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Shiner A, Sperandio RC, Naimi M, Emmenegger U. Prostate Cancer Liver Metastasis: An Ominous Metastatic Site in Need of Distinct Management Strategies. J Clin Med 2024; 13:734. [PMID: 38337427 PMCID: PMC10856097 DOI: 10.3390/jcm13030734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Prostate cancer liver metastasis (PCLM), seen in upwards of 25% of metastatic castration-resistant PC (mCRPC) patients, is the most lethal site of mCRPC with a median overall survival of 10-14 months. Despite its ominous prognosis and anticipated rise in incidence due to longer survival with contemporary therapy, PCLM is understudied. This review aims to summarize the existing literature regarding the risk factors associated with the development of PCLM, and to identify areas warranting further research. A literature search was conducted through Ovid MEDLINE from 2000 to March 2023. Relevant subject headings and text words were used to capture the following concepts: "Prostatic Neoplasms", "Liver Neoplasms", and "Neoplasm Metastasis". Citation searching identified additional manuscripts. Forty-one studies were retained for detailed analysis. The clinical risk factors for visceral/liver metastasis included <70 years, ≥T3 tumor, N1 nodal stage, de novo metastasis, PSA >20 ng/mL, and a Gleason score >8. Additional risk factors comprised elevated serum AST, LDH or ALP, decreased Hb, genetic markers like RB1 and PTEN loss, PIK3CB and MYC amplification, as well as numerous PC treatments either acting directly or indirectly through inducing liver injury. Further research regarding predictive factors, early detection strategies, and targeted therapies for PCLM are critical for improving patient outcomes.
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Affiliation(s)
- Audrey Shiner
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (R.C.S.); (M.N.)
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Rubens Copia Sperandio
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (R.C.S.); (M.N.)
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Mahdi Naimi
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (R.C.S.); (M.N.)
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Urban Emmenegger
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (R.C.S.); (M.N.)
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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Sigorski D, Wilk M, Gawlik-Urban A, Sałek-Zań A, Kiszka J, Malik M, Czerko K, Kuć K, Szczylik C, Kubiatowski T, Cybulska-Stopa B, Filipczyk-Cisarż E, Bodnar L, Skoneczna I. Real-life data of abiraterone acetate and enzalutamide treatment in post-chemotherapy metastatic castration-resistant prostate cancer in Poland. Front Oncol 2023; 13:1108937. [PMID: 37077831 PMCID: PMC10108911 DOI: 10.3389/fonc.2023.1108937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 02/27/2023] [Indexed: 04/05/2023] Open
Abstract
BackgroundAbiraterone acetate (ABI) and Enzalutamide (ENZA) are second-generation hormone drugs that show breakthrough activity in post-chemotherapy, metastatic castration-resistant prostate cancer (mCRPC). The leading oncological and urological guidelines indicate both drugs with the same strong recommendation. There is a lack of randomized trials which compare the efficacy of ABI and ENZA. The current study aimed to compare the effectiveness of the drugs with an analysis of prognostic factors related to those drugs.Patients and methodsThe study included 420 patients with docetaxel (DXL) pretreated mCRPC from seven Polish cancer centers. Patients were treated according to inclusion and exclusion criteria in the Polish national drug program (1000 mg ABI and 10 mg prednisone, n=76.2%; ENZA, 160 mg; n=23.8%). The study retrospectively analyzed the overall survival (OS), time to treatment failure (TTF), PSA 50% decline rate (PSA 50%) and selected clinic-pathological data.ResultsIn the study group, the median OS was 17 months (95% CI: 15.6-18.3). The median OS (26.1 vs. 15.7 mo.; p<0.001), TTF (14.2 vs. 7.6 mo.; p<0.001) and PSA 50% (87.5 vs. 56%; p<0.001) were higher in ENZA than in ABI treatment. Multivariate analysis shows that ENZA treatment and PSA nadir <17.35 ng/mL during or after DXL treatment were related to longer TTF. ENZA treatment, DXL dose ≥750 mg, PSA nadir <17.35 ng/mL during or after DXL treatment was related to longer OS.ConclusionsENZA treatment may be related to more favorable oncological outcomes than ABI treatment in the studied Polish population of patients. A 50% decline in PSA is an indicator of longer TTF and OS. Due to the non-randomized and retrospective nature of the analysis, the current results require prospective validation.
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Affiliation(s)
- Dawid Sigorski
- Department of Oncology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
- Department of Oncology and Immuno-Oncology, Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration Hospital, Olsztyn, Poland
- *Correspondence: Dawid Sigorski,
| | - Michał Wilk
- Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
| | - Angelika Gawlik-Urban
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
- Faculty of Health Sciences, University of Applied Sciences in Tarnów, Tarnów, Poland
| | - Agata Sałek-Zań
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Joanna Kiszka
- Department of Clinical Oncology, Subcarpathian Cancer Center, Brzozów, Poland
| | - Mateusz Malik
- Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Centre, Wroclaw, Poland
| | - Katarzyna Czerko
- Department of Clinical Oncology and Radiotherapy, St. John Paul II Mazovia Regional Hospital in Siedlce, Siedlce, Poland
| | - Kamil Kuć
- Department of Oncology, St. Pio’s Provincial Hospital, Przemyśl, Poland
| | - Cezary Szczylik
- Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
| | - Tomasz Kubiatowski
- Department of Oncology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
- Department of Oncology and Immuno-Oncology, Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration Hospital, Olsztyn, Poland
| | - Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Emilia Filipczyk-Cisarż
- Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Centre, Wroclaw, Poland
| | - Lubomir Bodnar
- Department of Clinical Oncology and Radiotherapy, St. John Paul II Mazovia Regional Hospital in Siedlce, Siedlce, Poland
- Faculty of Medical and Health Sciences, University of Natural Sciences and Humanities, Siedlce, Poland
| | - Iwona Skoneczna
- Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
- Department of Oncology, Grochowski Hospital, Warsaw, Poland
- Cancer & Cardio-Oncology Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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