTD)
- Department of Urology, University of Michigan, Ann Arbor, MI (SAT, JTW, TMM, JEM, BTD)
- Department of Pathology, University of Michigan, Ann Arbor, MI (SAT)
- Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC (DJU)
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16
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Palapattu GS, Salami SS, Cani AK, Hovelson DH, Lazo de la Vega L, Vandenberg KR, Bratley JV, Liu CJ, Kunju LP, Montgomery JS, Morgan TM, Natarajan S, Huang J, Tomlins SA, Marks LS. Molecular Profiling to Determine Clonality of Serial Magnetic Resonance Imaging/Ultrasound Fusion Biopsies from Men on Active Surveillance for Low-Risk Prostate Cancer. Clin Cancer Res 2017; 23:985-991. [PMID: 28031426 PMCID: PMC5315613 DOI: 10.1158/1078-0432.ccr-16-1454] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/21/2016] [Accepted: 09/11/2016] [Indexed: 12/19/2022]
Abstract
Purpose: To determine whether MRI/ultrasound (MRI/US) fusion biopsy facilitates longitudinal resampling of the same clonal focus of prostate cancer and to determine whether high-grade cancers can evolve from low-grade clones.Experimental Design: All men on active surveillance who underwent tracking MRI/US fusion biopsy of Gleason 6 prostate cancer, on at least two distinct occasions, between 2012 and 2014 were enrolled. MRI/US fusion was used to track and resample specific cancer foci. IHC for ERG and targeted RNA/DNA next-generation sequencing (NGS) were performed on formalin-fixed paraffin-embedded prostate biopsy specimens to assess clonality.Results: Thirty-one men with median age and PSA of 65 years and 4.6 ng/mL, respectively, were analyzed. The median sampling interval was 12 months (range, 5-35). Of the 26 evaluable men, ERG IHC concordance was found between initial and repeat biopsies in 25 (96%), indicating resampling of the same clonal focus over time. Targeted NGS supported ERG IHC results and identified unique and shared driving mutations, such as IDH1 and SPOP, in paired specimens. Of the nine men (34.6%) who were found to have Gleason ≥7 on repeat biopsy, all displayed temporal ERG concordance. Prioritized genetic alterations were detected in 50% (13/26) of paired samples. Oncogenic mutations were detected in 22% (2/9) of Gleason 6 cancers prior to progression and 44% (4/9) of Gleason ≥7 cancers when progression occurred.Conclusions: Precise tracking of prostate cancer foci via MRI/US fusion biopsy allowed subsequent resampling of the same clonal focus of cancer over time. Further research is needed to clarify the grade progression potential of Gleason 6 prostate cancer. Clin Cancer Res; 23(4); 985-91. ©2016 AACR.
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Affiliation(s)
- Ganesh S Palapattu
- Department of Urology, University of Michigan, Ann Arbor, Michigan.
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Simpa S Salami
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Andi K Cani
- Department of Pathology, Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan
| | - Daniel H Hovelson
- Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, Michigan
| | - Lorena Lazo de la Vega
- Department of Pathology, Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan
| | - Kelly R Vandenberg
- Department of Pathology, Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan
| | - Jarred V Bratley
- Department of Pathology, Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan
| | - Chia-Jen Liu
- Department of Pathology, Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan
| | - Lakshmi P Kunju
- Department of Pathology, Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan
| | - Jeffery S Montgomery
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Todd M Morgan
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Shyam Natarajan
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Jiaoti Huang
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina
| | - Scott A Tomlins
- Department of Urology, University of Michigan, Ann Arbor, Michigan.
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan
- Department of Pathology, Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan
| | - Leonard S Marks
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California.
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17
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Yates C, Long MD, Campbell MJ, Sucheston-Campbell L. miRNAs as drivers of TMPRSS2-ERG negative prostate tumors in African American men. FRONT BIOSCI-LANDMRK 2017; 22:212-229. [PMID: 27814612 PMCID: PMC5858730 DOI: 10.2741/4482] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
African Americans (AAs) who have PCa typically have more aggressive disease and make up a disproportionate number of the disease deaths, relative to European Americans (EAs). TMPRSS2 translocations, a common event in EA patients, are exploited in diagnostic and prognostic settings, whereas they are diminished in frequency in AA men. Thus, these patients with TMPRSS2 fusion-negative disease represent an under-investigated patient group. We propose that epigenetic events are a significant and alternative driver of aggressive disease in fusion-negative PCa. To reveal epigenetically governed microRNAs (miRNAs) that are enriched in fusion-negative disease and associated with aggressive in AA PCa, we leveraged both our experimental evidence and publically available data. These analyses identified 18 miRNAs that are differentially altered in fusion-negative disease, associated with DNA CpG methylation, and implicated in aggressive and AA PCas. Understanding the relationships between miRNA expression, upstream epigenetic regulation by DNA methylation, and downstream regulation of mRNA targets in fusion negative disease is imperative to understanding the biological basis of the racial health disparity in PCa.
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Affiliation(s)
- Clayton Yates
- Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, AL 36088
| | - Mark D Long
- Pharmacology and Therapeutics, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263
| | - Moray J Campbell
- Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, AL 36088,
| | - Lara Sucheston-Campbell
- Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263
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18
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Heterogeneity of ERG expression in prostate cancer: a large section mapping study of entire prostatectomy specimens from 125 patients. BMC Cancer 2016; 16:641. [PMID: 27530104 PMCID: PMC4988055 DOI: 10.1186/s12885-016-2674-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/03/2016] [Indexed: 11/18/2022] Open
Abstract
Background TMPRSS2:ERG fusions are frequent in prostate cancer, and occur predominantly in young patients. Several studies had proposed intratumoral heterogeneity of these fusions. This study was designed to determine frequency and extent of ERG fusion heterogeneity in early-onset prostate cancer (EO-PCA, <50 years) and in elderly patients. Methods The prostates from 63 EO-PCA and 62 elderly prostate cancer patients were thoroughly reviewed for presence of cancer foci. All 1592 tumor-containing sections were analyzed by immunohistochemistry for ERG expression. Results The prostates included in this study contained one tumor focus in 44, two tumor foci in 21, three tumor foci in 32, four tumor foci in 15, and five or more tumor foci in 13 patients. Among 59 cancer foci with ≤3 mm, 19 (32.2 %) were homogeneously ERG positive, 39 66.1 %) were homogeneously ERG negative, and one case (1.7 %) showed a heterogeneous ERG status. The fraction of homogeneously ERG positive cancer foci remained largely constant (14–37 %) with increasing tumor focus diameter but the fraction of heterogeneous ERG findings continuously increased with tumor size and reached 39 % in cancer foci larger than 22 mm. On a patient level, ERG expression was markedly more frequent in EO-PCA than in elderly patients: 13 % of EO-PCA were homogeneously and 62 % were heterogeneously ERG positive. In elderly patients, 3 % of cancers were homogeneously and 57 % were heterogeneously ERG positive (p = 0.0721). Conclusion These data show that about 20–30 % of prostate cancer foci have early ERG fusions. ERG fusions further occur in about 50 % of initially ERG negative cancer foci during cancer progression. The vast majority of cancers are heterogeneous for TMPRSS2:ERG fusions on a patient level, challenging the concept of classifying prostate cancer patients into “fusion type” and “non-fusion type” prostate cancer.
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19
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Abstract
Urology has been beset by several major trends that have shifted the entire paradigm for prostate cancer screening. These stem from a backlash against overdiagnosis and overtreatment due to prostate-specific antigen (PSA)-based screening efforts and have led national societies to modify their guidelines. More importantly, the public outcry has shifted the focus of early detection from an effort to diagnose any and all prostate cancers to an effort to diagnose clinically significant prostate cancers at an early stage. This review provides an update on contemporary biomarkers for prostate cancer that may be used to supplement PSA-based screening approaches.
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Okihara K, Ochiai A, Kamoi K, Fujizuka Y, Miki T, Ito K. Comprehensive assessment for novel prostate cancer markers in the prostate-specific antigen era: focusing on Asians and Asian countries. Int J Urol 2016; 22:334-41. [PMID: 25827049 DOI: 10.1111/iju.12701] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 11/17/2014] [Accepted: 12/03/2014] [Indexed: 11/27/2022]
Abstract
We reviewed the current evidence for three novel prostate tumor markers (PCA3, TMPRSS2:ERG and proPSA) that have been recently reported predominantly in Western countries. We focus our attention on Asian men in both clinical and basic research studies. There have been no reports on the clinical usefulness of these three markers for Asians living in Western countries. In Asian countries, evidence for the clinical usefulness of PCA3 and proPSA-related indices including Prostate Health Index is being accumulated, mainly in Japan. The process for how a novel marker is approved in the clinical setting is also discussed.
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Affiliation(s)
- Koji Okihara
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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21
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Fontugne J, Davis K, Palanisamy N, Udager A, Mehra R, McDaniel AS, Siddiqui J, Rubin MA, Mosquera JM, Tomlins SA. Clonal evaluation of prostate cancer foci in biopsies with discontinuous tumor involvement by dual ERG/SPINK1 immunohistochemistry. Mod Pathol 2016; 29:157-65. [PMID: 26743468 PMCID: PMC4732921 DOI: 10.1038/modpathol.2015.148] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 11/06/2015] [Accepted: 11/07/2015] [Indexed: 12/16/2022]
Abstract
The presence of two or more prostate cancer foci separated by intervening benign tissue in a single core is a well-recognized finding on prostate biopsy. Cancer involvement can be measured by including intervening benign tissue or only including the actual cancer involved area. Importantly, this parameter is a common enrollment criterion for active surveillance protocols. We hypothesized that spatially distinct prostate cancer foci in biopsies may arise from separate clones, impacting cancer involvement assessment. Hence, we used dual ERG/SPINK1 immunohistochemistry to determine the frequency of separate clones-when separate tumor foci showed discordant ERG and/or SPINK1 status-in discontinuously involved prostate biopsy cores from two academic institutions. In our cohort of 97 prostate biopsy cores with spatially discrete tumor foci (from 80 patients), discontinuous cancer involvement including intervening tissue ranged from 20 to 100% and Gleason scores ranged from 6 to 9. Twenty-four (25%) of 97 discontinuously involved cores harbored clonally distinct cancer foci by discordant ERG and/or SPINK1 expression status: 58% (14/24) had one ERG(+) focus, and one ERG(-)/SPINK1(-) focus; 29% (7/24) had one SPINK1(+) focus and one ERG(-)/SPINK1(-) focus; and 13% (3/24) had one ERG(+) focus and one SPINK1(+) focus. ERG and SPINK1 overexpression were mutually exclusive in all tumor foci. In summary, our results show that ~25% of discontinuously involved prostate biopsy cores showed tumor foci with discordant ERG/SPINK1 status, consistent with multiclonal disease. The relatively frequent presence of multiclonality in discontinuously involved prostate biopsy cores warrants studies on the potential clinical impact of clonality assessment, particularly in cases where tumor volume in a discontinuous core may impact active surveillance eligibility.
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Affiliation(s)
- Jacqueline Fontugne
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY, USA,Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian, New York, NY, USA
| | - Kristina Davis
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Aaron Udager
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Andrew S. McDaniel
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Javed Siddiqui
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mark A. Rubin
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY, USA,Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian, New York, NY, USA
| | - Juan Miguel Mosquera
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY, USA,Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian, New York, NY, USA
| | - Scott A. Tomlins
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA,Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
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23
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Abstract
Much progress has been made in research for prostate cancer in the past decade. There is now greater understanding for the genetic basis of familial prostate cancer with identification of rare but high-risk mutations (eg, BRCA2, HOXB13) and low-risk but common alleles (77 identified so far by genome-wide association studies) that could lead to targeted screening of patients at risk. This is especially important because screening for prostate cancer based on prostate-specific antigen remains controversial due to the high rate of overdiagnosis and unnecessary prostate biopsies, despite evidence that it reduces mortality. Classification of prostate cancer into distinct molecular subtypes, including mutually exclusive ETS-gene-fusion-positive and SPINK1-overexpressing, CHD1-loss cancers, could allow stratification of patients for different management strategies. Presently, men with localised disease can have very different prognoses and treatment options, ranging from observation alone through to radical surgery, with few good-quality randomised trials to inform on the best approach for an individual patient. The survival of patients with metastatic prostate cancer progressing on androgen-deprivation therapy (castration-resistant prostate cancer) has improved substantially. In addition to docetaxel, which has been used for more than a decade, in the past 4 years five new drugs have shown efficacy with improvements in overall survival leading to licensing for the treatment of metastatic castration-resistant prostate cancer. Because of this rapid change in the therapeutic landscape, no robust data exist to inform on the selection of patients for a specific treatment for castration-resistant prostate cancer or the best sequence of administration. Moreover, the high cost of the newer drugs limits their widespread use in several countries. Data from continuing clinical and translational research are urgently needed to improve, and, crucially, to personalise management.
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Affiliation(s)
- Gerhardt Attard
- Division of Clinical Studies, The Institute of Cancer Research, London, UK; Prostate Cancer Targeted Therapy Group, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - Chris Parker
- Academic Urology Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - Ros A Eeles
- Clinical Academic Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; Oncogenetics Team, Division of Cancer Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Fritz Schröder
- Erasmus University Medical Center, Rotterdam, Netherlands
| | - Scott A Tomlins
- Departments of Pathology Urology, Comprehensive Cancer Center and Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ian Tannock
- Princess Margaret Cancer Centre and University of Toronto, Toronto, ON, Canada
| | - Charles G Drake
- Division of Medical Oncology, Johns Hopkins Hospital, Baltimore, MA, USA
| | - Johann S de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, UK; Prostate Cancer Targeted Therapy Group, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK.
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24
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Merdan S, Tomlins SA, Barnett CL, Morgan TM, Montie JE, Wei JT, Denton BT. Assessment of long-term outcomes associated with urinary prostate cancer antigen 3 and TMPRSS2:ERG gene fusion at repeat biopsy. Cancer 2015; 121:4071-9. [PMID: 26280815 PMCID: PMC5657150 DOI: 10.1002/cncr.29611] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 07/01/2015] [Accepted: 07/06/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND In men with clinically localized prostate cancer who have undergone at least 1 previous negative biopsy and have elevated serum prostate-specific antigen (PSA) levels, long-term health outcomes associated with the assessment of urinary prostate cancer antigen 3 (PCA3) and the transmembrane protease, serine 2 (TMPRSS2):v-ets erythroblastosis virus E26 oncogene homolog (avian) (ERG) gene fusion (T2:ERG) have not been investigated previously in relation to the decision to recommend a repeat biopsy. METHODS The authors performed a decision analysis using a decision tree for men with elevated PSA levels. The probability of cancer was estimated using the Prostate Cancer Prevention Trial Risk Calculator (version 2.0). The use of PSA alone was compared with the use of PCA3 and T2:ERG scores, with each evaluated independently, in combination with PSA to trigger a repeat biopsy. When PCA3 and T2:ERG score evaluations were used, predefined thresholds were established to determine whether the patient should undergo a repeat biopsy. Biopsy outcomes were defined as either positive (with a Gleason score of <7, 7, or >7) or negative. Probabilities and estimates of 10-year overall survival and 15-year cancer-specific survival were derived from previous studies and a literature review. Outcomes were defined as age-dependent and Gleason score-dependent 10-year overall and 15-year cancer-specific survival rates and the percentage of biopsies avoided. RESULTS Incorporating the PCA3 score (biopsy threshold, 25; generated based on the urine PCA3 level normalized to the amount of PSA messenger RNA) or the T2:ERG score (biopsy threshold, 10; based on the urine T2:ERG level normalized to the amount of PSA messenger RNA) into the decision to recommend repeat biopsy would have avoided 55.4% or 64.7% of repeat biopsies for the base-case patient, respectively, and changes in the 10-year survival rate were only 0.93% or 1.41%, respectively. Multi-way sensitivity analyses suggested that these results were robust with respect to the model parameters. CONCLUSIONS The use of PCA3 or T2:ERG testing for repeat biopsy decisions can substantially reduce the number of biopsies without significantly affecting 10-year survival.
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Affiliation(s)
- Selin Merdan
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan
| | - Scott A Tomlins
- Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Christine L Barnett
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan
| | - Todd M Morgan
- Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan
| | - James E Montie
- Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan
| | - John T Wei
- Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Brian T Denton
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan
- Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan
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Tomlins SA, Groskopf J, Chinnaiyan AM. Reply to Carsten Stephan, Henning Cammann, and Klaus Jung's Letter to the Editor re: Scott A. Tomlins, John R. Day, Robert J. Lonigro, et al. Urine TMPRSS2:ERG Plus PCA3 for Individualized Prostate Cancer Risk Assessment. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2015.04.039. Eur Urol 2015; 68:e108. [DOI: 10.1016/j.eururo.2015.07.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 07/10/2015] [Indexed: 11/16/2022]
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Pellegrini KL, Sanda MG, Moreno CS. RNA biomarkers to facilitate the identification of aggressive prostate cancer. Mol Aspects Med 2015; 45:37-46. [PMID: 26022941 PMCID: PMC4637232 DOI: 10.1016/j.mam.2015.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 05/20/2015] [Indexed: 02/07/2023]
Abstract
A large number of men are diagnosed with prostate cancer each year, but many will not experience morbidity or mortality as a result of their cancers. Therefore, biomarkers for prostate cancer are necessary to carefully select patients for initial diagnostic biopsy or to facilitate care decisions for men who have already been diagnosed with prostate cancer. RNA-based approaches to biomarker discovery allow the investigation of non-coding RNAs, gene fusion transcripts, splice variants, and multi-gene expression panels in tissue, urine, or blood as opportunities to improve care decisions. This review focuses on RNA biomarkers that are available as commercial assays, and therefore already available for potential clinical use, as well as providing an overview of newer RNA biomarkers that are in earlier stages of clinical development.
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Affiliation(s)
- Kathryn L Pellegrini
- Department of Urology, Emory University School of Medicine, Winship Cancer Institute at Emory University, Atlanta, GA 30322, USA
| | - Martin G Sanda
- Department of Urology, Emory University School of Medicine, Winship Cancer Institute at Emory University, Atlanta, GA 30322, USA
| | - Carlos S Moreno
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Winship Cancer Institute at Emory University, Atlanta, GA 30322, USA.
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27
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Pal RP, Kockelbergh RC, Pringle JH, Cresswell L, Hew R, Dormer JP, Cooper C, Mellon JK, Barwell JG, Hollox EJ. Immunocytochemical detection of ERG expression in exfoliated urinary cells identifies with high specificity patients with prostate cancer. BJU Int 2015; 117:686-96. [DOI: 10.1111/bju.13184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Raj P. Pal
- Department of Cancer Studies and Molecular Medicine; University of Leicester; Leicester UK
- Department of Urology; University Hospitals of Leicester NHS Trust; Leicester UK
| | - Roger C. Kockelbergh
- Department of Urology; University Hospitals of Leicester NHS Trust; Leicester UK
| | - John Howard Pringle
- Department of Cancer Studies and Molecular Medicine; University of Leicester; Leicester UK
| | - Lara Cresswell
- Department of Cytogenetics; University Hospitals of Leicester NHS Trust; Leicester UK
| | - Roger Hew
- Department of Cellular Pathology; University Hospitals of Leicester NHS Trust; Leicester UK
| | - John P. Dormer
- Department of Cellular Pathology; University Hospitals of Leicester NHS Trust; Leicester UK
| | - Colin Cooper
- Department of Cancer Genetics; University of East Anglia; Norwich UK
| | - John Kilian Mellon
- Department of Urology; University Hospitals of Leicester NHS Trust; Leicester UK
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28
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Abstract
PURPOSE OF REVIEW The field of urology has been beset by several major trends that have affected the early detection of prostate cancer. These stem primarily from a backlash against overdiagnosis due to prostate specific antigen-based screening efforts and are epitomized by the US Preventive Services Task Force giving prostate specific antigen-based prostate cancer screening a 'D' recommendation. Consequently, the active surveillance strategy for low-risk prostate cancer has become commonplace, leading many to ask how best to follow these patients. More importantly, this public outcry has shifted the focus of early detection from an effort to diagnose any and all prostate cancers to an effort to diagnose only 'high-risk' cancer. Along with a trend for minimally invasive procedures, these forces have challenged the early detection field to more efficiently identify clinically significant prostate cancers at an early stage while limiting the number of biopsies. RECENT FINDINGS With US Food and Drug Administration approval, prostate cancer antigen 3 has emerged as the first bona-fide urinary biomarker for prostate cancer. Using the same platform, investigators have developed a second urinary test based on TMPRSS2:erg fusion. Recent literature supports the use of these biomarkers as a combined panel that improves risk evaluation in the setting of prostate cancer detection. Early works for applying urinary biomarkers for active surveillance are underway. Other biomarkers in the pipeline will require further prevalidation and validation work. SUMMARY Recent literature would support that urinary biomarkers have a clear role to supplement risk evaluation for men undergoing prostate biopsy and for prognostication.
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29
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Vlaeminck-Guillem V. Prognostic accuracy of prostate health index and urinary prostate cancer antigen 3 in predicting pathologic features after radical prostatectomy. Urol Oncol 2015; 33:498. [PMID: 26116413 DOI: 10.1016/j.urolonc.2015.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 05/15/2015] [Accepted: 05/26/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Virginie Vlaeminck-Guillem
- Biochemistry and Molecular Biology, Lyon-Sud University Hospital, Hospices Civils of Lyon, Pierre-Bénite, France; Cancer Research Centre of Lyon, INSERM1052, CNRS5286, Léon Bérard Centre, Lyon I University, Lyon, France
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30
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Novel RNA hybridization method for the in situ detection of ETV1, ETV4, and ETV5 gene fusions in prostate cancer. Appl Immunohistochem Mol Morphol 2015; 22:e32-40. [PMID: 25203299 DOI: 10.1097/pai.0000000000000095] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The genetic basis of 50% to 60% of prostate cancer (PCa) is attributable to rearrangements in E26 transformation-specific (ETS) (ERG, ETV1, ETV4, and ETV5), BRAF, and RAF1 genes and overexpression of SPINK1. The development and validation of reliable detection methods are warranted to classify various molecular subtypes of PCa for diagnostic and prognostic purposes. ETS gene rearrangements are typically detected by fluorescence in situ hybridization and reverse-transcription polymerase chain reaction methods. Recently, monoclonal antibodies against ERG have been developed that detect the truncated ERG protein in immunohistochemical assays where staining levels are strongly correlated with ERG rearrangement status by fluorescence in situ hybridization. However, specific antibodies for ETV1, ETV4, and ETV5 are unavailable, challenging their clinical use. We developed a novel RNA in situ hybridization-based assay for the in situ detection of ETV1, ETV4, and ETV5 in formalin-fixed paraffin-embedded tissues from prostate needle biopsies, prostatectomy, and metastatic PCa specimens using RNA probes. Further, with combined RNA in situ hybridization and immunohistochemistry we identified a rare subset of PCa with dual ETS gene rearrangements in collisions of independent tumor foci. The high specificity and sensitivity of RNA in situ hybridization provides an alternate method enabling bright-field in situ detection of ETS gene aberrations in routine clinically available PCa specimens.
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31
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Tomlins SA, Day JR, Lonigro RJ, Hovelson DH, Siddiqui J, Kunju LP, Dunn RL, Meyer S, Hodge P, Groskopf J, Wei JT, Chinnaiyan AM. Urine TMPRSS2:ERG Plus PCA3 for Individualized Prostate Cancer Risk Assessment. Eur Urol 2015; 70:45-53. [PMID: 25985884 DOI: 10.1016/j.eururo.2015.04.039] [Citation(s) in RCA: 263] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 04/29/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND TMPRSS2:ERG (T2:ERG) and prostate cancer antigen 3 (PCA3) are the most advanced urine-based prostate cancer (PCa) early detection biomarkers. OBJECTIVE Validate logistic regression models, termed Mi-Prostate Score (MiPS), that incorporate serum prostate-specific antigen (PSA; or the multivariate Prostate Cancer Prevention Trial risk calculator version 1.0 [PCPTrc]) and urine T2:ERG and PCA3 scores for predicting PCa and high-grade PCa on biopsy. DESIGN, SETTING, AND PARTICIPANTS T2:ERG and PCA3 scores were generated using clinical-grade transcription-mediated amplification assays. Pretrained MiPS models were applied to a validation cohort of whole urine samples prospectively collected after digital rectal examination from 1244 men presenting for biopsy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Area under the curve (AUC) was used to compare the performance of serum PSA (or the PCPTrc) alone and MiPS models. Decision curve analysis (DCA) was used to assess clinical benefit. RESULTS AND LIMITATIONS Among informative validation cohort samples (n=1225 [98%], 80% from patients presenting for initial biopsy), models incorporating T2:ERG had significantly greater AUC than PSA (or PCPTrc) for predicting PCa (PSA: 0.693 vs 0.585; PCPTrc: 0.718 vs 0.639; both p<0.001) or high-grade (Gleason score >6) PCa on biopsy (PSA: 0.729 vs 0.651, p<0.001; PCPTrc: 0.754 vs 0.707, p=0.006). MiPS models incorporating T2:ERG score had significantly greater AUC (all p<0.001) than models incorporating only PCA3 plus PSA (or PCPTrc or high-grade cancer PCPTrc [PCPThg]). DCA demonstrated net benefit of the MiPS_PCPTrc (or MiPS_PCPThg) model compared with the PCPTrc (or PCPThg) across relevant threshold probabilities. CONCLUSIONS Incorporating urine T2:ERG and PCA3 scores improves the performance of serum PSA (or PCPTrc) for predicting PCa and high-grade PCa on biopsy. PATIENT SUMMARY Incorporation of two prostate cancer (PCa)-specific biomarkers (TMPRSS2:ERG and PCA3) measured in the urine improved on serum prostate-specific antigen (or a multivariate risk calculator) for predicting the presence of PCa and high-grade PCa on biopsy. A combined test, Mi-Prostate Score, uses models validated in this study and is clinically available to provide individualized risk estimates.
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Affiliation(s)
- Scott A Tomlins
- Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - John R Day
- Hologic/Gen-Probe Inc., San Diego, CA, USA
| | - Robert J Lonigro
- Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel H Hovelson
- Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Javed Siddiqui
- Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - L Priya Kunju
- Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Rodney L Dunn
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | | | | - John T Wei
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Arul M Chinnaiyan
- Michigan Center for Translational Pathology, Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, USA; Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, MI, USA.
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32
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Barbieri CE, Tomlins SA. Reprint of: The prostate cancer genome: Perspectives and potential. Urol Oncol 2015; 33:95-102. [DOI: 10.1016/j.urolonc.2015.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 08/19/2013] [Indexed: 10/23/2022]
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Smith SC, Buehler D, Choi EYK, McHugh JB, Rubin BP, Billings SD, Balzer B, Thomas DG, Lucas DR, Goldblum JR, Patel RM. CIC-DUX sarcomas demonstrate frequent MYC amplification and ETS-family transcription factor expression. Mod Pathol 2015; 28:57-68. [PMID: 24947144 DOI: 10.1038/modpathol.2014.83] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 04/11/2014] [Accepted: 04/16/2014] [Indexed: 12/18/2022]
Abstract
Recent molecular advances have identified a novel, clinically aggressive subgroup of undifferentiated round cell sarcomas defined molecularly by oncogenic fusion of the gene, CIC, and either DUX4 or its paralog, DUX4L, herein termed CIC-DUX sarcomas. Morphologically, CIC-DUX sarcomas are round cell sarcomas with high-grade nuclear features, including vesicular chromatin and nucleoli, patchy clear cell foci, myxoid change, and necrosis. Here, we studied a cohort of 10 cases, including 6 newly identified cases, 2 with paired metastases. Given our prior observation of trisomy 8 in these tumors, we assayed for amplification and expression of MYC (c-Myc) and representative downstream targets. Trisomy 8 was detected in 5/7 testable cases, with further amplification of MYC locus in 6/7 testable cases and immunohistochemical expression of MYC in 10/10. The canonical MYC transcriptional target, p21, but not MTDH, was differentially expressed compared with Ewing sarcomas. Given prior observation of induction of ETS-family transcription factors by the fusion oncoprotein, we assayed and identified highly prevalent positivity for ERG (9/10) and FLI1 (8/8). These findings are cautionary regarding use of these immunostains in prospective case workup, whereas the prevalent MYC amplification may represent a therapeutically targetable oncogenic pathway in CIC-DUX sarcomas.
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Affiliation(s)
- Steven Christopher Smith
- 1] Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA [2] Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Darya Buehler
- Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital, Madison, WI, USA
| | - Eun-Young Karen Choi
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Jonathan B McHugh
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Brian P Rubin
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Steven D Billings
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Bonnie Balzer
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dafydd G Thomas
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - David R Lucas
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - John R Goldblum
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Rajiv M Patel
- 1] Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA [2] Department of Dermatology, University of Michigan Health System, Ann Arbor, MI, USA
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34
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Tallon L, Luangphakdy D, Ruffion A, Colombel M, Devonec M, Champetier D, Paparel P, Decaussin-Petrucci M, Perrin P, Vlaeminck-Guillem V. Comparative evaluation of urinary PCA3 and TMPRSS2: ERG scores and serum PHI in predicting prostate cancer aggressiveness. Int J Mol Sci 2014; 15:13299-316. [PMID: 25079439 PMCID: PMC4159795 DOI: 10.3390/ijms150813299] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 07/15/2014] [Accepted: 07/18/2014] [Indexed: 11/16/2022] Open
Abstract
It has been suggested that urinary PCA3 and TMPRSS2:ERG fusion tests and serum PHI correlate to cancer aggressiveness-related pathological criteria at prostatectomy. To evaluate and compare their ability in predicting prostate cancer aggressiveness, PHI and urinary PCA3 and TMPRSS2:ERG (T2) scores were assessed in 154 patients who underwent radical prostatectomy for biopsy-proven prostate cancer. Univariate and multivariate analyses using logistic regression and decision curve analyses were performed. All three markers were predictors of a tumor volume≥0.5 mL. Only PHI predicted Gleason score≥7. T2 score and PHI were both independent predictors of extracapsular extension(≥pT3), while multifocality was only predicted by PCA3 score. Moreover, when compared to a base model (age, digital rectal examination, serum PSA, and Gleason sum at biopsy), the addition of both PCA3 score and PHI to the base model induced a significant increase (+12%) when predicting tumor volume>0.5 mL. PHI and urinary PCA3 and T2 scores can be considered as complementary predictors of cancer aggressiveness at prostatectomy.
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Affiliation(s)
- Lucile Tallon
- Medical Unit of Molecular Oncology and Transfer, Department of Biochemistry and Molecular Biology, University Hospital of Lyon Sud, Hospices Civils of Lyon, Chemin du Grand Revoyet, 69495 Pierre Bénite, France.
| | - Devillier Luangphakdy
- Medical Unit of Molecular Oncology and Transfer, Department of Biochemistry and Molecular Biology, University Hospital of Lyon Sud, Hospices Civils of Lyon, Chemin du Grand Revoyet, 69495 Pierre Bénite, France.
| | - Alain Ruffion
- Department of Medicine and Pharmacy, Faculty of Lyon 1 University, 8 Avenue Rockefeller, 69373 Lyon, France.
| | - Marc Colombel
- Department of Medicine and Pharmacy, Faculty of Lyon 1 University, 8 Avenue Rockefeller, 69373 Lyon, France.
| | - Marian Devonec
- Department of Medicine and Pharmacy, Faculty of Lyon 1 University, 8 Avenue Rockefeller, 69373 Lyon, France.
| | - Denis Champetier
- Department of Urology, University Hospital of Lyon Sud, Hospices Civils of Lyon, Chemin du Grand Revoyet, 69495 Pierre Bénite, France.
| | - Philippe Paparel
- Department of Medicine and Pharmacy, Faculty of Lyon 1 University, 8 Avenue Rockefeller, 69373 Lyon, France.
| | - Myriam Decaussin-Petrucci
- Department of Medicine and Pharmacy, Faculty of Lyon 1 University, 8 Avenue Rockefeller, 69373 Lyon, France.
| | - Paul Perrin
- Department of Medicine and Pharmacy, Faculty of Lyon 1 University, 8 Avenue Rockefeller, 69373 Lyon, France.
| | - Virginie Vlaeminck-Guillem
- Medical Unit of Molecular Oncology and Transfer, Department of Biochemistry and Molecular Biology, University Hospital of Lyon Sud, Hospices Civils of Lyon, Chemin du Grand Revoyet, 69495 Pierre Bénite, France.
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Khani F, Mosquera JM, Park K, Blattner M, O'Reilly C, MacDonald TY, Chen Z, Srivastava A, Tewari AK, Barbieri CE, Rubin MA, Robinson BD. Evidence for molecular differences in prostate cancer between African American and Caucasian men. Clin Cancer Res 2014; 20:4925-34. [PMID: 25056375 DOI: 10.1158/1078-0432.ccr-13-2265] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this study was to compare the frequency of ERG rearrangement, PTEN deletion, SPINK1 overexpression, and SPOP mutation in prostate cancer in African American and Caucasian men. EXPERIMENTAL DESIGN Dominant tumor nodules from radical prostatectomy specimens of 105 African American men (AAM) were compared with 113 dominant nodules from Caucasian men (CaM). Clinical and pathologic characteristics of the two groups were similar. SPINK1 overexpression was evaluated by immunohistochemistry, ERG rearrangement and PTEN deletion by FISH, and SPOP mutation by Sanger sequencing. RESULTS ERG rearrangement was identified in 48 of 113 tumors (42.5%) in CaM and 29 of 105 tumors (27.6%) in AAM (P = 0.024). PTEN deletion was seen in 19 of 96 tumors (19.8%) in CaM and 7 of 101 tumors (6.9%) in AAM (P = 0.011). SPINK1 overexpression was present in 9 of 110 tumors (8.2%) in CaM and 25 of 105 tumors (23.4%) in AAM (P = 0.002). SPOP mutation was identified in 8 of 78 (10.3%) tumors in CaM and 4 of 88 (4.5%) tumors in AAM (P = 0.230). When adjusted for age, body mass index, Gleason score, and pathologic stage, ERG rearrangement and SPINK1 overexpression remain significantly different (P = 0.018 and P = 0.008, respectively), and differences in PTEN deletion and SPOP mutation approach significance (P = 0.061 and P = 0.087, respectively). CONCLUSIONS Significant molecular differences exist between prostate cancers in AAM and CaM. SPINK1 overexpression, an alteration associated with more aggressive prostate cancers, was more frequent in AAM, whereas ERG rearrangement and PTEN deletion were less frequent in this cohort. Further investigation is warranted to determine whether these molecular differences explain some of the disparity in incidence and mortality between these two ethnic groups.
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Affiliation(s)
- Francesca Khani
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Juan Miguel Mosquera
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York. Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Kyung Park
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Mirjam Blattner
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Catherine O'Reilly
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Theresa Y MacDonald
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Zhengming Chen
- Department of Public Health, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Abhishek Srivastava
- Department of Urology, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Ashutosh K Tewari
- Department of Urology, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Christopher E Barbieri
- Department of Urology, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Mark A Rubin
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York. Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York. Department of Urology, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York
| | - Brian D Robinson
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York. Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York. Department of Urology, Weill Medical College of Cornell University and New York-Presbyterian Hospital, New York, New York.
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36
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Kong HY, Byun J. Emerging roles of human prostatic Acid phosphatase. Biomol Ther (Seoul) 2014; 21:10-20. [PMID: 24009853 PMCID: PMC3762301 DOI: 10.4062/biomolther.2012.095] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 01/10/2013] [Accepted: 01/14/2013] [Indexed: 11/21/2022] Open
Abstract
Prostate cancer is one of the most prevalent non-skin related cancers. It is the second leading cause of cancer deaths among males in most Western countries. If prostate cancer is diagnosed in its early stages, there is a higher probability that it will be completely cured. Prostatic acid phosphatase (PAP) is a non-specific phosphomonoesterase synthesized in prostate epithelial cells and its level proportionally increases with prostate cancer progression. PAP was the biochemical diagnostic mainstay for prostate cancer until the introduction of prostate-specific antigen (PSA) which improved the detection of early-stage prostate cancer and largely displaced PAP. Recently, however, there is a renewed interest in PAP because of its usefulness in prognosticating intermediate to high-risk prostate cancers and its success in the immunotherapy of prostate cancer. Although PAP is believed to be a key regulator of prostate cell growth, its exact role in normal prostate as well as detailed molecular mechanism of PAP regulation is still unclear. Here, many different aspects of PAP in prostate cancer are revisited and its emerging roles in other environment are discussed.
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Affiliation(s)
- Hoon Young Kong
- Department of Molecular Biology, Institute of Nanosensor and Biotechnology, Dankook University, Yongin 448-701, Republic of Korea
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Zuhlke KA, Johnson AM, Tomlins SA, Palanisamy N, Carpten JD, Lange EM, Isaacs WB, Cooney KA. Identification of a novel germline SPOP mutation in a family with hereditary prostate cancer. Prostate 2014; 74:983-90. [PMID: 24796539 PMCID: PMC4230298 DOI: 10.1002/pros.22818] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 04/11/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND Family history of prostate cancer is a well-recognized risk factor. Previous linkage studies have reported a putative prostate cancer susceptibility locus at chromosome 17q21-22. SPOP (Speckle-type POZ protein) maps to the 17q21-22 candidate linkage region and is one of the most frequently mutated genes in sporadic prostate cancers. METHODS We performed targeted next generation sequencing to analyze 2009 exons from 202 genes in a candidate linkage region on chromosome 17q21-22 using 94 unrelated familial prostate cancer cases from the University of Michigan Prostate Cancer Genetics Project (n=54) and Johns Hopkins University (n=40) including the exons and UTRs of SPOP. RESULTS We identified a novel SPOP missense mutation (N296I) in a man with prostate cancer diagnosed at age 43. This mutation completely segregates with prostate cancer affection status among the men in this family. The N296I mutation resides within the evolutionarily conserved Bric-a-brac, Tramtrack, Broad-complex (BTB) domain, involved in recruiting targets to Cul3 for degradation. Analysis of the prostate tumor from this individual verified the presence of heterozygous N296I as well as an ERG fusion. CONCLUSIONS We have discovered a novel mutation in SPOP that tracks with prostate cancer within a family and is predicted to be deleterious. Taken together, our results implicate SPOP as a candidate gene for hereditary prostate cancer.
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Affiliation(s)
- Kimberly A. Zuhlke
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Anna M. Johnson
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Scott A. Tomlins
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nallasivam Palanisamy
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Ethan M. Lange
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - William B. Isaacs
- Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kathleen A. Cooney
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
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38
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Abstract
The winner of the Wachtel prize navigates a journey from the prostate cancer genome to the clinic.
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Affiliation(s)
- Scott A Tomlins
- Department of Pathology, Michigan Center for Translational Pathology, Department of Urology, Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
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39
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Smith SC, Palanisamy N, Zuhlke KA, Johnson AM, Siddiqui J, Chinnaiyan AM, Kunju LP, Cooney KA, Tomlins SA. HOXB13 G84E-related familial prostate cancers: a clinical, histologic, and molecular survey. Am J Surg Pathol 2014; 38:615-26. [PMID: 24722062 PMCID: PMC3988475 DOI: 10.1097/pas.0000000000000090] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Recent genetic epidemiologic studies identified a germline mutation in the homeobox transcription factor, HOXB13 G84E, which is associated with markedly increased risk for prostate cancer, particularly early-onset hereditary prostate cancer. The histomorphologic and molecular features of cancers arising in such carriers have not been studied. Here, we reviewed prostatectomy specimens from 23 HOXB13 G84E mutation carriers, mapping the total cancer burden by anatomically distinct cancer focus and evaluating morphologic features. We also assessed basic molecular subtypes for all cancer foci (ERG/SPINK1 status) by dual immunohistochemistry staining on full sections. The cohort showed a median age of 58 years, a median serum PSA level of 5.7 ng/mL, and a median of 6 cancer foci (range, 1 to 14) per case. Of evaluable cases, dominant foci were Gleason score 6 in 23%, 3+4=7 in 41%, 4+3=7 in 23%, and ≥8 in 14%; biochemical recurrence was observed in 1 case over a median of 36 months follow-up. Histologic review found a high prevalence of cases showing cancers with a spectrum of features previously described with pseudohyperplastic carcinomas, with 45% of cases showing a dominant focus with such features. Molecular subtyping revealed a strikingly low prevalence of ERG cancer with increased prevalence of SPINK1 cancer (dominant focus ERG 17%, SPINK1 26%, ERG/SPINK1 52%, single ERG/SPINK1 focus 4%). One ERG/SPINK1 dominant focus showed aberrant p63 immunophenotype. In summary, HOXB13 G84E variant-related prostate cancers show frequent pseudohyperplastic-type features and markedly low prevalence of ERG cancers relative to unselected cases and, especially, to early-onset cohorts. These findings suggest that novel molecular pathways may drive disease in HOXB13 G84E carriers.
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Affiliation(s)
- Steven C. Smith
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nallasivam Palanisamy
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI USA
| | - Kimberly A. Zuhlke
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Anna M. Johnson
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Javed Siddiqui
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Arul M. Chinnaiyan
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI USA
- Howard Hughes Medical Institute
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI USA
| | - Lakshmi P Kunju
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI USA
| | - Kathleen A. Cooney
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI USA
| | - Scott A. Tomlins
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI USA
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI USA
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Stephan C, Ralla B, Jung K. Prostate-specific antigen and other serum and urine markers in prostate cancer. Biochim Biophys Acta Rev Cancer 2014; 1846:99-112. [PMID: 24727384 DOI: 10.1016/j.bbcan.2014.04.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 03/24/2014] [Accepted: 04/01/2014] [Indexed: 11/16/2022]
Abstract
Prostate-specific antigen (PSA) is one of the most widely used tumor markers, and strongly correlates with the risk of harboring from prostate cancer (PCa). This risk is visible already several years in advance but PSA has severe limitations for PCa detection with its low specificity and low negative predictive value. There is an urgent need for new biomarkers especially to detect clinically significant and aggressive PCa. From all PSA-based markers, the FDA-approved Prostate Health Index (phi) shows improved specificity over percent free and total PSA. Other serum kallikreins or sarcosine in serum or urine show more diverging data. In urine, the FDA-approved prostate cancer gene 3 (PCA3) has also proven its utility in the detection and management of early PCa. However, some aspects on its correlation with aggressiveness and the low sensitivity at very high values have to be re-examined. The detection of a fusion of the androgen regulated TMPRSS2 gene with the ERG oncogene (from the ETS family), which acts as transcription factor gene, in tissue of ~50% of all PCa patients was one milestone in PCa research. When combining the urinary assays for TMPRSS2:ERG and PCA3, an improved accuracy for PCa detection is visible. PCA3 and phi as the best available PCa biomarkers show an equal performance in direct comparisons.
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Affiliation(s)
- Carsten Stephan
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute for Urologic Research, Berlin, Germany.
| | - Bernhard Ralla
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Klaus Jung
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute for Urologic Research, Berlin, Germany
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Evaluation of tissue PCA3 expression in prostate cancer by RNA in situ hybridization--a correlative study with urine PCA3 and TMPRSS2-ERG. Mod Pathol 2014; 27:609-20. [PMID: 24072184 PMCID: PMC3968238 DOI: 10.1038/modpathol.2013.169] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/19/2013] [Accepted: 08/08/2013] [Indexed: 12/16/2022]
Abstract
PCA3 is a prostate-specific non-coding RNA, with utility as a urine-based early detection biomarker. Here, we report the evaluation of tissue PCA3 expression by RNA in situ hybridization in a cohort of 41 mapped prostatectomy specimens. We compared tissue PCA3 expression with tissue level ERG expression and matched pre-prostatectomy urine PCA3 and TMPRSS2-ERG levels. Across 136 slides containing 138 foci of prostate cancer, PCA3 was expressed in 55% of cancer foci and 71% of high-grade prostatic intraepithelial neoplasia foci. Overall, the specificity of tissue PCA3 was >90% for prostate cancer and high-grade prostatic intraepithelial neoplasia combined. Tissue PCA3 cancer expression was not significantly associated with urine PCA3 expression. PCA3 and ERG positivity in cancer foci was positively associated (P<0.01). We report the first comprehensive assessment of PCA3 expression in prostatectomy specimens, and find limited correlation between tissue PCA3 and matched urine in prostate cancer.
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42
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Urine PCA3 and TMPRSS2:ERG Using Cancer-specific Markers to Detect Cancer. Eur Urol 2014; 65:543-5. [DOI: 10.1016/j.eururo.2012.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 12/03/2012] [Indexed: 11/21/2022]
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Barbieri CE, Tomlins SA. The prostate cancer genome: Perspectives and potential. Urol Oncol 2014; 32:53.e15-22. [DOI: 10.1016/j.urolonc.2013.08.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 08/19/2013] [Indexed: 11/15/2022]
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45
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46
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Tavukcu HH, Mangir N, Ozyurek M, Turkeri L. Preliminary Results of Noninvasive Detection of TMPRSS2:ERG Gene Fusion in a Cohort of Patients With Localized Prostate Cancer. Korean J Urol 2013; 54:359-63. [PMID: 23789042 PMCID: PMC3685633 DOI: 10.4111/kju.2013.54.6.359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 02/20/2013] [Indexed: 12/31/2022] Open
Abstract
Purpose The aim of this study was to evaluate TMPRSS2:ERG fusion rates in tissue, urine, blood, and pubic hair samples in a cohort of patients with localized prostate cancer and to correlate these findings with various clinicopathological parameters. Materials and Methods A cohort of 40 patients undergoing radical prostatectomy for localized prostate cancer (RRP group) and 10 control patients undergoing prostate biopsy were enrolled between 2006 and 2008. Urine, pubic hair, and peripheral blood samples were obtained following prostatic massage before the needle biopsy or radical prostatectomy. Quantitative polymerase chain reaction analysis was performed on all collected samples. Results The patients' mean age was 62.4 (±5.5) years. We observed higher expressions of TMPRSS2:ERG fusion in tissue, urine, and blood samples from the RRP group than in samples from the control group. Overall, the fusion was present in urine samples of 23 RRP patients (57.5%). To predict high-stage cancer (>T3a), the Gleason score was the only significant factor in the logistic regression analysis (score, 10.579; p=0.001). Quantitative evaluation of the gene fusion in tissue (Pearson r=0.36, p=0.011) and urine (Pearson r=0.34, p=0.014) samples had a significant positive correlation with the preoperative prostate-specific antigen level. Conclusions Urine sediments collected after prostatic massage appear to be a feasible noninvasive method of detecting TMPRSS2:ERG fusion. The Gleason score is the only significant factor to predict high-stage cancer (>T3a). No correlation between TMPRSS2:ERG gene fusion status and tumor stage, Gleason grade, prostate-specific antigen level, or surgical margin status was observed.
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47
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Hossain D, Bostwick DG. Significance of the TMPRSS2:ERG gene fusion in prostate cancer. BJU Int 2013; 111:834-5. [PMID: 23578235 DOI: 10.1111/bju.12120] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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48
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Tomlins SA, Palanisamy N, Brenner JC, Stall JN, Siddiqui J, Thomas DG, Lucas DR, Chinnaiyan AM, Kunju LP. Usefulness of a monoclonal ERG/FLI1 antibody for immunohistochemical discrimination of Ewing family tumors. Am J Clin Pathol 2013; 139:771-9. [PMID: 23690120 DOI: 10.1309/ajcpn4l1bmrqpeit] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Ewing family tumors (EFTs) and prostate carcinomas are characterized by rearrangement of ETS genes, most commonly FLI1 (EFTs) and ERG (prostate carcinomas). Previously, we characterized an antibody against ERG (EPR3864) for detecting ERG-rearranged prostate carcinoma. Because EPR3864 also cross-reacts with FLI1, we evaluated the usefulness of EPR3864 for discriminating EFTs from other small round blue cell tumors (SRBCTs) with immunohistochemistry. Of 57 evaluable EFTs, 47 (82%) demonstrated at least moderate, diffuse, nuclear ERG/FLI1 staining (including 89% and 100% of cases with confirmed EWSR1:FLI1 and EWSR1:ERG fusions, respectively), of which 1, 3, and 43 showed negative, cytoplasmic, or membranous CD99 staining, respectively. Among other SRBCTs (61 cases, 7 types), at least moderate, diffuse, nuclear EPR3864 staining was seen in all precursor B-lymphoblastic lymphomas/leukemias and subsets of Burkitt lymphomas (10%) and synovial sarcomas (45%). In summary, EPR3864 may be useful in detecting EWSR1:FLI1 and EWSR1:ERG rearranged EFTs in addition to prostate carcinomas.
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49
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Kim W, Febbo PG. The current and future role of sequence-based analysis in prostate cancer treatment. Per Med 2013; 10:257-273. [PMID: 29768744 DOI: 10.2217/pme.13.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Prostate cancer is the most commonly diagnosed, nondermatologic malignancy in US men. Localized disease can be managed through active surveillance or curative, locally directed therapies, but 30% of men treated with surgery or radiation will need additional (often systemic) treatment for relapsed disease. While spectacular advances in medical treatment of advanced prostate cancer have improved the quality and duration of patients' lives, metastatic prostate cancer remains an incurable, lethal disease that requires additional therapies and better treatment strategies. The advent of ultra-high-throughput sequencing technology provides an opportunity to comprehensively assess the constellation of genetic and molecular events underlying each patient's tumor, and promises to enhance our ability to deliver specifically tailored personalized treatment to men with prostate cancer. The known biological and clinical heterogeneity of prostate cancer presents both opportunities and challenges to the application and utilization of sequence-based analysis to guide prostate cancer treatment.
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Affiliation(s)
- Won Kim
- University of California, 1600 Divisadero Street, A717, Box 1711, San Francisco, CA 94115, USA
| | - Phillip G Febbo
- University of California, 1600 Divisadero Street, A717, Box 1711, San Francisco, CA 94115, USA.
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50
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Hessels D, Schalken JA. Recurrent Gene Fusions in Prostate Cancer: Their Clinical Implications and Uses. Curr Urol Rep 2013; 14:214-22. [DOI: 10.1007/s11934-013-0321-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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