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Mehring G, Steinbach C, Pose R, Knipper S, Koehler D, Werner S, Riethdorf S, von Amsberg G, Ambrosini F, Maurer T. Limited prognostic role of routine serum markers (AP, CEA, LDH and NSE) in oligorecurrent prostate cancer patients undergoing PSMA-radioguided surgery. World J Urol 2024; 42:256. [PMID: 38656636 PMCID: PMC11043188 DOI: 10.1007/s00345-024-04948-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION We evaluated the prognostic role of pre-salvage prostate-specific membrane antigen-radioguided surgery (PSMA-RGS) serum levels of alkaline phosphatase (AP), carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH), and neuron-specific enolase (NSE). MATERIALS AND METHODS Patients who consecutively underwent PSMA-RGS for prostate cancer (PCa) oligorecurrence between January 2019 and January 2022 were selected. Biomarkers were assessed one day before surgery. Cox regression and logistic regression models tested the relationship between biochemical recurrence-free survival (BFS), 6- and 12-month biochemical recurrence (BCR), and several independent variables, including biomarkers. RESULTS 153 consecutive patients were analyzed. In the univariable Cox regression analysis, none of the biomarkers achieved predictor status (AP: hazard ratio [HR] = 1.03, 95% CI 0.99, 1.01; p = 0.19; CEA: HR = 1.73, 95% CI 0.94, 1.21; p = 0.34; LDH: HR = 1.01, 95% CI 1.00, 1.01; p = 0.05; NSE: HR = 1.02, 95% CI 0.98, 1.06; p = 0.39). The only independent predictor of BFS was the number of positive lesions on PSMA PET (HR = 1.17, 95% CI 1.02, 1.30; p = 0.03). The number of positive lesions was confirmed as independent predictor for BCR within 6 and 12 months (BCR < 6 months: odds ratio [OR] = 1.1, 95% CI 1.0, 1.3; p = 0.04; BCR < 12 months: OR = 1.1, 95% CI 1.0, 1.3; p = 0.04). CONCLUSION The assessment of AP, CEA, LDH, and NSE before salvage PSMA-RGS showed no prognostic impact. Further studies are needed to identify possible predictors that will optimize patient selection for salvage PSMA-RGS.
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Affiliation(s)
- Gisa Mehring
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Christina Steinbach
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Randi Pose
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Sophie Knipper
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Daniel Koehler
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Werner
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Riethdorf
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gunhild von Amsberg
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Department of Oncology, Hematology and Bone Marrow Transplantation With Section Pneumology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Francesca Ambrosini
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Tobias Maurer
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Sutherland DEK, Azad AA, Murphy DG, Eapen RS, Kostos L, Hofman MS. Role of FDG PET/CT in Management of Patients with Prostate Cancer. Semin Nucl Med 2024; 54:4-13. [PMID: 37400321 DOI: 10.1053/j.semnuclmed.2023.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
Prostate cancer is the second most common cancer in men worldwide. [18F]FDG PET/CT imaging, a well-known and effective technique for detecting malignancies, has not been considered a useful tool for prostate cancer imaging by many because of its perceived low [18F]FDG uptake. Incidentally detected focal [18F]FDG uptake in the prostate is not uncommon, and typically benign. Imaging features that would increase concern for an underlying prostatic carcinoma, include focal uptake in the periphery near the gland margin without calcifications. [18F]FDG PET/CT imaging provides little value in the initial staging of prostate cancer, particularly in the era of prostate specific membrane antigen (PSMA) radiotracer. In cases of biochemical recurrence, the value of [18F]FDG PET/CT increases notably when Grade group 4 or 5 and elevated PSA levels are present. Active research is underway for theranostic approaches to prostate cancer, including [177Lu]Lu-PSMA therapy. Dual tracer staging using FDG and PSMA imaging significantly enhances the accuracy of disease site assessment. Specifically, the addition of [18F]FDG PET/CT imaging allows for the evaluation of discordant disease (PSMA negative/FDG positive). The maximal benefit from [177Lu]Lu-PSMA therapy relies on significant PSMA accumulation across all disease sites, and the identification of discordant disease suggests that these patients may derive less benefit from the treatment. The genuine value of [18F]FDG PET/CT imaging lies in advanced prostate cancer, PSMA-negative disease, as a prognostic biomarker, and the realm of new targeted theranostic agents.
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Affiliation(s)
- Duncan E K Sutherland
- Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Arun A Azad
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Renu S Eapen
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Louise Kostos
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michael S Hofman
- Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.
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3
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Dondi F, Antonelli A, Suardi N, Guerini AE, Albano D, Lucchini S, Camoni L, Treglia G, Bertagna F. PET/CT and Conventional Imaging for the Assessment of Neuroendocrine Prostate Cancer: A Systematic Review. Cancers (Basel) 2023; 15:4404. [PMID: 37686680 PMCID: PMC10486674 DOI: 10.3390/cancers15174404] [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: 07/04/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Neuroendocrine prostate cancer (NEPC) is a rare neoplasm, and the role of both conventional imaging (CI) and positron emission tomography/computed tomography (PET/CT) for its assessment has not been clearly evaluated and demonstrated. The aim of this systematic review was to analyze the diagnostic performances of these imaging modalities in this setting. METHODS A wide literature search of the PubMed/MEDLINE, Scopus, and Web of Science databases was made to find relevant published articles about the role of CI and PET/CT for the evaluation of NEPC. RESULTS 13 studies were included in the systematic review. PET/CT imaging with different radiopharmaceuticals has been evaluated in many studies (10) compared to CI (3 studies), which has only a limited role in NEPC. Focusing on PET/CT, a study used [18F]FDG, labeled somatostatin analogs were used in 5 cases, a study used [68Ga]Ga-FAPI-04, [68Ga]Ga-PSMA-11 was evaluated in a single case, and two works used different tracers. CONCLUSION Published data on the role of PET/CT for the assessment of NEPC are limited. At present, it is still uncertain which tracer performs best, and although [18F]FDG has been evaluated and seems to offer some advantages in availability and clinical staging, other tracers may be more useful to understand tumor biology or identify targets for subsequent radioligand therapy. Further research is therefore desirable. In contrast, data are still limited to draw a final conclusion on the role and the specific characteristics of CI in this rare form of neoplasm, and therefore, more studies are needed in this setting.
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Affiliation(s)
- Francesco Dondi
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | | | - Nazareno Suardi
- Department of Urology, Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Andrea Emanuele Guerini
- Department of Radiation Oncology, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Domenico Albano
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Silvia Lucchini
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Luca Camoni
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Giorgio Treglia
- Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Francesco Bertagna
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
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Ying M, Mao J, Sheng L, Wu H, Bai G, Zhong Z, Pan Z. Biomarkers for Prostate Cancer Bone Metastasis Detection and Prediction. J Pers Med 2023; 13:jpm13050705. [PMID: 37240875 DOI: 10.3390/jpm13050705] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
Prostate cancer (PCa) causes deaths worldwide, ranking second after lung cancer. Bone metastasis (BM) frequently results from advanced PCa, affecting approximately 90% of patients, and it also often results in severe skeletal-related events. Traditional diagnostic methods for bone metastases, such as tissue biopsies and imaging, have substantial drawbacks. This article summarizes the significance of biomarkers in PCa accompanied with BM, including (1) bone formation markers like osteopontin (OPN), pro-collagen type I C-terminal pro-peptide (PICP), osteoprotegerin (OPG), pro-collagen type I N-terminal pro-peptide (PINP), alkaline phosphatase (ALP), and osteocalcin (OC); (2) bone resorption markers, including C-telopeptide of type I collagen (CTx), N-telopeptide of type I collagen (NTx), bone sialoprotein (BSP), tartrate-resistant acid phosphatase (TRACP), deoxypyridinoline (D-PYD), pyridoxine (PYD), and C-terminal pyridinoline cross-linked telopeptide of type I collagen (ICTP); (3) prostate-specific antigen (PSA); (4) neuroendocrine markers, such as chromogranin A (CgA), neuron-specific enolase (NSE), and pro-gastrin releasing peptide (ProGRP); (5) liquid biopsy markers, such as circulating tumor cells (CTCs), microRNA (miRNA), circulating tumor DNA (ctDNA), and cell-free DNA (cfDNA) and exosomes. In summary, some of these markers are already in widespread clinical use, while others still require further laboratory or clinical studies to validate their value for clinical application.
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Affiliation(s)
- Mingshuai Ying
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 322000, China
| | - Jianshui Mao
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 322000, China
| | - Lingchao Sheng
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 322000, China
| | - Hongwei Wu
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 322000, China
| | - Guangchao Bai
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 322000, China
| | - Zhuolin Zhong
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 322000, China
| | - Zhijun Pan
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 322000, China
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China
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De Vitis C, Battaglia AM, Pallocca M, Santamaria G, Mimmi MC, Sacco A, De Nicola F, Gaspari M, Salvati V, Ascenzi F, Bruschini S, Esposito A, Ricci G, Sperandio E, Massacci A, Prestagiacomo LE, Vecchione A, Ricci A, Sciacchitano S, Salerno G, French D, Aversa I, Cereda C, Fanciulli M, Chiaradonna F, Solito E, Cuda G, Costanzo F, Ciliberto G, Mancini R, Biamonte F. ALDOC- and ENO2- driven glucose metabolism sustains 3D tumor spheroids growth regardless of nutrient environmental conditions: a multi-omics analysis. J Exp Clin Cancer Res 2023; 42:69. [PMID: 36945054 PMCID: PMC10031988 DOI: 10.1186/s13046-023-02641-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/07/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Metastases are the major cause of cancer-related morbidity and mortality. By the time cancer cells detach from their primary site to eventually spread to distant sites, they need to acquire the ability to survive in non-adherent conditions and to proliferate within a new microenvironment in spite of stressing conditions that may severely constrain the metastatic process. In this study, we gained insight into the molecular mechanisms allowing cancer cells to survive and proliferate in an anchorage-independent manner, regardless of both tumor-intrinsic variables and nutrient culture conditions. METHODS 3D spheroids derived from lung adenocarcinoma (LUAD) and breast cancer cells were cultured in either nutrient-rich or -restricted culture conditions. A multi-omics approach, including transcriptomics, proteomics, and metabolomics, was used to explore the molecular changes underlying the transition from 2 to 3D cultures. Small interfering RNA-mediated loss of function assays were used to validate the role of the identified differentially expressed genes and proteins in H460 and HCC827 LUAD as well as in MCF7 and T47D breast cancer cell lines. RESULTS We found that the transition from 2 to 3D cultures of H460 and MCF7 cells is associated with significant changes in the expression of genes and proteins involved in metabolic reprogramming. In particular, we observed that 3D tumor spheroid growth implies the overexpression of ALDOC and ENO2 glycolytic enzymes concomitant with the enhanced consumption of glucose and fructose and the enhanced production of lactate. Transfection with siRNA against both ALDOC and ENO2 determined a significant reduction in lactate production, viability and size of 3D tumor spheroids produced by H460, HCC827, MCF7, and T47D cell lines. CONCLUSIONS Our results show that anchorage-independent survival and growth of cancer cells are supported by changes in genes and proteins that drive glucose metabolism towards an enhanced lactate production. Notably, this finding is valid for all lung and breast cancer cell lines we have analyzed in different nutrient environmental conditions. broader Validation of this mechanism in other cancer cells of different origin will be necessary to broaden the role of ALDOC and ENO2 to other tumor types. Future in vivo studies will be necessary to assess the role of ALDOC and ENO2 in cancer metastasis.
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Affiliation(s)
- Claudia De Vitis
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ''Sapienza'' University of Rome, Rome, Italy
| | - Anna Martina Battaglia
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
| | - Matteo Pallocca
- Biostatistics, Bioinformatics and Clinical Trial Center, IRCCS ''Regina Elena'' National Cancer Institute, Rome, Italy
| | - Gianluca Santamaria
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
| | | | - Alessandro Sacco
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
| | - Francesca De Nicola
- SAFU Laboratory, IRCCS ''Regina Elena'' National Cancer Institute, Rome, Italy
| | - Marco Gaspari
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
| | - Valentina Salvati
- Preclinical Models and New Therapeutic Agents Unit, IRCCS ''Regina Elena'' National Cancer Institute, Rome, Italy
| | - Francesca Ascenzi
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ''Sapienza'' University of Rome, Rome, Italy
| | - Sara Bruschini
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ''Sapienza'' University of Rome, Rome, Italy
| | - Antonella Esposito
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
| | - Giulia Ricci
- Department of Experimental Medicine, Università Degli Studi Della Campania ''Luigi Vanvitelli'', Naples, Italy
| | - Eleonora Sperandio
- Biostatistics, Bioinformatics and Clinical Trial Center, IRCCS ''Regina Elena'' National Cancer Institute, Rome, Italy
| | - Alice Massacci
- Biostatistics, Bioinformatics and Clinical Trial Center, IRCCS ''Regina Elena'' National Cancer Institute, Rome, Italy
| | - Licia Elvira Prestagiacomo
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
| | - Andrea Vecchione
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ''Sapienza'' University of Rome, Rome, Italy
| | - Alberto Ricci
- Respiratory Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ''Sapienza'' University of Rome, Rome, Italy
| | - Gerardo Salerno
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Deborah French
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ''Sapienza'' University of Rome, Rome, Italy
| | - Ilenia Aversa
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
| | - Cristina Cereda
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Maurizio Fanciulli
- SAFU Laboratory, IRCCS ''Regina Elena'' National Cancer Institute, Rome, Italy
| | | | - Egle Solito
- Barts and The London School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, E1 2AT, UK
| | - Giovanni Cuda
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
| | - Francesco Costanzo
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
- Magna Graecia University of Catanzaro, Interdepartmental Centre of Services, Catanzaro, Italy
| | - Gennaro Ciliberto
- Scientific Director, IRCCS ''Regina Elena'' National Cancer Institute, Rome, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ''Sapienza'' University of Rome, Rome, Italy.
| | - Flavia Biamonte
- Department of Experimental and Clinical Medicine, ''Magna Graecia'' University of Catanzaro, Catanzaro, Italy
- Barts and The London School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, E1 2AT, UK
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Jadvar H. The VISION Forward: Recognition and Implication of PSMA-/ 18F-FDG+ mCRPC. J Nucl Med 2022; 63:812-815. [PMID: 34933889 PMCID: PMC9157736 DOI: 10.2967/jnumed.121.263274] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Metastatic castration resistant prostate cancer (mCRPC) is incurable. The expression of the transmembrane protein prostate-specific membrane antigen (PSMA) is markedly increased in most mCRPC lesions. PSMA has been recognized as a viable biologic target for imaging and radionuclide therapy (theranostics) in mCRPC. The PET agents 68Ga-PSMA-11 and 18F-DCFPyL have recently been approved for imaging evaluation of patients with suspected metastasis who are candidates for initial definitive therapy and patients with suspected recurrence based on elevated serum prostate-specific antigen level. Radioligand therapy (RLT) with 177Lu-PSMA-617 (177Lu-vipivotide tetraxetan, Pluvicto, Novartis/AAA) was approved on March 23, 2022, based on the favorable results of the VISION trial. It has been recognized that PET imaging of PSMA expression and glucose metabolism (with 18F-FDG) provides a more comprehensive assessment of the tumor burden and heterogeneity. However, there are many unresolved issues that surround whether or not imaging with 18F-FDG PET is advantageous in the clinical setting of PSMA RLT in mCRPR.
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Affiliation(s)
- Hossein Jadvar
- Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California
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Ong S, Pascoe C, Kelly BD, Ballok Z, Webb D, Bolton D, Murphy D, Sengupta S, Bowden P, Lawrentschuk N. PSMA PET-CT Imaging Predicts Treatment Progression in Men with Biochemically Recurrent Prostate Cancer-A Prospective Study of Men with 3 Year Follow Up. Cancers (Basel) 2022; 14:cancers14112717. [PMID: 35681697 PMCID: PMC9179348 DOI: 10.3390/cancers14112717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) is an essential imaging tool that is used to locate prostate cancer when it recurs. The results of this scan are used to guide clinical decisions for the management of cancer. However, the long-term effect of these clinical decisions is yet to be determined. In this study, we followed men with recurrent prostate cancer for 3 years after they had a clinical decision made based on a PSMA PET-CT. Our results showed that 75% of men had no addition or change in their treatment plan 3 years after their initial clinical decision was made. In men with a PSMA PET-CT that showed no suspected cancer, 85% had no addition or change to their treatment plan. This indicates that clinical decisions made using PSMA PET-CT in this setting can have a medium- to long-lasting effect. Abstract Prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) is a novel imaging modality used to stage recurrent prostate cancer. It has the potential to improve prognostication and ultimately guide the timing of treatment for men with recurrent prostate cancer. This study aims to assess the clinical impact of PSMA PET-CT by analyzing its predictive value of treatment progression after 3 years of follow-up. In this prospective cohort study of 100 men, patients received a PSMA PET-CT for restaging of their disease which was used by a multi-disciplinary team to make a treatment decision. The primary endpoint was treatment progression. This was defined as the addition or change of any treatment modalities such as androgen deprivation therapy (ADT), radiation therapy or chemotherapy. The median follow-up time was 36 months (IQR 24–40 months). No treatment progression was found in 72 (75%) men and therefore 24 (25%) patients were found to have treatment progression. In men with a negative PSMA PET-CT result, 5/33 (15.1%) had treatment progression and 28/33 (84.8%) had no treatment progression. In conclusion, clinical decisions made with PSMA PET-CT results led to 75% of men having no treatment progression at 3 years of follow-up. In men with negative PSMA PET-CT results, this increased to 85% of men.
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Affiliation(s)
- Sean Ong
- EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Richmond, VIC 3121, Australia; (C.P.); (D.W.); (D.B.); (D.M.); (P.B.); (N.L.)
- Young Urology Researcher’s Organisation, Melbourne, VIC 3000, Australia
- Department of Surgery, University of Melbourne, Parkville, VIC 3010, Australia
- Correspondence: ; Tel.: +61-039-426-6666
| | - Claire Pascoe
- EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Richmond, VIC 3121, Australia; (C.P.); (D.W.); (D.B.); (D.M.); (P.B.); (N.L.)
| | - Brian D. Kelly
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia;
- Department of Urology, Eastern Health, Box Hill, VIC 3128, Australia;
| | - Zita Ballok
- Department of Nuclear Medicine, Richmond Medical Imaging, Richmond, VIC 3121, Australia;
| | - David Webb
- EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Richmond, VIC 3121, Australia; (C.P.); (D.W.); (D.B.); (D.M.); (P.B.); (N.L.)
- Olivia Newton-John Cancer and Wellness Centre, Austin Health, Heidelberg, VIC 3084, Australia
| | - Damien Bolton
- EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Richmond, VIC 3121, Australia; (C.P.); (D.W.); (D.B.); (D.M.); (P.B.); (N.L.)
- Young Urology Researcher’s Organisation, Melbourne, VIC 3000, Australia
- Department of Surgery, University of Melbourne, Parkville, VIC 3010, Australia
- Olivia Newton-John Cancer and Wellness Centre, Austin Health, Heidelberg, VIC 3084, Australia
| | - Declan Murphy
- EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Richmond, VIC 3121, Australia; (C.P.); (D.W.); (D.B.); (D.M.); (P.B.); (N.L.)
- Department of Surgery, University of Melbourne, Parkville, VIC 3010, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia;
| | - Shomik Sengupta
- Department of Urology, Eastern Health, Box Hill, VIC 3128, Australia;
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia
| | - Patrick Bowden
- EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Richmond, VIC 3121, Australia; (C.P.); (D.W.); (D.B.); (D.M.); (P.B.); (N.L.)
| | - Nathan Lawrentschuk
- EJ Whitten Prostate Cancer Research Centre, Epworth HealthCare, Richmond, VIC 3121, Australia; (C.P.); (D.W.); (D.B.); (D.M.); (P.B.); (N.L.)
- Young Urology Researcher’s Organisation, Melbourne, VIC 3000, Australia
- Department of Surgery, University of Melbourne, Parkville, VIC 3010, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia;
- Department of Urology, Royal Melbourne Hospital, Melbourne, VIC 3051, Australia
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McNally CJ, Watt J, Kurth MJ, Lamont JV, Moore T, Fitzgerald P, Pandha H, McKenna DJ, Ruddock MW. A Novel Combination of Serum Markers in a Multivariate Model to Help Triage Patients Into “Low-” and “High-Risk” Categories for Prostate Cancer. Front Oncol 2022; 12:837127. [PMID: 35664747 PMCID: PMC9161691 DOI: 10.3389/fonc.2022.837127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Almost 50,000 men in the United Kingdom (UK) are diagnosed each year with prostate cancer (PCa). Secondary referrals for investigations rely on serum prostate-specific antigen (PSA) levels and digital rectal examination. However, both tests lack sensitivity and specificity, resulting in unnecessary referrals to secondary care for costly and invasive biopsies. Materials and Methods Serum samples and clinical information were collected from N = 125 age-matched patients (n = 61 non-PCa and n = 64 PCa) and analyzed using Biochip Array Technology on high-sensitivity cytokine array I (IL-2, IL-4, IL-6, IL-8, IL-10, IL-1α, IL-1β, TNFα, MCP-1, INFγ, EGF, and VEGF), cerebral array II (CRP, D-dimer, neuron-specific enolase, and sTNFR1), and tumor PSA oncology array (fPSA, tPSA, and CEA). Results The data showed that 11/19 (68.8%) markers were significantly different between the non-PCa and the PCa patients. A combination of EGF, log10 IL-8, log10 MCP-1, and log10 tPSA significantly improved the predictive potential of tPSA alone to identify patients with PCa (DeLong, p < 0.001). This marker combination had an increased area under the receiver operator characteristic (0.860 vs. 0.700), sensitivity (78.7 vs. 68.9%), specificity (76.5 vs. 67.2%), PPV (76.2 vs. 66.7%), and NPV (79.0 vs. 69.4%) compared with tPSA. Conclusions The novel combination of serum markers identified in this study could be employed to help triage patients into “low-” and “high-risk” categories, allowing general practitioners to improve the management of patients in primary care settings and potentially reducing the number of referrals for unnecessary, invasive, and costly treatments.
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Affiliation(s)
| | - Joanne Watt
- Clinical Studies Group, Randox Laboratories Ltd., Crumlin, United Kingdom
| | - Mary Jo Kurth
- Clinical Studies Group, Randox Laboratories Ltd., Crumlin, United Kingdom
| | - John V. Lamont
- Clinical Studies Group, Randox Laboratories Ltd., Crumlin, United Kingdom
| | - Tara Moore
- Genomic Medicine Research Group, Ulster University, Coleraine, United Kingdom
| | - Peter Fitzgerald
- Clinical Studies Group, Randox Laboratories Ltd., Crumlin, United Kingdom
| | - Hardev Pandha
- Royal Surrey County Hospital NHS Foundation Trust, Research Development and Innovations Department, The Royal Surrey County Hospital, Guildford, United Kingdom
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Declan J. McKenna
- Genomic Medicine Research Group, Ulster University, Coleraine, United Kingdom
| | - Mark W. Ruddock
- Clinical Studies Group, Randox Laboratories Ltd., Crumlin, United Kingdom
- *Correspondence: Mark W. Ruddock,
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9
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Slabáková E, Kahounová Z, Procházková J, Souček K. Regulation of Neuroendocrine-like Differentiation in Prostate Cancer by Non-Coding RNAs. Noncoding RNA 2021; 7:ncrna7040075. [PMID: 34940756 PMCID: PMC8704250 DOI: 10.3390/ncrna7040075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/18/2021] [Accepted: 11/29/2021] [Indexed: 12/21/2022] Open
Abstract
Neuroendocrine prostate cancer (NEPC) represents a variant of prostate cancer that occurs in response to treatment resistance or, to a much lesser extent, de novo. Unravelling the molecular mechanisms behind transdifferentiation of cancer cells to neuroendocrine-like cancer cells is essential for development of new treatment opportunities. This review focuses on summarizing the role of small molecules, predominantly microRNAs, in this phenomenon. A published literature search was performed to identify microRNAs, which are reported and experimentally validated to modulate neuroendocrine markers and/or regulators and to affect the complex neuroendocrine phenotype. Next, available patients’ expression datasets were surveyed to identify deregulated microRNAs, and their effect on NEPC and prostate cancer progression is summarized. Finally, possibilities of miRNA detection and quantification in body fluids of prostate cancer patients and their possible use as liquid biopsy in prostate cancer monitoring are discussed. All the addressed clinical and experimental contexts point to an association of NEPC with upregulation of miR-375 and downregulation of miR-34a and miR-19b-3p. Together, this review provides an overview of different roles of non-coding RNAs in the emergence of neuroendocrine prostate cancer.
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10
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Serum markers change for intraocular metastasis in renal cell carcinoma. Biosci Rep 2021; 41:229708. [PMID: 34467977 PMCID: PMC8438111 DOI: 10.1042/bsr20203116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 07/31/2021] [Accepted: 08/23/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: Renal cell carcinoma is prone to early metastasis. In general, intraocular metastasis (IOM) is not common. In the present study, we studied the relationship between different biochemical indicators and the occurrence of IOM in renal cancer patients, and identified the potential risk factors. Methods: A retrospective analysis of the clinical data of 214 patients with renal cell carcinoma from October 2001 to August 2016 was carried out. The difference and correlation of various indicators between the two groups with or without IOM was analyzed, and binary logistic regression analysis was used to explore the risk factors of IOM in renal cancer patients. The diagnostic value of each independent related factor was calculated according to the receiver operating curve (ROC). Results: The level of neuron-specific enolase (NSE) in renal cell carcinoma patients with IOM was significantly higher than that in patients without IOM (P<0.05). There was no significant difference in alkaline phosphatase (ALP), hemoglobin (Hb), serum calcium concentration, α fetoprotein (AFP), carcinoembryonic antigen (CEA), CA-125 etc. between IOM group and non-IOM (NIOM) group (P>0.05). Binary logistic regression analysis showed that NSE was an independent risk factor for IOM in renal cell carcinoma patients (P<0.05). ROC curve shows that the factor has high accuracy in predicting IOM, and the area under the curve (AUC) is 0.774. The cut-off value of NSE was 49.5 U/l, the sensitivity was 72.2% and the specificity was 80.1%. Conclusion: NSE concentration is a risk factor for IOM in patients with renal cell cancer. If the concentration of NSE in the patient’s body is ≥49.5 U/l, disease monitoring and eye scans should be strengthened.
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11
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Ye C, Chen GH, Chen X, Qin SF, Shi MF, Zhou T. Upregulation of erythropoietin and erythropoietin receptor in castration-resistant progression of prostate cancer. Asian J Androl 2021; 22:422-426. [PMID: 31417010 PMCID: PMC7406089 DOI: 10.4103/aja.aja_80_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Hypoxia-induced erythropoietin signaling plays an important role in tumor growth and invasion. In the present study, we investigated the contribution of erythropoietin signaling pathway to castration-resistant prostate cancer and the development of a neuroendocrine phenotype. Immunohistochemical staining showed that the erythropoietin and erythropoietin receptor scores in castration-resistant prostate cancer and androgen-dependent prostate cancer were 7.55 versus 4.5 and 7.45 versus 5.9,respectively (P < 0.001). Furthermore, a cell proliferation assay was conducted, and the differential expression of erythropoietin and erythropoietin receptor in LNCaP cells and hypoxia-induced LNCaP cells was evaluated using western blot and quantitative real-time PCR. The proliferation capacity of hypoxia-induced LNCaP cells was similar in cultures of both fetal bovine serum and charcoal-stripped fetal bovine serum, suggesting that LNCaP cells acquired hypoxia-induced androgen-independent growth. After 2 weeks of hypoxic culture, LNCaP cells showed a neuroendocrine cell change and increased expression of neuron-specific enolase, erythropoietin, and erythropoietin receptor; knockdown of erythropoietin receptor reversed the hypoxia-induced upregulation of neuron-specific enolase in the LNCaP cells. In conclusion, the concurrent upregulation of erythropoietin and erythropoietin receptor in castration-resistant prostate cancer suggests that the erythropoietin/erythropoietin receptor autocrine loop plays an important role in the progression of castration resistance and is responsible for the development of a neuroendocrine phenotype.
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Affiliation(s)
- Chen Ye
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Guang-Hua Chen
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Xin Chen
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Sheng-Fei Qin
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Min-Feng Shi
- Reproductive Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Tie Zhou
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
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12
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Moritz J, Bauernhofer T, Mannweiler S, Langsenlehner T, Pummer K, Dandachi N, Pichler M. Evaluation of Blood-based Biomarkers for Prediction of Response in Carboplatin-treated Metastatic Castration-resistant Prostate Cancer Patients. In Vivo 2021; 34:3631-3638. [PMID: 33144478 DOI: 10.21873/invivo.12209] [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: 08/10/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Carboplatin-containing treatment regimens demonstrate moderate efficacy in metastatic castration-resistant prostate cancer (mCRPC). In this study, we retrospectively analyzed the efficacy of carboplatin in relation to blood-based parameters. PATIENTS AND METHODS A retrospective chart review was performed for 20 patients with mCRPC who received carboplatin in a single center. RESULTS Median overall survival was 3.8 months (95%CI=1.5-7.1), median progression-free survival was 1.7 months. We observed two partial remissions (PR, 10%), four stable diseases (SD, 20%) and 14 disease progressions (PD, 70%), resulting in a clinical benefit rate of 30%. A doubling of NSE (neurone specific enolase) values was associated with a 19% absolute higher response rate (95%CI=14-23, p=0.027). All other laboratory parameters failed as predictive markers of response to carboplatin. In univariate Cox regression analysis, only NSE was significantly associated with impaired PFS (HR=0.7, 95%CI=0.56-0.96, p=0.030). CONCLUSION Carboplatin showed moderate efficacy against mCRPC in this unselected population of patients and NSE levels may help to predict the success of this treatment.
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Affiliation(s)
- Jennifer Moritz
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - Thomas Bauernhofer
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | | | - Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria
| | - Karl Pummer
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Nadia Dandachi
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria .,Research Unit Epigenetic and Genetic Cancer Biomarkers, Medical University of Graz, Graz, Austria
| | - Martin Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
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Neuroendocrine and Aggressive-Variant Prostate Cancer. Cancers (Basel) 2020; 12:cancers12123792. [PMID: 33339136 PMCID: PMC7765615 DOI: 10.3390/cancers12123792] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 01/12/2023] Open
Abstract
In prostate cancer, neuroendocrine (NE) differentiation may rarely present de novo or more frequently arises following hormonal therapy in patients with castration-resistant prostate cancer (CRPC). Its distinct phenotype is characterized by an aggressive clinical course, lack of responsiveness to hormonal therapies and poor prognosis. Importantly, a subset of CRPC patients exhibits an aggressive-variant disease with very similar clinical and molecular characteristics to small-cell prostate cancer (SCPC) even though tumors do not have NE differentiation. This aggressive-variant prostate cancer (AVPC) also shares the sensitivity of SCPC to platinum-based chemotherapy albeit with short-lived clinical benefit. As optimal treatment strategies for AVPC remain elusive, currently ongoing research efforts aim to enhance our understanding of the biology of this disease entity and improve treatment outcomes for our patients. This review is an overview of our current knowledge on prostate cancer with NE differentiation and AVPC, with a focus on their clinical characteristics and management, including available as well as experimental therapeutic strategies.
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Liu D, Mao Y, Chen C, Zhu F, Lu W, Ma H. Expression patterns and clinical significances of ENO2 in lung cancer: an analysis based on Oncomine database. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:639. [PMID: 32566576 PMCID: PMC7290642 DOI: 10.21037/atm-20-3354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Lung cancer is a heterogeneous malignant tumor involving more than 50 histological subtypes. Currently, molecularly targeted drugs have been shown to have promising applications in the clinical treatment of lung cancer. This study aims to explore the expression patterns and prognostic potential of enolase 2 (ENO2) in lung cancer. Methods Differential expressions of ENO2 in lung cancer cases were analyzed using the Oncomine database. Meanwhile, the prognostic potentials of ENO2 in lung cancer were assessed by deploying the Kaplan-Meier plotter database. Results Forty-one studies reported a significant difference in ENO2 expression between tumors and the normal healthy control tissues. Among all the studies, there was an upregulation of ENO2 in 29 studies, and downregulation in 12 studies. 9/41 studies revealed upregulated ENO2 in distinct types of tumor tissues, including cervical cancer, esophageal cancer, kidney cancer, leukemia, melanoma, pancreatic cancer, sarcoma, and lung cancer. Furthermore, upregulated ENO2 was identified in 365 cases of lung cancer (P<0.05). By analyzing the Kaplan-Meier Plotter database, the ENO2 level was negatively correlated to the overall survival of lung cancer patients (P<0.05). Subsequently, subgroup analysis revealed that the prognostic potential of ENO2 was much more pronounced in lung adenocarcinoma patients (P<0.05). Conclusions ENO2 is upregulated in lung cancer tissues and linked to the prognosis. It can be used as a therapeutic target for developing lung cancer drugs.
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Affiliation(s)
- Desen Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Yiming Mao
- Department of Thoracic Surgery, Suzhou Kowloon Hospital Shanghai Jiaotong University School of Medicine, Suzhou 215028, China
| | - Cheng Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Feng Zhu
- Department of Thoracic Surgery, Suzhou Kowloon Hospital Shanghai Jiaotong University School of Medicine, Suzhou 215028, China
| | - Wenqiang Lu
- Department of Thoracic Surgery, Suzhou Kowloon Hospital Shanghai Jiaotong University School of Medicine, Suzhou 215028, China
| | - Haitao Ma
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
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Rosar F, Ribbat K, Ries M, Linxweiler J, Bartholomä M, Maus S, Schreckenberger M, Ezziddin S, Khreish F. Neuron-specific enolase has potential value as a biomarker for [ 18F]FDG/[ 68Ga]Ga-PSMA-11 PET mismatch findings in advanced mCRPC patients. EJNMMI Res 2020; 10:52. [PMID: 32449086 PMCID: PMC7246282 DOI: 10.1186/s13550-020-00640-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/04/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND PSMA-targeted radioligand therapy (PSMA-RLT) yielded impressive results in the metastasized castration-resistant prostate carcinoma (mCRPC) setting. High expression of PSMA is essential for successful PSMA-RLT. However, some patients develop [18F]FDG-avid lesions with low or no PSMA expression ([18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings on PET/CT) in the course of treatment. Those lesions are not affected by PSMA-RLT and a change in therapy management is needed. To enable early mismatch detection, possible blood parameters as indicators for the occurrence of [18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings on PET/CT were evaluated. METHODS Retrospective study of N = 66 advanced mCRPC patients with dual [68Ga]Ga-PSMA-11 and [18F]FDG PET/CT imaging within 4 weeks, who were referred for or received [177Lu]Lu-PSMA-617 radioligand therapy. Prostate-specific antigen (PSA), neuron-specific enolase (NSE), gamma-glutamyltransferase (GGT), and alkaline phosphatase (ALP) were tested as indicators for the occurrence of [18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings. Additional to absolute values, relative changes (ΔPSA, ΔNSE, ΔGGT, ΔALP) over a period of 4 ± 1 weeks prior to [18F]FDG PET/CT were analyzed. RESULTS In total, 41/66 (62%) patients revealed at least one [18F]FDG/[68Ga]Ga-PSMA-11 mismatch finding on PET/CT. These mismatch findings were detected in 13/41 (32%) patients by screening for and in 28/41 (68%) patients during PSMA-RLT. NSE serum level (55.4 ± 44.6 μg/l vs. 18.5 ± 8 μg/l, p < 0.001) and ΔNSE (93.8 ± 124.5% vs. 2.9 ± 39.5%, p < 0.001) were significantly higher in the mismatch group than in the non-mismatch group. No significant differences were found for serum PSA (p = 0.424), ΔPSA (p = 0.417), serum ALP (p = 0.937), ΔALP (p = 0.611), serum GGT (p = 0.773), and ΔGGT (p = 0.971). For NSE and ΔNSE, the maximum value of the Youden index in ROC analysis was at a cut-off level of 26.8 μg/l (sensitivity 78%, specificity 96%) and at + 13.9% (sensitivity 84%, specificity 75%), respectively. An introduced scoring system of both parameters achieved a sensitivity of 90% and a specificity of 88% for the occurrence of [18F]FDG/[68Ga]Ga-PSMA-11 mismatch. CONCLUSION We observed a significantly higher absolute serum concentration and a higher relative increase of NSE in advanced mCRPC patients with [18F]FDG-avid and insufficient PSMA expressing metastases ([18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings on PET/CT) in our cohort. NSE might be used as a potential laboratory indicator for [18F]FDG/[68Ga]Ga-PSMA-11 mismatch findings, if this observation is confirmed in future, ideally prospective, studies in larger patient cohorts.
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Affiliation(s)
- Florian Rosar
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany.
| | - Kalle Ribbat
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | - Martin Ries
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | | | - Mark Bartholomä
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | - Stephan Maus
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | | | - Samer Ezziddin
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
| | - Fadi Khreish
- Department of Nuclear Medicine, Saarland University-Medical Center, Kirrberger Str. 100, Geb. 50, 66421, Homburg, Germany
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In-situ growth of NiWO4 saw-blade-like nanostructures and their application in photo-electrochemical (PEC) immunosensor system designed for the detection of neuron-specific enolase. Biosens Bioelectron 2019; 141:111331. [DOI: 10.1016/j.bios.2019.111331] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 11/21/2022]
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