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Bosch D, van der Velden KJM, Oving IM, Wyndaele DNJ, Weijs LE, van Schelven WD, Oyen WJG, Te Beek ET, van de Luijtgaarden ACM, Somford DM, Nagarajah J, Hermsen R, Mehra N, Gerritsen WR, van der Doelen MJ, van Oort IM. The Impact of Baseline PSMA PET/CT Versus CT on Outcomes of 223Ra Therapy in Metastatic Castration-Resistant Prostate Cancer Patients. J Nucl Med 2024; 65:541-547. [PMID: 38423781 DOI: 10.2967/jnumed.123.266654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/05/2024] [Indexed: 03/02/2024] Open
Abstract
Imaging before 223Ra-dichloride (223Ra) therapy is crucial for selecting metastatic castration-resistant prostate cancer (mCRPC) patients with bone-only disease. The purpose of this study was to evaluate if baseline prostate-specific membrane antigen (PSMA) PET/CT (bPSMA) versus CT is associated with outcomes of 223Ra therapy. Methods: A secondary analysis of the data of a prospective observational study (NCT04995614) was performed. Patients received a maximum of 6 223Ra cycles and were retrospectively divided into the bPSMA or baseline CT (bCT) groups. All patients received baseline bone scintigraphy. Primary endpoints were alkaline phosphatase and prostate-specific antigen response. Secondary endpoints were overall survival (OS) and radiologic response. Results: Between 2017 and 2020, 122 mCRPC patients were included: 18 (14.8%) in the bPSMA group and 104 (85.2%) in the bCT group. All baseline characteristics were comparable. No significant differences in alkaline phosphatase or prostate-specific antigen response were found. The bCT group showed an OS significantly shorter than that of the bPSMA group (12.4 vs. 19.9 mo, P = 0.038). In 31 of 76 patients (40.1%) in the bCT group who also received posttherapy CT, lymph node or visceral metastases (soft-tissue involvement [STI]) were detected after 223Ra therapy, compared with 0 of 15 patients in the bPSMA group who received posttherapy PSMA PET/CT or CT. No significant difference in OS was found between patients in the bCT or posttherapy CT subgroup without STI (46/76) and the bPSMA group. Conclusion: bPSMA versus CT does not seem to impact biochemical response during 223Ra therapy in mCRPC patients. Nevertheless, patients in the bCT group had a significantly shorter OS, most likely due to underdetection of STI in this group. Therefore, replacing bCT with PSMA PET/CT appears to be a valuable screening method for identifying patients who will benefit most from 223Ra therapy.
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Affiliation(s)
- Dianne Bosch
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Irma M Oving
- Department of Medical Oncology, Ziekenhuisgroep Twente, Almelo, The Netherlands
| | - Dirk N J Wyndaele
- Department of Nuclear Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Leo E Weijs
- Department of Radiology and Nuclear Medicine, Ziekenhuisgroep Twente, Almelo, Netherlands
| | - W Dick van Schelven
- Department of Nuclear Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Wim J G Oyen
- Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Nuclear Medicine, Humanitas Clinical and Research Center, Milan, Italy
| | - Erik T Te Beek
- Department of Nuclear Medicine, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Addy C M van de Luijtgaarden
- Department of Medical Oncology, Reinier de G raaf Gasthuis and Reinier Haga Prostate Cancer Center, Delft, The Netherlands
| | - Diederik M Somford
- Department of Urology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - James Nagarajah
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rick Hermsen
- Department of Nuclear Medicine, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; and
| | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Inge M van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
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2
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van der Doelen MJ, Oving IM, Wyndaele DNJ, van Basten JP, Terheggen F, van de Luijtgaarden ACM, Oyen WJG, van Schelven WD, van den Berkmortel F, Mehra N, Janssen MJR, Prins JB, Gerritsen WR, Custers JAE, van Oort IM. Health-related quality of life, psychological distress, and fatigue in metastatic castration-resistant prostate cancer patients treated with radium-223 therapy. Prostate Cancer Prostatic Dis 2023; 26:142-150. [PMID: 35804188 PMCID: PMC10023564 DOI: 10.1038/s41391-022-00569-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Radium-223 is a registered treatment option for symptomatic bone metastatic castration-resistant prostate cancer (mCRPC). Aim of this multicenter, prospective observational cohort study was to evaluate health-related quality of life (HR-QoL), psychological distress and fatigue in mCRPC patients treated with radium-223. METHODS Primary endpoint was cancer-specific and bone metastases-related HR-QoL, as measured by the EORTC QLQ-C30 and BM-22 questionnaires. Secondary endpoints were psychological distress and fatigue, evaluated by the HADS and CIS-Fatigue questionnaires. Outcomes were analyzed for the total cohort and between subgroups (1-3 versus 4-5 versus 6 radium-223 injections). A trajectory analysis was performed to explore HR-QoL patterns over time. RESULTS In total, 122 patients were included for analysis. Baseline HR-QoL, pain intensity, psychological distress and fatigue were worse in patients who did not complete radium-223 therapy. In patients who completed therapy, stabilization of HR-QoL was perceived and psychological distress and fatigue remained stable, whereas clinically meaningful and statistically significant deterioration of HR-QoL, psychological distress and fatigue over time was observed in patients who discontinued radium-223 therapy. Trajectory analysis revealed that HR-QoL deterioration over time was more likely in patients with baseline opioid use, low hemoglobin and high alkaline phosphatase levels. CONCLUSIONS Patients who discontinued radium-223 therapy showed worse HR-QoL, psychological distress and fatigue at baseline and more frequent deterioration of HR-QoL, psychological distress and fatigue over time when compared to patients who completed therapy. Specific attention with regard to HR-QoL during follow-up is indicated in patients with opioid use, low hemoglobin and high alkaline phosphatase levels before radium-223 therapy initiation. CLINICAL TRIAL REGISTRATION NUMBER NCT04995614.
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Affiliation(s)
- Maarten J van der Doelen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Irma M Oving
- Department of Medical Oncology, Ziekenhuisgroep Twente, Almelo, Netherlands
| | - Dirk N J Wyndaele
- Department of Nuclear Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Frederiek Terheggen
- Department of Medical Oncology, Bravis Hospital, Roosendaal, The Netherlands
| | - Addy C M van de Luijtgaarden
- Department of Medical Oncology, Reinier de Graaf Gasthuis and Reinier Haga Prostate Cancer Center, Delft, The Netherlands
| | - Wim J G Oyen
- Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Nuclear Medicine, Humanitas Clinical and Research Center, Milan, Italy
| | - W Dick van Schelven
- Department of Nuclear Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | | | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel J R Janssen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Inge M van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
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3
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Starmans MPA, Ho LS, Smits F, Beije N, de Kruijff I, de Jong JJ, Somford DM, Boevé ER, te Slaa E, Cauberg ECC, Klaver S, van der Heijden AG, Wijburg CJ, van de Luijtgaarden ACM, van Melick HHE, Cauffman E, de Vries P, Jacobs R, Niessen WJ, Visser JJ, Klein S, Boormans JL, van der Veldt AAM. Optimization of Preoperative Lymph Node Staging in Patients with Muscle-Invasive Bladder Cancer Using Radiomics on Computed Tomography. J Pers Med 2022; 12:jpm12050726. [PMID: 35629148 PMCID: PMC9147130 DOI: 10.3390/jpm12050726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 12/10/2022] Open
Abstract
Approximately 25% of the patients with muscle-invasive bladder cancer (MIBC) who are clinically node negative have occult lymph node metastases at radical cystectomy (RC) and pelvic lymph node dissection. The aim of this study was to evaluate preoperative CT-based radiomics to differentiate between pN+ and pN0 disease in patients with clinical stage cT2-T4aN0-N1M0 MIBC. Patients with cT2-T4aN0-N1M0 MIBC, of whom preoperative CT scans and pathology reports were available, were included from the prospective, multicenter CirGuidance trial. After manual segmentation of the lymph nodes, 564 radiomics features were extracted. A combination of different machine-learning methods was used to develop various decision models to differentiate between patients with pN+ and pN0 disease. A total of 209 patients (159 pN0; 50 pN+) were included, with a total of 3153 segmented lymph nodes. None of the individual radiomics features showed significant differences between pN+ and pN0 disease, and none of the radiomics models performed substantially better than random guessing. Hence, CT-based radiomics does not contribute to differentiation between pN+ and pN0 disease in patients with cT2-T4aN0-N1M0 MIBC.
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Affiliation(s)
- Martijn P. A. Starmans
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (L.S.H.); (F.S.); (W.J.N.); (J.J.V.); (S.K.); (A.A.M.v.d.V.)
- Correspondence: ; Tel.: +31-10-704-10-26
| | - Li Shen Ho
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (L.S.H.); (F.S.); (W.J.N.); (J.J.V.); (S.K.); (A.A.M.v.d.V.)
| | - Fokko Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (L.S.H.); (F.S.); (W.J.N.); (J.J.V.); (S.K.); (A.A.M.v.d.V.)
| | - Nick Beije
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (N.B.); (I.d.K.)
| | - Inge de Kruijff
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (N.B.); (I.d.K.)
| | - Joep J. de Jong
- Department of Urology, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (J.J.d.J.); (J.L.B.)
| | - Diederik M. Somford
- Department of Urology, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands;
| | - Egbert R. Boevé
- Department of Urology, Franciscus Gasthuis & Vlietland, 3045 PM Rotterdam, The Netherlands;
| | - Ed te Slaa
- Department of Urology, Isala, 8025 AB Zwolle, The Netherlands; (E.t.S.); (E.C.C.C.)
| | | | - Sjoerd Klaver
- Department of Urology, Maasstad, 3079 DZ Rotterdam, The Netherlands;
| | | | - Carl J. Wijburg
- Department of Urology, Rijnstate, 6815 AD Arnhem, The Netherlands;
| | | | - Harm H. E. van Melick
- Department of Urology, St Antonius Ziekenhuis, Nieuwegein, 3543 AZ Utrecht, The Netherlands;
| | - Ella Cauffman
- Department of Urology, Zuyderland, 6162 BG Sittard, The Netherlands; (E.C.); (P.d.V.); (R.J.)
| | - Peter de Vries
- Department of Urology, Zuyderland, 6162 BG Sittard, The Netherlands; (E.C.); (P.d.V.); (R.J.)
| | - Rens Jacobs
- Department of Urology, Zuyderland, 6162 BG Sittard, The Netherlands; (E.C.); (P.d.V.); (R.J.)
| | - Wiro J. Niessen
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (L.S.H.); (F.S.); (W.J.N.); (J.J.V.); (S.K.); (A.A.M.v.d.V.)
| | - Jacob J. Visser
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (L.S.H.); (F.S.); (W.J.N.); (J.J.V.); (S.K.); (A.A.M.v.d.V.)
| | - Stefan Klein
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (L.S.H.); (F.S.); (W.J.N.); (J.J.V.); (S.K.); (A.A.M.v.d.V.)
| | - Joost L. Boormans
- Department of Urology, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (J.J.d.J.); (J.L.B.)
| | - Astrid A. M. van der Veldt
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands; (L.S.H.); (F.S.); (W.J.N.); (J.J.V.); (S.K.); (A.A.M.v.d.V.)
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (N.B.); (I.d.K.)
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Kuppen MCP, Westgeest HM, van den Eertwegh AJM, Coenen JLLM, van Moorselaar RJA, van den Berg P, Geenen MM, Mehra N, Hendriks MP, Lampe MI, van de Luijtgaarden ACM, Peters FPJ, Roeleveld TA, Smilde TJ, de Wit R, van Oort IM, Gerritsen WR, Uyl-de Groot CA. Health-related Quality of Life and Pain in a Real-world Castration-resistant Prostate Cancer Population: Results From the PRO-CAPRI Study in the Netherlands. Clin Genitourin Cancer 2019; 18:e233-e253. [PMID: 31883940 DOI: 10.1016/j.clgc.2019.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/18/2019] [Accepted: 11/27/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND The purpose of this study was to determine generic, cancer-specific, and prostate cancer-specific health-related quality of life (HRQoL), pain and changes over time in patients with metastatic castration-resistant prostate cancer (mCRPC) in daily practice. PATIENTS AND METHODS PRO-CAPRI is an observational, prospective study in 10 hospitals in the Netherlands. Patients with mCRPC completed the EQ-5D, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and Brief Pain Inventory-Short Form (BPI-SF) every 3 months and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Prostate Cancer Module (EORTC QLQ-PR25) every 6 months for a maximum of 2 years. Subgroups were identified based on chemotherapy pretreatment. Outcomes were generic, cancer-specific, and prostate cancer-specific HRQoL and self-reported pain. Descriptive statistics were performed including changes over time and minimal important differences (MID) between subgroups. RESULTS In total, 151 included patients answered 873 questionnaires. The median follow-up from the start of the study was 19.5 months, and 84% were treated with at least 1 life-prolonging agent. Overall, patients were in good clinical condition (Eatern Cooperative Oncology Group performance status 0-1 in 78%) with normal baseline hemoglobin, lactate dehydrogenase, and alkaline phosphatase. At inclusion, generic HRQoL was high with a mean EQ visual analog score of 73.2 out of 100. The lowest scores were reported on role and physical functioning (mean scores of 69 and 76 of 100, respectively), and fatigue, pain, and insomnia were the most impaired domains. These domains deteriorated in > 50% of patients. CONCLUSION Although most patients were treated with new treatments during follow-up, mCRPC has a negative impact on HRQoL with deterioration in all domains over time, especially role and physical functioning. These domains need specific attention during follow-up to maintain HRQoL as long as possible by timely start of adequate supportive care management.
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Affiliation(s)
- Malou C P Kuppen
- Institute for Medical Technology Assessment, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Hans M Westgeest
- Department of Internal Medicine, Amphia Hospital, Breda, the Netherlands
| | | | | | | | - Pieter van den Berg
- Department of Internal Medicine, TerGooi Ziekenhuizen, Hilversum, the Netherlands
| | - Maud M Geenen
- Department of Internal Medicine, OLVG, Amsterdam, the Netherlands
| | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mathijs P Hendriks
- Department of Internal Medicine, Northwest Clinics, Alkmaar, the Netherlands
| | - Menuhin I Lampe
- Department of Urology, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Addy C M van de Luijtgaarden
- Department of Internal Medicine, Reinier de Graaf Gasthuis and Reineir Haga Prostate Cancer Center, Delft, the Netherlands
| | - Frank P J Peters
- Department of Internal Medicine, Zuyderland Medical Center, Heerlen-Sittard-Geleen, the Netherlands
| | - Ton A Roeleveld
- Department of Urology, Northwest Clinics, Alkmaar, the Netherlands
| | - Tineke J Smilde
- Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Ronald de Wit
- Department of Medical Oncology, Erasmus MC Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
| | - Inge M van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Carin A Uyl-de Groot
- Institute for Medical Technology Assessment, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Kuppen MCP, Westgeest HM, van den Eertwegh AJM, van Moorselaar RJA, van Oort IM, Coenen JLLM, van den Bergh ACMF, Mehra N, Somford DM, Bergman AM, Ten Bokkel Huinink D, Fossion L, Geenen MM, Hendriks MP, van de Luijtgaarden ACM, Polee MB, Weijl NI, van de Wouw AJ, de Wit R, Uyl-de Groot CA, Gerritsen WR. Real-world Outcomes of Sequential Androgen-receptor Targeting Therapies with or Without Interposed Life-prolonging Drugs in Metastatic Castration-resistant Prostate Cancer: Results from the Dutch Castration-resistant Prostate Cancer Registry. Eur Urol Oncol 2019; 4:618-627. [PMID: 31601523 DOI: 10.1016/j.euo.2019.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/20/2019] [Accepted: 09/17/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cross resistance between androgen-receptor targeting therapies (ARTs) (abiraterone acetate plus prednisone [ABI+P] or enzalutamide [ENZ]) for treatment of metastatic castration-resistant prostate cancer (mCRPC) may affect responses to second ART (ART2). OBJECTIVE To establish treatment duration and prostate-specific antigen (PSA) response of ART2 in real-world mCRPC patients treated with or without other life-prolonging drugs (LPDs; ie, docetaxel, cabazitaxel, or radium-223) between ART1 and ART2. DESIGN, SETTING, AND PARTICIPANTS Castration-resistant prostate cancer patients, diagnosed between 2010 and 2016 were retrospectively registered in Castration-resistant Prostate Cancer Registry (CAPRI). Patients treated with both ARTs were clustered into two subgroups: ART1>ART2 or ART1>LPD>ART2. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Outcomes were ≥50% PSA response and treatment duration of ART2. Descriptive statistics and binary logistic regression after multiple imputations were performed. RESULTS AND LIMITATIONS A total of 273 patients were included with a median follow-up of 8.4 mo from ART2. Patients with ART1>ART2 were older and had favourable prognostic characteristics at ART2 baseline compared with patients with ART1>LPD>ART2. No differences between ART1>ART2 and ART1>LPD>ART2 were found in PSA response and treatment duration. Multivariate analysis suggested that PSA response of ART2 was less likely in patients with visceral metastases (odds ratio [OR] 0.143, p=0.04) and more likely in patients with a relatively longer duration of androgen-deprivation treatment (OR 1.028, p=0.01) and with ABI + P before ENZ (OR 3.192, p=0.02). A major limitation of this study was missing data, a common problem in retrospective observational research. CONCLUSIONS The effect of ART2 seems to be low, with a low PSA response rate and a short treatment duration irrespective of interposed chemotherapy or radium-223, especially in patients with short time on castration, visceral disease, and ENZ before ABI+P. PATIENT SUMMARY We observed no differences in outcomes of patients treated with sequential abiraterone acetate plus prednisone (ABI+P) and enzalutamide (ENZ) with or without interposed chemotherapy or radium-223. In general, outcomes were lower than those in randomised trials, questioning the additional effect of second treatment with ABI+P or ENZ in daily practice.
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Affiliation(s)
- Malou C P Kuppen
- Institute for Medical Technology Assessment, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands.
| | - Hans M Westgeest
- Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands
| | | | | | - Inge M van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - A C M Fons van den Bergh
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Diederik M Somford
- Department of Urology, Canisius Wilhemina Hospital, Nijmegen, The Netherlands
| | - Andre M Bergman
- Division of Internal Medicine (MOD) and Oncogenomics, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - Laurent Fossion
- Department of Urology, Maxima Medical Center, Eindhoven, The Netherlands
| | - Maud M Geenen
- Department of Internal Medicine, OLVG, Amsterdam, The Netherlands
| | - Mathijs P Hendriks
- Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands
| | | | - Marco B Polee
- Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Nir I Weijl
- Department of Internal Medicine, MCH-Bronovo Hospital, 's-Gravenhage, The Netherlands
| | - Agnes J van de Wouw
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - Ronald de Wit
- Department of Medical Oncology, Erasmus MC Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | - Carin A Uyl-de Groot
- Institute for Medical Technology Assessment, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
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6
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Westgeest HM, Kuppen MCP, van den Eertwegh AJM, de Wit R, Coenen JLLM, van den Berg HPP, Mehra N, van Oort IM, Fossion LMCL, Hendriks MP, Bloemendal HJ, van de Luijtgaarden ACM, Ten Bokkel Huinink D, van den Bergh ACMF, van den Bosch J, Polee MB, Weijl N, Bergman AM, Uyl-de Groot CA, Gerritsen WR. Second-Line Cabazitaxel Treatment in Castration-Resistant Prostate Cancer Clinical Trials Compared to Standard of Care in CAPRI: Observational Study in the Netherlands. Clin Genitourin Cancer 2019; 17:e946-e956. [PMID: 31439536 DOI: 10.1016/j.clgc.2019.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/24/2019] [Accepted: 05/20/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cabazitaxel has been shown to improve overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC) patients after docetaxel in the TROPIC trial. However, trial populations may not reflect the real-world population. We compared patient characteristics and outcomes of cabazitaxel within and outside trials (standard of care, SOC). PATIENTS AND METHODS mCRPC patients treated with cabazitaxel directly after docetaxel therapy before 2017 were retrospectively identified and followed to 2018. Patients were grouped on the basis of treatment within a trial or SOC. Outcomes included OS and prostate-specific antigen (PSA) response. RESULTS From 3616 patients in the CAPRI registry, we identified 356 patients treated with cabazitaxel, with 173 patients treated in the second line. Trial patients had favorable prognostic factors: fewer symptoms, less visceral disease, lower lactate dehydrogenase, higher hemoglobin, more docetaxel cycles, and longer treatment-free interval since docetaxel therapy. PSA response (≥ 50% decline) was 28 versus 12%, respectively (P = .209). Median OS was 13.6 versus 9.6 months for trial and SOC subgroups, respectively (hazard ratio = 0.73, P = .067). After correction for prognostic factors, there was no difference in survival (hazard ratio = 1.00, P = .999). Longer duration of androgen deprivation therapy treatment, lower lactate dehydrogenase, and lower PSA were associated with longer OS; visceral disease had a trend for shorter OS. CONCLUSION Patients treated with cabazitaxel in trials were fitter and showed outcomes comparable to registration trials. Conversely, those treated in daily practice showed features of more aggressive disease and worse outcome. This underlines the importance of adequate estimation of trial eligibility and health status of mCRPC patients in daily practice to ensure optimal outcomes.
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Affiliation(s)
- Hans M Westgeest
- Department of Internal Medicine, Amphia Ziekenhuis, Breda, The Netherlands.
| | - Malou C P Kuppen
- Institute for Medical Technology Assessment, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
| | | | - Ronald de Wit
- Department of Medical Oncology, Erasmus MC Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | | | | | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Inge M van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Mathijs P Hendriks
- Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands
| | - Haiko J Bloemendal
- Department of Internal Medicine, Meander Medisch Centrum, Amersfoort, The Netherlands
| | - Addy C M van de Luijtgaarden
- Department of Internal Medicine, Reinier de Graaf Gasthuis and Reinier Haga Prostate Cancer Centre, Delft, The Netherlands
| | | | - A C M Fons van den Bergh
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joan van den Bosch
- Department of Internal Medicine, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands
| | - Marco B Polee
- Department of Internal Medicine, Medical Center, Leeuwarden, The Netherlands
| | - Nir Weijl
- Department of Internal Medicine, MCH-Bronovo Ziekenhuis, 's-Gravenhage, The Netherlands
| | - Andre M Bergman
- Division of Internal Medicine (MOD) and Oncogenomics, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Carin A Uyl-de Groot
- Institute for Medical Technology Assessment, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
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Versleijen-Jonkers YMH, Vlenterie M, van de Luijtgaarden ACM, van der Graaf WTA. Anti-angiogenic therapy, a new player in the field of sarcoma treatment. Crit Rev Oncol Hematol 2014; 91:172-85. [PMID: 24613529 DOI: 10.1016/j.critrevonc.2014.02.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/19/2013] [Accepted: 02/05/2014] [Indexed: 01/12/2023] Open
Abstract
Sarcomas encompass a heterogeneous family of mesenchymal malignancies. In metastatic disease improvement in outcome has been limited and there is a clear need for the development of new therapies. One potential target is angiogenesis, already an accepted target for treatment of more prevalent cancers. Multiple (pre)clinical studies focused on the role of angiogenesis and anti-angiogenic treatment in sarcomas. However, getting significant results is complicated due to the relatively small number of patients and the broad range of sarcoma subtypes. Recently, pazopanib has been approved for the treatment of advanced soft tissue sarcoma patients, which is an important step forward and paves the way for the introduction of anti-angiogenic treatment in sarcomas. However, more studies are needed to understand the biological mechanisms by which patients respond to angiogenic inhibitors and to detect markers of response. This review covers the knowledge that has been gained on the role of angiogenesis and anti-angiogenic therapy in sarcomas.
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Affiliation(s)
- Yvonne M H Versleijen-Jonkers
- Department of Medical Oncology, Radboud University Medical Center, Internal Postal Code 452, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Myrella Vlenterie
- Department of Medical Oncology, Radboud University Medical Center, Internal Postal Code 452, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Addy C M van de Luijtgaarden
- Department of Medical Oncology, Radboud University Medical Center, Internal Postal Code 452, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Winette T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Internal Postal Code 452, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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8
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Fleuren EDG, Versleijen-Jonkers YMH, van de Luijtgaarden ACM, Molkenboer-Kuenen JDM, Heskamp S, Roeffen MHS, van Laarhoven HWM, Houghton PJ, Oyen WJG, Boerman OC, van der Graaf WTA. Predicting IGF-1R therapy response in bone sarcomas: immuno-SPECT imaging with radiolabeled R1507. Clin Cancer Res 2011; 17:7693-703. [PMID: 22038993 DOI: 10.1158/1078-0432.ccr-11-1488] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate whether indium-111-labeled R1507 ((111)In-R1507) immuno-SPECT (single-photon emission computed tomography), a novel noninvasive, in vivo screening method to visualize membranous insulin-like growth factor 1 receptor (IGF-1R) expression and accessibility, can be used to predict IGF-1R treatment (R1507) response in bone sarcomas. EXPERIMENTAL DESIGN BALB/c nude mice were subcutaneously implanted with IGF-1R-expressing human bone sarcoma xenografts (OS-1, EW-5, and EW-8) which showed high, modest, or no response, respectively, to R1507, a monoclonal antibody targeting the extracellular domain of IGF-1R. An IGF-1R-negative tumor (OS-33), unresponsive to IGF-1R inhibitors, was examined as well. Mice were injected with (111)In-R1507. Biodistribution and immuno-SPECT/computed tomography imaging studies were carried out 1, 3, and 7 days p.i. in mice with OS-1 and EW-5 xenografts and 3 days p.i. in mice with EW-8 and OS-33 xenografts. RESULTS Biodistribution studies showed specific accumulation of (111)In-R1507 in OS-1 and EW-5 xenografts (27.5 ± 6.5%ID/g and 14.0 ± 2.8%ID/g, 3 days p.i., respectively). Most importantly, (111)In-R1507 uptake in IGF-1R positive, but unresponsive, EW-8 xenografts (6.5 ± 1.5%ID/g, 3 days p.i.) was similar to that of the IGF-1R-negative OS-33 tumor (5.5 ± 0.6%ID/g, 3 days p.i.). Uptake in normal tissues was low and nonspecific. Corresponding immuno-SPECT images clearly discriminated between high, modest, and nonresponding tumors by showing a homogeneous (OS-1), heterogeneous (EW-5), or nonspecific (EW-8 and OS-33) tumor uptake of (111)In-R1507. CONCLUSIONS (111)In-R1507 immuno-SPECT is an excellent method to visualize membranous IGF-1R expression and target accessibility in vivo in human bone sarcoma xenografts and may serve as an independent marker to predict IGF-1R therapy (R1507) response in bone sarcoma patients.
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MESH Headings
- Animals
- Antibodies, Monoclonal/pharmacokinetics
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal, Humanized
- Bone Neoplasms/diagnostic imaging
- Bone Neoplasms/drug therapy
- Bone Neoplasms/pathology
- Cell Line, Tumor
- Female
- Humans
- Immunohistochemistry
- Indium Radioisotopes
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Positron-Emission Tomography/methods
- Prognosis
- Receptor, IGF Type 1/antagonists & inhibitors
- Receptor, IGF Type 1/metabolism
- Reproducibility of Results
- Sarcoma/diagnostic imaging
- Sarcoma/drug therapy
- Sarcoma/pathology
- Tissue Distribution
- Tomography, Emission-Computed, Single-Photon/methods
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Emmy D G Fleuren
- Departments of Medical Oncology and Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Quak E, van de Luijtgaarden ACM, de Geus-Oei LF, van der Graaf WTA, Oyen WJG. Clinical applications of positron emission tomography in sarcoma management. Expert Rev Anticancer Ther 2011; 11:195-204. [PMID: 21342039 DOI: 10.1586/era.10.133] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Positron emission tomography (PET) with the fluorine-18-labeled glucose analog FDG is a technique that noninvasively visualizes glucose metabolism in the human body. In oncology, the addition of FDG-PET to the conventional anatomical imaging techniques provides very useful clinical information in diagnosis, staging, treatment response monitoring and follow-up. In the heterogeneous group of patients with sarcoma, FDG-PET has been shown to be of great value in improving patient care. In this article we will discuss the current role of FDG-PET in the management of patients with sarcoma and its value in assessing tumor grade, guiding biopsy, staging, monitoring treatment response, restaging and prognostication. Our future expectation is that the value of PET will only augment owing to the implementation of FDG-PET in clinical guidelines, the increasing availability worldwide, and the development of new tracers and new hybrid imaging techniques.
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Affiliation(s)
- Elske Quak
- Department of Nuclear Medicine, Internal Postal Code 444, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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van de Luijtgaarden ACM, Veth RPH, Slootweg PJ, Wijers-Koster PM, Schultze Kool LJ, Bovee JVMG, van der Graaf WTA. Metastatic potential of an aneurysmal bone cyst. Virchows Arch 2009; 455:455-9. [PMID: 19838726 PMCID: PMC2772953 DOI: 10.1007/s00428-009-0845-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 09/14/2009] [Accepted: 10/03/2009] [Indexed: 11/29/2022]
Abstract
Aneurysmal bone cysts (ABCs) are benign bone tumors consisting of blood-filled cavities lined by connective tissue septa. Recently, the hypothesis that ABCs are lesions reactive to local hemodynamics has been challenged after the discovery of specific recurrent chromosomal abnormalities. Multiple cases of malignant transformation of ABC into (osteo)sarcoma have been described, as well as a number of cases of telangiectatic osteosarcoma which had been misdiagnosed as ABC. We herewith document a case of a pelvic ABC metastatic to the lung, liver, and kidneys. Diagnosis was confirmed by the presence of a break in the USP6 gene, which is pathognomonic for ABC, in a pulmonary metastasis of our patient. Sarcomatous transformation as an explanation for this behavior was ruled out by demonstrating diploid DNA content in both the pulmonary lesion and the primary tumor.
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Affiliation(s)
- Addy C M van de Luijtgaarden
- Department of Medical Oncology (452), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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