Efficacy and safety of combined androgen blockade with antiandrogen for advanced prostate cancer

Serum amyloid A (SAA) and Interleukin-6 (IL-6) as the potential biomarkers for gastric cancer

To explore serum amyloid A (SAA) and interleukin-6 (IL-6) as potential diagnostic biomarkers for gastric cancer (GCa) and the application value of the combined diagnosis of SAA, IL6, and Cancer embryonic antigen. Serum samples were collected before the initial surgery from 159 patients comprising samples from 122 patients with GCa and 37 patients with benign gastric disease. All patients were hospitalized at Beijing Aerospace General Hospital in China between 2018 and 2020. The IL-6 and SAA levels were assessed using standard laboratory protocols. The levels of SAA and IL-6 were significantly higher in patients with GCa than in controls. Compared with the healthy group, the concentration of SAA and IL-6 in FIGO III-IV group were significantly higher and the difference were statistically significant. In addition, significant differences were observed between the FIGO III-IV group and FIGO I-II groups. The Receiver operating characteristic (ROC) curve for the combined detection of SAA, IL-6, and Cancer embryonic antigen showed an area under the curve (AUC) of 0.948, sensitivity of 91.0%, and specificity of 89.2%. Spearman's correlation analysis indicated obvious correlations among the levels of serum SAA, IL-6, advanced FIGO stage, lymphatic invasion, and distant metastasis. AA and IL-6 may serve as useful biomarkers for poor prognosis of GCa. Clinical diagnosis combined with SAA and IL-6 may help assess therapeutic outcomes.

Complete androgen blockade vs. medical castration alone as adjuvant androgen deprivation therapy for prostate cancer patients following radical prostatectomy: a retrospective cohort study

Background:

Till date, the optimal treatment strategy for delivering adjuvant androgen deprivation therapy (ADT) in localized and locally advanced prostate cancer (PCa), as a lower stage in PCa progression compared with metastatic PCa, is still unclear. This study compares the efficacy of castration alone with complete androgen blockade (CAB) as adjuvant ADT in patients with localized and locally advanced PCa undergoing radical prostatectomy (RP).

Methods:

Patients diagnosed with PCa, without lymph node or distant metastasis, who received RP in West China Hospital between January 2009 and April 2019, were enrolled in this study. We performed survival, multivariable Cox proportional hazard regression, and subgroup analyses.

Results:

A total of 262 patients were enrolled, including 107 patients who received castration alone and 155 patients who received CAB. The survival analysis revealed that there was no significant difference between the two groups (hazard ratios [HR] = 1.07, 95% confidence intervals [95% CI] = 0.60–1.90, P = 0.8195). Moreover, the multivariable Cox model provided similarly negative results before and after adjustment for potential covariant. Similarly, there was no significant difference in the clinical recurrence between the two groups in both non-adjusted and adjusted models. Furthermore, our subgroup analysis showed that CAB achieved better biochemical recurrence (BCR) outcomes than medical castration alone as adjuvant ADT for locally advanced PCa (P for interaction = 0.0247, HR = 0.37, 95% CI = 0.14–1.00, P = 0.0497).

Conclusion:

Combined androgen blockade achieved better BCR outcomes compared with medical castration alone as adjuvant ADT for locally advanced PCa without lymph node metastasis.

OUP accepted manuscript

Background

The outcomes of metastatic hormone-sensitive prostate cancer (mHSPC) have significantly improved through treatment intensification, yet Black representation in those studies is suboptimal.

Methods

A multi-institutional, retrospective analysis of Black men with mHSPC was conducted, focusing on baseline demographics, treatment patterns, genomic profiles, clinical outcomes including prostate-specific antigen response, time to castrate-resistant prostate cancer (CRPC), and subsequent treatments.

Results

A total of 107 patients, median age 64 years, 62% with de novo metastases at diagnosis and 64% with high-volume disease, were included. Twenty-nine patients (27%) were treated with androgen deprivation therapy (ADT) with and without first generation anti-androgens, while 20%, 38% and 5% received chemotherapy, abiraterone, and enzalutamide, respectively. At time of data cut-off, 57 (54%) patients had developed CRPC, with a median time to CRPC of 25.4 months (95% CI 20.3-30.4). The median time to CRPC was 46.3 months (18.9-73.7) and 23.4 months (18.6-28.2) for patients who received ADT with or without first-generation anti-androgens and treatment intensification, respectively. The 2-year survival rate was 93.3%, and estimated median overall survival of was 74.9 months (95% CI, 68.7-81.0). Most patients (90%) underwent germline testing; the most frequent known alterations were found within the DNA repair group of genes. Somatic testing revealed pathogenic alterations of interest, notably TP53 (24%) and CDK12 (12%).

Conclusion

In our cohort, Black men with mHSPC presented with a high proportion of de novo metastases and high-volume disease. Treatment outcomes were very favorable with ADT-based regimens. The genomic landscape suggests different molecular profile relative to White patients with potential therapeutic implications.

MicroRNA‑195‑5p is associated with cell proliferation, migration and invasion in prostate cancer and targets MIB1

Mind bomb 1 (MIB1) is a well‑known E3 ubiquitin ligase. MicroRNAs (miRNAs/miRs) have been found to serve important functions in cancer cell physiology. However, the clinical significance and biological function of MIB1 and miRNAs in prostate cancer (PCa) are yet to be fully elucidated. The current study predicted the interaction between MIB1 and miR‑195‑5p using TargetScan, and the results were confirmed by performing a dual‑luciferase reporter assay. The mRNA expression level of MIB1 and miR‑195‑5p in PCa and adjacent normal tissues, and PCa cell lines was detected using reverse transcription‑quantitative PCR. Cell Counting Kit‑8 and Transwell assays were used to measure the proliferation, and migration and invasion of VCaP and DU145 PCa cell lines, respectively, while western blot analysis was used to detect the protein expression level of MIB1. The results revealed that the mRNA expression level of MIB1 was increased, while the mRNA expression level of miR‑195‑5p was decreased in PCa tissues (P<0.001 and P<0.01, respectively) and in various cell lines, including PC‑3 (P<0.001 and P<0.05, respectively), VCaP (P<0.001 and P<0.01, respectively), 22Rv1 (P<0.001 and P<0.05, respectively), DU145 (P<0.001 and P<0.01, respectively) and LNCaP (P<0.001 and P<0.05, respectively). miR‑195‑5p mimics rescued the inhibitory effects caused by knockdown of MIB1 on cell proliferation, migration and invasion in the VCaP and DU145 cell lines. In addition, MIB1 overexpression restored the miR‑195‑5p overexpression‑induced repression of cell proliferation and invasion. The current study revealed that the MIB1 gene was an effector of cell proliferation, migration and invasion in PCa cell lines. Furthermore, miR‑195‑5p may regulate PCa cell proliferation and invasion by regulating MIB1, indicating its potential therapeutic application for PCa in the future.

A novel germline BRCA2 mutation in a Chinese patient with prostate cancer sensitive to platinum chemotherapy: a case report

Background

Germline BRCA2 mutation is associated with an aggressive prostate cancer phenotype and indicates higher risk for hereditary cancer. Recently, numerous studies have attempted to identify the genomic landscape of prostate cancer to better understand the genomic drivers of this disease and look for the molecular targets to guide treatment selection.

Case presentation

We report a 67-year-old patient diagnosed with prostate cancer who experienced rapid disease progression after androgen deprivation therapy and subsequent docetaxel treatment. The patient had a strong family history of malignancy as his mother was diagnosed with breast cancer and his father was died of lung cancer. Next generation sequencing demonstrated a novel pathogenic germline BRCA2 mutation (p.Gly2181Glufs*10) in the patient. His mother with breast cancer and his son were found to have the same BRCA2 mutation. The patient experienced impressive and durable responses to carboplatin treatment.

Conclusions

This case demonstrated that the carboplatin could have a dramatic antitumor effect on patients with prostate cancer with germline BRCA2 mutations and family history will help to ensure that patients and their families can be provided with proper genetic counseling.

Synthesis and biological evaluation of novel 1,4-benzodiazepin-3-one derivatives as potential antitumor agents against prostate cancer

A novel tumor suppressing agent was discovered against PC-3 prostate cancer cells from the screening of a 1,4-benzodiazepin-3-one library. In this study, 96 highly diversified 2,4,5-trisubstituted 1,4-benzodiazepin-3-one derivatives were prepared by a two-step approach using sequential Ugi multicomponent reaction and simultaneous deprotection and cyclization to afford pure compounds bearing a wide variety of substituents. The most promising compound showed a potent and selective antiproliferative activity against prostate cancer cell line PC-3 (GI₅₀ = 10.2 µM), but had no effect on LNCAP, LAPC4 and DU145 cell lines. The compound was initially prepared as a mixture of two diastereomers and after their separation by HPLC, similar antiproliferative activities against PC-3 cells were observed for both diastereomers (2S,5S: GI₅₀ = 10.8 µM and 2S,5R: GI₅₀ = 7.0 µM). Additionally, both diastereomers showed comparable stability profiles after incubation with human liver microsomes. Finally, in vivo evaluation of the hit compound with the chick chorioallantoic membrane xenograft assay revealed a good toxicity profile and significant antitumor activity after intravenous injection.

Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update

PURPOSE

Update all preceding ASCO guidelines on initial hormonal management of noncastrate advanced, recurrent, or metastatic prostate cancer.

METHODS

The Expert Panel based recommendations on a systematic literature review. Recommendations were approved by the Expert Panel and the ASCO Clinical Practice Guidelines Committee.

RESULTS

Four clinical practice guidelines, one clinical practice guidelines endorsement, 19 systematic reviews with or without meta-analyses, 47 phase III randomized controlled trials, nine cohort studies, and two review papers informed the guideline update.

RECOMMENDATIONS

Docetaxel, abiraterone, enzalutamide, or apalutamide, each when administered with androgen deprivation therapy (ADT), represent four separate standards of care for noncastrate metastatic prostate cancer. Currently, the use of any of these agents in any particular combination or series cannot be recommended. ADT plus docetaxel, abiraterone, enzalutamide, or apalutamide should be offered to men with metastatic noncastrate prostate cancer, including those who received prior therapies, but have not yet progressed. The combination of ADT plus abiraterone and prednisolone should be considered for men with noncastrate locally advanced nonmetastatic prostate cancer who have undergone radiotherapy, rather than castration monotherapy. Immediate ADT may be offered to men who initially present with noncastrate locally advanced nonmetastatic disease who have not undergone previous local treatment and are unwilling or unable to undergo radiotherapy. Intermittent ADT may be offered to men with high-risk biochemically recurrent nonmetastatic prostate cancer. Active surveillance may be offered to men with low-risk biochemically recurrent nonmetastatic prostate cancer. The panel does not support use of either micronized abiraterone acetate or the 250 mg dose of abiraterone with a low-fat breakfast in the noncastrate setting at this time.Additional information is available at www.asco.org/genitourinary-cancer-guidelines.

Efficacy of abiraterone combined with flutamide on prostate cancer patients and its effect on serum miR-493-5p and miR-195-5p

Efficacy of abiraterone combined with flutamide on patients with prostate cancer (PCa) and its effect on levels of miR-493-5p and miR-195-5p contained in serum were investigated. The medical records of 146 PCa patients admitted to Longhua Hospital Shanghai University of Traditional Chinese Medicine from January 2011 to December 2013 were selected. Eighty-four patients were treated with abiraterone combined with flutamide as a study group, 62 patients were treated with abiraterone alone as a control group. The curative effect, adverse reactions, quality of life and five-year overall survival (OS) of the two groups were compared. The serum prostate-specific antigen (PSA) level was measured by radioimmunoassay at 3 days (T1) before treatment, 1 month (T2), 2 months (T3), and 6 months (T4) after treatment, and the relative expression of miR-493-5p and miR-195-5p in serum were detected by qRT-PCR. The total effective rate of the study group was significantly higher than that of the control group (P<0.05). The total incidence of toxic and side effects in the study group was significantly lower than that in the control group (P<0.05). The improvement rate of quality of life in the study group was significantly higher than that in the control group (P<0.05). OS in the study group was significantly higher than that in the control group at 5 years (P<0.05). There was no significant difference in serum PSA level between the two groups at T1 (P>0.05); there was no significant difference in the relative expression of miR-493-5p and miR-195-5p between the two groups at T1 (P>0.05). In conclusion, abiraterone combined with flutamide has better curative effect and lower incidence of adverse reactions in patients with metastatic castration-resistant PCa (CRPC) than abiraterone alone, and can increase the expression levels of miR-493-5p and miR-195-5p in patient serum.