1
|
Yanada BA, Homewood D, Dias BH, Ogluszko C, Corcoran NM. The treatment landscape of nonmetastatic castrate resistant prostate cancer: A contemporary perspective. Urol Oncol 2024; 42:175.e9-175.e18. [PMID: 38555235 DOI: 10.1016/j.urolonc.2024.03.005] [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: 12/19/2023] [Revised: 02/13/2024] [Accepted: 03/06/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES The incidence of nonmetastatic castrate resistant prostate cancer (nmCRPC) is not well defined in contemporary practice. The aim of this study is to describe the incidence and patterns of treatment of nmCRPC over the last 6 years at a single high-volume Australian health institution. SUBJECTS AND METHODS All men newly diagnosed with prostate cancer at Western Health, Melbourne from January 2016 to December 2021 were included in the study. Those diagnosed with nonmetastatic prostate cancer and treated with medical or surgical castration for biochemical failure post attempted curative therapy were retrospectively reviewed for signs of castration resistance using prostate specific antigen (PSA) and testosterone biochemical markers up until October 2022. RESULTS From January 2016 to December 2021, 822 patients were diagnosed with prostate cancer, 590 had localized disease, 373 underwent definitive locoregional therapy, and 31 went on to have biochemical recurrence and were commenced on androgen deprivation therapy. Twenty-five patients had undetectable PSA levels and were classified as having nonmetastatic castrate sensitive prostate cancer (nmCSPC), whilst the remaining 6 patients experienced a rising PSA and were thus classified as nmCRPC. The incidence rate of nmCRPC was 228 cases per 100,000 person-years. The median age at the time of prostate biopsy was 74 years (interquartile range [IQR] 64-79) in the nmCRPC group and 62 years (IQR 57-69) in the nmCSPC group. The median prebiopsy PSA (ng/ml) in the nmCRPC and nmCSPC groups were 27.5 (IQR 19.9-50.4), and 16.5 (IQR 9.0-26.0), respectively. The median duration from prostate cancer diagnosis to onset of nmCRPC was 24 months (IQR 17-29) and the median PSA doubling time was 3.4 months (IQR 2.2-5.7). CONCLUSIONS Thus, nmCRPC is an uncommon disease. Further population-based studies are required to better understand the incidence of nmCRPC.
Collapse
Affiliation(s)
- Brendan A Yanada
- Department of Urology, Western Health, Footscray, VIC, Australia; Department of Urology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
| | - David Homewood
- Department of Urology, Western Health, Footscray, VIC, Australia; Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
| | - Brendan H Dias
- Department of Urology, Western Health, Footscray, VIC, Australia; Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
| | - Cindy Ogluszko
- Department of Urology, Western Health, Footscray, VIC, Australia
| | - Niall M Corcoran
- Department of Urology, Western Health, Footscray, VIC, Australia; Department of Surgery, The University of Melbourne, Parkville, VIC, Australia; Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
| |
Collapse
|
2
|
Agarwal DK, Mulholland C, Koye DN, Sathianathen N, Yao H, Dundee P, Moon D, Furrer M, Giudice C, Wang W, Simpson JA, Kearsley J, Norris B, Zargar H, Pan HY, Mottrie A, Fuller A, Mottaran A, Challacombe B, Kua B, Metcalfe C, Wagner C, Dubey D, Gomez Sancha F, Bruyère F, Gautam G, Pooleri GK, Bozzini G, Lau H, Thyer I, Teoh J, Vass J, Vivian J, McDermott K, Winter M, Ragavan N, Campbell N, Harke NN, Richard PO, Teloken P, Dekuyper P, Sutherland P, Ahlawat R, Nair R, Pemberton R, Catterwell R, Oomen RJ, Weston R, Moritz R, Krishnappa RS, Leslie S, Van Appledorn S, Yuvaraja T, Meert T, Dujardin T, Gross T, Walton T, Huang WC, Caumartin Y, Agarwal A, Lawrentschuk N, Corcoran NM. Corrigendum to "RPN (Radius, Position of tumour, iNvasion of renal sinus) Classification and Nephrometry Scoring System: An Internationally Developed Clinical Classification To Describe the Surgical Difficulty for Renal Masses for Which Robotic Partial Nephrectomy Is Planned" [Eur. Urol. Open Sci. 54 (2023) 33-42]. EUR UROL SUPPL 2024; 63:2-3. [PMID: 38523653 PMCID: PMC10958212 DOI: 10.1016/j.euros.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
[This corrects the article DOI: 10.1016/j.euros.2023.05.007.].
Collapse
Affiliation(s)
- Dinesh K. Agarwal
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
- Department of Urology, Western Health, Melbourne, Australia
- Department of Urology, Mercy Health, Melbourne, Australia
| | - Clancy Mulholland
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Digsu N. Koye
- Centre for Epidemiology and Biostatics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Henry Yao
- Department of Urology, Western Health, Melbourne, Australia
| | - Philip Dundee
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Daniel Moon
- University of Melbourne, Royal Melbourne Clinical School, Melbourne, Australia
| | - Marc Furrer
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
- Urology Centre, Guy’s and St. Thomas’ Hospitals NHS Trust, London, UK
- Department of Urology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Christina Giudice
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Wayland Wang
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Julie A. Simpson
- Centre for Epidemiology and Biostatics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jamie Kearsley
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Briony Norris
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Homi Zargar
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Henry Y.C. Pan
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Alex Mottrie
- Department of Urology, OLV Hospital, Aalst, Belgium
- Orsi Academy, Ghent, Belgium
| | - Andrew Fuller
- Department of Urology, Royal Adelaide Hospital, Adelaide, Australia
| | - Angelo Mottaran
- Department of Urology, OLV Hospital, Aalst, Belgium
- Orsi Academy, Ghent, Belgium
| | - Ben Challacombe
- Urology Centre, Guy’s and St. Thomas’ Hospitals NHS Trust, London, UK
| | - Boon Kua
- Department of Urology, Wesley Hospital, Brisbane, Australia
| | - Charles Metcalfe
- Division of Urology, Department of Surgery, University of Calgary, Calgary, Canada
| | | | - Deepak Dubey
- Department of Urology, Manipal Hospital, Bangalore, India
| | | | | | - Gagan Gautam
- Division of Urologic Oncology, Max Institute of Cancer Care, New Delhi, India
| | - Ginil K. Pooleri
- Division of Uro-oncology, Department of Urology, Amrita Institute of Medical Sciences, Kochi, India
| | | | - Howard Lau
- Department of Urology, Westmead Hospital, Sydney, Australia
| | - Isaac Thyer
- Department of Urology, Fiona Stanley Hospital, Perth, Australia
| | - Jeremy Teoh
- S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Justin Vass
- Department of Urology, Royal North Shore Hospital, Sydney, Australia
| | - Justin Vivian
- Department of Urology, St. John of God Subiaco Hospital, Perth, Australia
| | - Kara McDermott
- Department of Urology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Mathew Winter
- Department of Urology, Royal North Shore Hospital, Sydney, Australia
| | | | | | - Nina N. Harke
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - Patrick O. Richard
- Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, University of Sherbrooke, Sherbrooke, Canada
| | - Patrick Teloken
- Department of Urology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Peter Dekuyper
- Department of Urology, AZ Maria Middelares, Ghent, Belgium
| | | | - Rajesh Ahlawat
- Division of Urology and Renal Transplantation, Medanta Kidney and Urology Institute, Gurgaon, India
| | - Rajesh Nair
- Urology Centre, Guy’s and St. Thomas’ Hospitals NHS Trust, London, UK
| | - Richard Pemberton
- Department of Urology, St. John of God Subiaco Hospital, Perth, Australia
| | - Rick Catterwell
- Urology Centre, Guy’s and St. Thomas’ Hospitals NHS Trust, London, UK
- Department of Urology, Royal Adelaide Hospital, Adelaide, Australia
| | - Robert J.A. Oomen
- Department of Urology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Robin Weston
- Department of Urology, Royal Liverpool University Hospital, Liverpool, UK
| | - Rudolf Moritz
- Department of Urology and Neuro-Urology, Marien Hospital, Herne, Germany
| | | | - Scott Leslie
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - T.B. Yuvaraja
- Department of Uro-Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - Thibault Meert
- Department of Urology, Imelda Hospital, Bonheiden, Belgium
| | - Thierry Dujardin
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec, Canada
| | - Tobias Gross
- Urology Unit, Die Berner Urologen AG, Bern, Switzerland
| | - Tom Walton
- Department of Urology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - William C. Huang
- Departments of Urology and Radiology, NYU Langone Health, New York, NY, USA
| | - Yves Caumartin
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec, Canada
| | - Ashwin Agarwal
- St. Vincent’s Clinical School, University of Melbourne, Melbourne, Australia
| | - Nathan Lawrentschuk
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
- University of Melbourne, Royal Melbourne Clinical School, Melbourne, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - Niall M. Corcoran
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
- Department of Urology, Western Health, Melbourne, Australia
- University of Melbourne, Royal Melbourne Clinical School, Melbourne, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Australia
| |
Collapse
|
3
|
Homewood D, Fu MH, Sathianathen N, La Bianca S, Tran B, Corcoran NM. Evolution of hormonal therapy for prostate cancer. Aust J Gen Pract 2024; 53:291-300. [PMID: 38697060 DOI: 10.31128/ajgp-11-23-7028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
BACKGROUND Prostate cancer (PCa) is the most common malignancy after skin cancer in men in Australia. Its management varies according to tumour stage. Due to the significant dependence on androgen receptor signalling, agents that interfere with this pathway (most commonly medical castration in the form of androgen deprivation therapy [ADT]) are the mainstay treatment of advanced disease. OBJECTIVE This review provides a contemporary update on ADT, with further discussion of emerging novel therapies for primary care. DISCUSSION ADT is currently indicated for the treatment of metastatic prostate cancer, disease recurrence following attempted local curative therapy, as well as combined use with radiotherapy for intermediate/high-risk disease. There has been rapid development of new pharmaceuticals targeting the androgen receptor. These are reviewed historically with an emphasis placed on emerging therapies, their common side effects, and how to manage them in the general practice setting.
Collapse
Affiliation(s)
- David Homewood
- BSci, MD, Urology Research Registrar, Department of Urology, Western Health, Melbourne, Vic; Department of Surgery, University of Melbourne,@Melbourne, Vic; Research Fellow, International@Medical Robotics Academy, Melbourne, Vic
| | - Ming Hei Fu
- MB, BCH, BAO (NUI, RCSI), Hospital Medical Officer, Department of Urology, St Vincent@s Hospital, Melbourne, Vic
| | - Niranjan Sathianathen
- MBBS, MD, SET Registrar (Urology), Department of Urology, Western Health, Melbourne, Vic
| | - Shane La Bianca
- MBBS, FRACS (Urol), MAICD, Urologist, SJOG Healthcare Murdoch, Perth, Vic; Urologist, Perth Urology Clinic, Perth, WA; Senior Lecturer, (Faculty/School), Notre Dame University, Fremantle, WA
| | - Benjamin Tran
- MBBS, FRACP, Associate Professor, Medical Oncologist, Victorian Comprehensive Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Vic
| | - Niall M Corcoran
- MB, BCh, BAO, PhD, FRACS (Urol), Urological Surgeon, Royal Melbourne Hospital, Frankston Hospital, Vic; Principal Research Fellow, Department of Surgery, University of Melbourne, Vic; Research and Education Lead, GU-oncology, Victorian Comprehensive Cancer Centre, Vic
| |
Collapse
|
4
|
Homewood D, Lucas H, Kennedy C, Majer J, Sathianathen N, Corcoran NM. When less is more: Updates in active surveillance and watchful waiting in the management of prostate cancer. Aust J Gen Pract 2024; 53:253-257. [PMID: 38697055 DOI: 10.31128/ajgp-06-23-6866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
BACKGROUND Prostate cancer is the second most common cancer among men globally. A range of management options are available for prostate cancer, including surgery, radiation therapy, hormone therapy, chemotherapy, or surveillance. Conservative strategies include active surveillance and watchful waiting, which differ in their intent. OBJECTIVE We provide a targeted instructive management algorithm for improving understanding of conservative strategies in prostate cancer. DISCUSSION Active surveillance involves close monitoring with curative intent when there is evidence of disease progression. In contrast, watchful waiting is palliative in intent and focuses on delaying treatment until symptoms or complications develop. Conservative approaches have demonstrated similar long-term oncological outcomes to radical treatment, while reducing harm from overtreatment, and maintaining quality of life by avoiding potential side effects such as urinary incontinence and erectile dysfunction. The decision to employ a conservative approach is determined by both patient and disease factors. Conservative management strategies play a vital role in the management of prostate cancer.
Collapse
Affiliation(s)
- David Homewood
- BSci, MD, Urology Research Registrar, Department of Urology, Western Health, Melbourne, Vic; Department of Surgery, University of Melbourne,@Melbourne, Vic; Research Fellow, International@Medical Robotics Academy, Melbourne, Vic
| | - Harrison Lucas
- BSci, MD, Hospital Medical Officer, Department of Urology, Western Health, Melbourne, Vic
| | - Caitlin Kennedy
- B BioMed, MD, DRANZCOG, RACGP@Registrar, Drysdale Clinic, Drysdale, Vic
| | - James Majer
- BMed, MD, General Practitioner Registrar, Department of General Practice, Deakin University Geelong Clinical School, Geelong, Vic
| | - Niranjan Sathianathen
- MBBS, MD, SET Registrar (Urology), Department of Urology, Western Health, Melbourne, Vic
| | - Niall M Corcoran
- MB, BCh, BAO, PhD, FRACS (Urol), Urological Surgeon, Royal Melbourne Hospital, Frankston Hospital, Vic; Principal Research Fellow, Department of Surgery, University of Melbourne, Vic; Research and Education Lead, GU-oncology, Victorian Comprehensive Cancer Centre, Vic
| |
Collapse
|
5
|
Homewood D, Corcoran NM, Bolton D. Urology. Aust J Gen Pract 2024; 53:245. [PMID: 38697070 DOI: 10.31128/ajgp-03-24-7192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Affiliation(s)
- David Homewood
- BSci, MD, Urology Research Registrar, Department of Urology, Western Health, Melbourne, Vic; Department of Surgery, University of Melbourne,@Melbourne, Vic; Research Fellow, International@Medical Robotics Academy, Melbourne, Vic
| | - Niall M Corcoran
- MB, BCh, BAO, PhD, FRACS (Urol), Urological Surgeon, Royal Melbourne Hospital, Frankston Hospital, Vic; Principal Research Fellow, Department of Surgery, University of Melbourne, Vic; Research and Education Lead, GU-oncology, Victorian Comprehensive Cancer Centre, Vic
| | - Damien Bolton
- MD, PhD, MBBS, BA, FRCS, FRACS (Urol), Urologist, Department of Urology, Austin Health, Melbourne, Vic
| |
Collapse
|
6
|
Pope B, Park G, Lau E, Belic J, Lach R, George A, McCoy P, Nguyen A, Grima C, Campbell B, Jung CH, Ditter EJ, Zhao H, Wedge DC, Brewer DS, Lynch AG, Dev H, Gnanpragasam VJ, Rosenfeld N, Hovens CM, Corcoran NM, Massie CE. Ultrasensitive Detection of Circulating Tumour DNA enriches for Patients with a Greater Risk of Recurrence of Clinically Localised Prostate Cancer. Eur Urol 2024; 85:407-410. [PMID: 38378299 DOI: 10.1016/j.eururo.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/17/2023] [Accepted: 01/10/2024] [Indexed: 02/22/2024]
Affiliation(s)
- Bernard Pope
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia; Melbourne Bioinformatics, The University of Melbourne, Carlton, Australia; Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia; Department of Clinical Pathology, The University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Australia.
| | - Gahee Park
- Early Cancer Institute, University of Cambridge Department of Oncology, Hutchison Research Centre, Cambridge, UK; Cancer Research UK Cambridge Centre, Cambridge, UK; Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Cambridge, UK
| | - Edmund Lau
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia; Melbourne Bioinformatics, The University of Melbourne, Carlton, Australia
| | - Jelena Belic
- Early Cancer Institute, University of Cambridge Department of Oncology, Hutchison Research Centre, Cambridge, UK; Cancer Research UK Cambridge Centre, Cambridge, UK; Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Cambridge, UK
| | - Radoslaw Lach
- Early Cancer Institute, University of Cambridge Department of Oncology, Hutchison Research Centre, Cambridge, UK; Cancer Research UK Cambridge Centre, Cambridge, UK; Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Cambridge, UK
| | - Anne George
- Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Cambridge, UK; Department of Surgery, Division of Urology, University of Cambridge, Cambridge, UK; Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Academic Urology Group, Department of Surgery, University of Cambridge, Cambridge, UK; Cambridge Urology Translational Research and Clinical Trials, Cambridge, UK
| | - Patrick McCoy
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia
| | - Anne Nguyen
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia
| | - Corrina Grima
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia
| | - Bethany Campbell
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia
| | - Chol-Hee Jung
- Melbourne Bioinformatics, The University of Melbourne, Carlton, Australia
| | - Emma-Jane Ditter
- Cancer Research UK Cambridge Centre, Cambridge, UK; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Hui Zhao
- Cancer Research UK Cambridge Centre, Cambridge, UK; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - David C Wedge
- Manchester Cancer Research Centre, University of Manchester, Manchester, UK
| | - Daniel S Brewer
- Norwich Medical School, University of East Anglia, Norwich, UK; Earlham Institute, Norwich, UK
| | - Andy G Lynch
- School of Medicine, University of St. Andrews, St. Andrews, UK; School of Mathematics and Statistics, University of St. Andrews, St. Andrews, UK
| | - Harveer Dev
- Early Cancer Institute, University of Cambridge Department of Oncology, Hutchison Research Centre, Cambridge, UK; Cancer Research UK Cambridge Centre, Cambridge, UK; Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Cambridge, UK
| | - Vincent J Gnanpragasam
- Department of Surgery, Division of Urology, University of Cambridge, Cambridge, UK; Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Cambridge Urology Translational Research and Clinical Trials, Cambridge, UK
| | - Nitzan Rosenfeld
- Cancer Research UK Cambridge Centre, Cambridge, UK; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Christopher M Hovens
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia; Department of Urology, Western Health, Footscray, Australia; Australian Prostate Cancer Research Centre, Melbourne, Australia
| | - Niall M Corcoran
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia; Department of Urology, Western Health, Footscray, Australia; Department of Urology, Royal Melbourne Hospital, Parkville, Australia; Victorian Comprehensive Cancer Centre, Parkville, Australia
| | - Charles E Massie
- Early Cancer Institute, University of Cambridge Department of Oncology, Hutchison Research Centre, Cambridge, UK; Cancer Research UK Cambridge Centre, Cambridge, UK; Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Cambridge, UK
| |
Collapse
|
7
|
Woodcock DJ, Sahli A, Teslo R, Bhandari V, Gruber AJ, Ziubroniewicz A, Gundem G, Xu Y, Butler A, Anokian E, Pope BJ, Jung CH, Tarabichi M, Dentro SC, Farmery JHR, Van Loo P, Warren AY, Gnanapragasam V, Hamdy FC, Bova GS, Foster CS, Neal DE, Lu YJ, Kote-Jarai Z, Fraser M, Bristow RG, Boutros PC, Costello AJ, Corcoran NM, Hovens CM, Massie CE, Lynch AG, Brewer DS, Eeles RA, Cooper CS, Wedge DC. Genomic evolution shapes prostate cancer disease type. Cell Genom 2024; 4:100511. [PMID: 38428419 PMCID: PMC10943594 DOI: 10.1016/j.xgen.2024.100511] [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] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 10/11/2021] [Accepted: 02/08/2024] [Indexed: 03/03/2024]
Abstract
The development of cancer is an evolutionary process involving the sequential acquisition of genetic alterations that disrupt normal biological processes, enabling tumor cells to rapidly proliferate and eventually invade and metastasize to other tissues. We investigated the genomic evolution of prostate cancer through the application of three separate classification methods, each designed to investigate a different aspect of tumor evolution. Integrating the results revealed the existence of two distinct types of prostate cancer that arise from divergent evolutionary trajectories, designated as the Canonical and Alternative evolutionary disease types. We therefore propose the evotype model for prostate cancer evolution wherein Alternative-evotype tumors diverge from those of the Canonical-evotype through the stochastic accumulation of genetic alterations associated with disruptions to androgen receptor DNA binding. Our model unifies many previous molecular observations, providing a powerful new framework to investigate prostate cancer disease progression.
Collapse
Affiliation(s)
- Dan J Woodcock
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Oxford, UK; Big Data Institute, University of Oxford, Oxford, UK
| | - Atef Sahli
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; Big Data Institute, University of Oxford, Oxford, UK
| | | | - Vinayak Bhandari
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Andreas J Gruber
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; Big Data Institute, University of Oxford, Oxford, UK; Department of Biology, University of Konstanz, Konstanz, Germany
| | - Aleksandra Ziubroniewicz
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Big Data Institute, University of Oxford, Oxford, UK
| | - Gunes Gundem
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, UK; Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Yaobo Xu
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, UK
| | - Adam Butler
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, UK
| | | | - Bernard J Pope
- Melbourne Bioinformatics, University of Melbourne, Melbourne, VIC, Australia; Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Chol-Hee Jung
- Melbourne Bioinformatics, University of Melbourne, Melbourne, VIC, Australia
| | - Maxime Tarabichi
- The Francis Crick Institute, London, UK; Institute of Interdisciplinary Research (IRIBHM), Universite Libre de Bruxelles, Brussels, Belgium
| | - Stefan C Dentro
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, UK; The Francis Crick Institute, London, UK
| | - J Henry R Farmery
- Statistics and Computational Biology Laboratory, Cancer Research UK Cambridge Institute, Cambridge, UK
| | - Peter Van Loo
- The Francis Crick Institute, London, UK; Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anne Y Warren
- Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Vincent Gnanapragasam
- Cambridge Urology Translational Research and Clinical Trials Office, Addenbrooke's Hospital, Cambridge, UK; Division of Urology, Department of Surgery, University of Cambridge, Cambridge, UK; Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - G Steven Bova
- Prostate Cancer Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Tays Cancer Center, Tampere University Hospital, Tampere, Finland
| | | | - David E Neal
- Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, Cambridge, UK; Department of Surgical Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Yong-Jie Lu
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | | | - Michael Fraser
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Robert G Bristow
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada; Division of Cancer Sciences, Faculty of Biology, Health and Medicine, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK; CRUK Manchester Institute, University of Manchester, Manchester, UK; Manchester Cancer Research Centre, University of Manchester, Manchester, UK
| | - Paul C Boutros
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada; Departments of Human Genetics and Urology, University of California, Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anthony J Costello
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Department of Urology, Royal Melbourne Hospital, Melbourne, VIC, Australia; Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - Niall M Corcoran
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Department of Urology, Royal Melbourne Hospital, Melbourne, VIC, Australia; Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - Christopher M Hovens
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Department of Urology, Royal Melbourne Hospital, Melbourne, VIC, Australia; Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - Charlie E Massie
- Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, Cambridge, UK; Early Detection Programme and Urological Malignancies Programme, Cancer Research UK Cambridge Centre, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Andy G Lynch
- Statistics and Computational Biology Laboratory, Cancer Research UK Cambridge Institute, Cambridge, UK; School of Medicine/School of Mathematics and Statistics, University of St Andrews, St Andrews, UK
| | - Daniel S Brewer
- Norwich Medical School, University of East Anglia, Norwich, UK; Earlham Institute, Norwich, UK.
| | - Rosalind A Eeles
- The Institute of Cancer Research, London, UK; Royal Marsden NHS Foundation Trust, London, UK.
| | - Colin S Cooper
- The Institute of Cancer Research, London, UK; Norwich Medical School, University of East Anglia, Norwich, UK.
| | - David C Wedge
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; Big Data Institute, University of Oxford, Oxford, UK; Manchester Cancer Research Centre, University of Manchester, Manchester, UK; Oxford NIHR Biomedical Research Centre, Oxford, UK; Manchester NIHR Biomedical Research Centre, Manchester, UK.
| |
Collapse
|
8
|
Agarwal DK, Dundee P, Corcoran NM. Re: Razdan et al.: The State of Robotic Partial Nephrectomy: Operative, Functional, and Oncological Outcomes From A Robust Multi-Institution Collaborative (Urology 2023;173:92-97). Urology 2024; 183:304. [PMID: 37879541 DOI: 10.1016/j.urology.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Dinesh K Agarwal
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Urology, Western Health, Melbourne, Australia.
| | - Philip Dundee
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Niall M Corcoran
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Urology, Western Health, Melbourne, Australia; Department of Surgery, University of Melbourne, Melbourne, Australia
| |
Collapse
|
9
|
Furrer MA, Sathianathen N, Gahl B, Corcoran NM, Soliman C, Rodriguez Calero JA, Ineichen GB, Gahl M, Kiss B, Thalmann GN. Oncological outcomes after attempted nerve-sparing radical prostatectomy (NSRP) in patients with high-risk prostate cancer are comparable to standard non-NSRP: a longitudinal long-term propensity-matched single-centre study. BJU Int 2024; 133:53-62. [PMID: 37548822 DOI: 10.1111/bju.16126] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 08/08/2023]
Abstract
OBJECTIVE To assess the long-term safety of nerve-sparing radical prostatectomy (NSRP) in men with high-risk prostate cancer (PCa) by comparing survival outcomes, disease recurrence, the need for additional therapy, and perioperative outcomes of patients undergoing NSRP to those having non-NSRP. PATIENTS AND METHODS We included consecutive patients at a single, academic centre who underwent open RP for high-risk PCa, defined as preoperative prostate-specific antigen level of > 20 ng/mL and/or postoperative International Society of Urological Pathology Grade Group 4 or 5 (i.e., Gleason score ≥ 8) and/or ≥pT3 and/or pN1 assessing the RP and lymph node specimen. We calculated a propensity score and used inverse probability of treatment weighting to match baseline characteristics of patients with high-risk PCa who underwent NSRP vs non-NSRP. We analysed oncological outcome as time-to-event and calculated hazard ratios (HRs). RESULTS A total of 726 patients were included in this analysis of which 84% (n = 609) underwent NSRP. There was no evidence for the positive surgical margin rate being different between the NSRP and non-NSRP groups (47% vs 49%, P = 0.64). Likewise, there was no evidence for the need for postoperative radiotherapy being different in men who underwent NSRP from those who underwent non-NSRP (HR 0.78, 95% confidence interval [CI] 0.53-1.15). NSRP did not impact the risk of any recurrence (HR 0.99, 95% CI 0.73-1.34, P = 0.09) and there was no evidence for survival being different in men who underwent NSRP to those who underwent non-NSRP (HR 0.65, 95% CI 0.39-1.08). There was also no evidence for the cancer-specific survival (HR 0.56, 95% CI 0.29-1.11) or progression-free survival (HR 0.99, 95% CI 0.73-1.34) being different between the groups. CONCLUSION In patients with high-risk PCa, NSRP can be attempted without compromising long-term oncological outcomes provided a comprehensive assessment of objective (e.g., T Stage) and subjective (e.g., intraoperative appraisal of tissue planes) criteria are conducted.
Collapse
Affiliation(s)
- Marc A Furrer
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Urology, Solothurner Spitäler AG, Kantonsspital Olten and Bürgerspital Solothurn, Biberist, Switzerland
- Department of Urology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Niranjan Sathianathen
- Department of Urology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | - Brigitta Gahl
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | - Niall M Corcoran
- Department of Urology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Urology, Western Health, St Albans, Victoria, Australia
| | - Christopher Soliman
- Department of Urology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | | | - Gallus B Ineichen
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Miriam Gahl
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Bernhard Kiss
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - George N Thalmann
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
10
|
Yanada BA, Dias BH, Corcoran NM, Zargar H, Bishop C, Wallace S, Hayes D, Huang JG. Implementation of the enhanced recovery after surgery protocol for radical cystectomy patients: A single centre experience. Investig Clin Urol 2024; 65:32-39. [PMID: 38197749 PMCID: PMC10789537 DOI: 10.4111/icu.20230282] [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: 08/19/2023] [Revised: 10/18/2023] [Accepted: 11/22/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE The enhanced recovery after surgery (ERAS) protocol for radical cystectomy aims to facilitate postoperative recovery and hasten a return to normal daily activities. This study aims to report on the perioperative outcomes of implementation of an ERAS protocol at a single Australian institution. MATERIALS AND METHODS We identified 73 patients with pT1-T4 bladder cancer who underwent open radical cystectomy at Western Health, Victoria between June 2016 and August 2021. A retrospective analysis of a prospectively maintained database was performed. Perioperative outcomes included length of hospital stay, nasogastric tube requirement and duration of postoperative ileus. RESULTS The median age was 74 years (interquartile range [IQR] 66-78) for the ERAS group and 70 years (IQR 65-78) for the pre-ERAS group patients. All patients in each group underwent ileal conduit formation. The median length of hospital stay was 7.0 days (IQR 7.0-9.3) for the ERAS group and 12.0 days (IQR 8.0-16.0) for the pre-ERAS group (p=0.003). Within the ERAS group, 25.0% had a postoperative ileus, and 25.0% had a nasogastric tube inserted, compared with 64.9% (p=0.001) and 45.9% (p=0.063) respectively within pre-ERAS group. The median bowel function recovery time, defined as duration from surgery to first bowel action, was 5.0 days (IQR 4.0-7.0) in the ERAS group and 7.5 days (IQR 5.0-8.5) in the pre-ERAS group (p=0.016). CONCLUSIONS Implementation of an ERAS protocol is associated with a reduction in hospital length of stay, postoperative ileus and bowel function recovery time.
Collapse
Affiliation(s)
- Brendan A Yanada
- Department of Urology, Western Health, Footscray, VIC, Australia.
| | - Brendan H Dias
- Department of Urology, Western Health, Footscray, VIC, Australia
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
| | - Niall M Corcoran
- Department of Urology, Western Health, Footscray, VIC, Australia
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
| | - Homayoun Zargar
- Department of Urology, Western Health, Footscray, VIC, Australia
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
| | - Conrad Bishop
- Department of Urology, Western Health, Footscray, VIC, Australia
| | - Sue Wallace
- Department of Urology, Western Health, Footscray, VIC, Australia
| | - Diana Hayes
- Department of Urology, Western Health, Footscray, VIC, Australia
| | - James G Huang
- Department of Urology, Western Health, Footscray, VIC, Australia
| |
Collapse
|
11
|
Sathianathen NJ, Furrer MA, Mulholland CJ, Katsios A, Soliman C, Lawrentschuk N, Peters JS, Zargar H, Costello AJ, Hovens CM, Bishop C, Rao R, Tong R, Steiner D, Moon D, Thomas BC, Dundee P, Calero JAR, Thalmann GN, Corcoran NM. Lymphovascular Invasion at the Time of Radical Prostatectomy Adversely Impacts Oncological Outcomes. Cancers (Basel) 2023; 16:123. [PMID: 38201549 PMCID: PMC10778356 DOI: 10.3390/cancers16010123] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Lymphovascular invasion, whereby tumour cells or cell clusters are identified in the lumen of lymphatic or blood vessels, is thought to be an essential step in disease dissemination. It has been established as an independent negative prognostic indicator in a range of cancers. We therefore aimed to assess the impact of lymphovascular invasion at the time of prostatectomy on oncological outcomes. We performed a multicentre, retrospective cohort study of 3495 men who underwent radical prostatectomy for localised prostate cancer. Only men with negative preoperative staging were included. We assessed the relationship between lymphovascular invasion and adverse pathological features using multivariable logistic regression models. Kaplan-Meier curves and Cox proportional hazard models were created to evaluate the impact of lymphovascular invasion on oncological outcomes. Lymphovascular invasion was identified in 19% (n = 653) of men undergoing prostatectomy. There was an increased incidence of lymphovascular invasion-positive disease in men with high International Society of Urological Pathology (ISUP) grade and non-organ-confined disease (p < 0.01). The presence of lymphovascular invasion significantly increased the likelihood of pathological node-positive disease on multivariable logistic regression analysis (OR 15, 95%CI 9.7-23.6). The presence of lymphovascular invasion at radical prostatectomy significantly increased the risk of biochemical recurrence (HR 2.0, 95%CI 1.6-2.4). Furthermore, lymphovascular invasion significantly increased the risk of metastasis in the whole cohort (HR 2.2, 95%CI 1.6-3.0). The same relationship was seen across D'Amico risk groups. The presence of lymphovascular invasion at the time of radical prostatectomy is associated with aggressive prostate cancer disease features and is an indicator of poor oncological prognosis.
Collapse
Affiliation(s)
- Niranjan J. Sathianathen
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
| | - Marc A. Furrer
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Department of Urology, University of Bern, 3010 Bern, Switzerland; (A.K.); (G.N.T.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
- Department of Urology, Solothurner Spitäler AG, Kantonsspital Olten, 4600 Olten, Switzerland
- Department of Urology, Solothurner Spitäler AG, Bürgerspital Solothurn, 4500 Solothurn, Switzerland
| | - Clancy J. Mulholland
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
| | - Andreas Katsios
- Department of Urology, University of Bern, 3010 Bern, Switzerland; (A.K.); (G.N.T.)
| | - Christopher Soliman
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
| | - Nathan Lawrentschuk
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
| | - Justin S. Peters
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
| | - Homi Zargar
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
| | - Anthony J. Costello
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
- Australian Prostate Centre, North Melbourne, VIC 3051, Australia
| | - Christopher M. Hovens
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
- Australian Prostate Centre, North Melbourne, VIC 3051, Australia
| | - Conrad Bishop
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
- Department of Urology, Footscray Hospital Western Health, Melbourne, VIC 3011, Australia
| | - Ranjit Rao
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
| | - Raymond Tong
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
| | - Daniel Steiner
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
| | - Daniel Moon
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Genitourinary Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3050, Australia
| | - Benjamin C. Thomas
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
- Department of Urology, Solothurner Spitäler AG, Bürgerspital Solothurn, 4500 Solothurn, Switzerland
| | - Philip Dundee
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Epworth Healthcare, Melbourne, VIC 3121, Australia; (C.M.H.); (C.B.)
- Department of Urology, Solothurner Spitäler AG, Bürgerspital Solothurn, 4500 Solothurn, Switzerland
| | | | - George N. Thalmann
- Department of Urology, University of Bern, 3010 Bern, Switzerland; (A.K.); (G.N.T.)
| | - Niall M. Corcoran
- Department of Urology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3050, Australia (C.J.M.); (C.S.); (N.L.); (J.S.P.); (H.Z.); (A.J.C.); (R.R.); (R.T.); (D.M.); (B.C.T.); (P.D.); (N.M.C.)
- Department of Urology, Solothurner Spitäler AG, Bürgerspital Solothurn, 4500 Solothurn, Switzerland
- Australian Prostate Centre, North Melbourne, VIC 3051, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, VIC 3050, Australia
- Department of Surgery, University of Melbourne, Melbourne, VIC 3050, Australia
| |
Collapse
|
12
|
Furrer MA, Sathianathen N, Gahl B, Wuethrich PY, Giannarini G, Corcoran NM, Thalmann GN. Functional Impact of Neuro-Vascular Bundle Preservation in High Risk Prostate Cancer without Compromising Oncological Outcomes: A Propensity-Modelled Analysis. Cancers (Basel) 2023; 15:5839. [PMID: 38136384 PMCID: PMC10741934 DOI: 10.3390/cancers15245839] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Nerve sparing (NS) is a surgical technique to optimize functional outcomes of radical prostatectomy (RP). However, it is not recommended in high risk (HR) cases because of the risk of a positive surgical margin that may increase the risk of cancer recurrence. In the last two decades there has been a change of perspective to the effect that in well-selected cases NS could be an oncologically safe option with better functional outcomes. Therefore, we aim to compare the functional outcomes and oncological safety of NS during RP in men with HR disease. A total of 1340 patients were included in this analysis, of which 12% (n = 158) underwent non-NSRP and 39% (n = 516) and 50% (n = 666) uni- and bilateral NSRP, respectively. We calculated a propensity score and used inverse probability of treatment weighting (IPTW) to balance the baseline characteristics of Pca patients undergoing non-NSRP and those having uni- and bilateral NSRP, respectively. NS improved functional outcomes; after IPTW, only 3% of patients having non-NSRP reached complete erectile function recovery (without erectile aid) at 24 months, whereas 22% reached erectile function recovery (with erectile aid), while 87% were continent. Unilateral NS increased the probability of functional recovery in all outcomes (OR 1.1 or 1.2, respectively), bilateral NS slightly more so (OR 1.1 to 1.4). NSRP did not impact the risk of any recurrence (HR 0.99, 95%CI 0.73-1.34, p = 0.09), and there was no difference in survival for men who underwent NSRP (HR 0.65, 95%CI 0.39-1.08). There was no difference in cancer-specific survival (0.56, 95%CI 0.29-1.11). Our study found that NSRP significantly improved functional outcomes and can be safely performed in carefully selected patients with HR-PCa without compromising long term oncological outcomes.
Collapse
Affiliation(s)
- Marc A. Furrer
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, 3012 Bern, Switzerland;
- Department of Urology, Solothurner Spitäler AG, Kantonsspital Olten, 4600 Olten, Switzerland
- Bürgerspital Solothurn, 4500 Solothurn, Switzerland
- Department of Urology, The University of Melbourne, Royal Melbourne Hospital, Parkville, VIC 3050, Australia; (N.S.); (N.M.C.)
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Niranjan Sathianathen
- Department of Urology, The University of Melbourne, Royal Melbourne Hospital, Parkville, VIC 3050, Australia; (N.S.); (N.M.C.)
| | - Brigitta Gahl
- Clinical Trials Unit Bern, University of Bern, 3010 Bern, Switzerland;
| | - Patrick Y. Wuethrich
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Gianluca Giannarini
- Urology Unit, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
| | - Niall M. Corcoran
- Department of Urology, The University of Melbourne, Royal Melbourne Hospital, Parkville, VIC 3050, Australia; (N.S.); (N.M.C.)
- Department of Urology, Western Health, St. Albans, VIC 3021, Australia
| | - George N. Thalmann
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, 3012 Bern, Switzerland;
| |
Collapse
|
13
|
Sathianathen NJ, Lawrentschuk N, Konety B, Azad AA, Corcoran NM, Bolton DM, Murphy DG. Cost Effectiveness of Systemic Treatment Intensification for Metastatic Hormone-sensitive Prostate Cancer: Is Triplet Therapy Cost Effective? Eur Urol Oncol 2023:S2588-9311(23)00278-X. [PMID: 38057191 DOI: 10.1016/j.euo.2023.11.013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND AND OBJECTIVE There has been a shift toward systemic treatment intensification for men with metastatic hormone-sensitive prostate cancer (mHSPC). Recent trials have demonstrated the efficacy of triplet therapy with an androgen receptor signalling inhibitor (ARSI), docetaxel, and androgen deprivation therapy (ADT). However, ARSI treatment is expensive. The objective was to determine the cost effectiveness of current treatments strategies for men with mHSPC. METHODS We developed a Markov state-transition model to simulate outcomes for men with newly diagnosed mHSPC. For the simulation, patients were entered in the model in the mHSPC disease state before progressing to castration-resistant disease and finally dying from prostate cancer. Costs were calculated from a USA health sector perspective in 2022 US dollars. Deterministic and probabilistic sensitivity analyses were conducted to account for uncertainty in the parameter estimates. We also performed scenario analyses for costs in the UK and Australian health sectors. KEY FINDINGS AND LIMITATIONS Treatment intensification with doublet and triplet therapy resulted in an improvement in quality-adjusted survival for all strategies in comparison to ADT monotherapy. However, only docetaxel doublet therapy was cost effective at standard thresholds, with an incremental cost-effectiveness ratio of $13 647. The cost of ARSIs needed to be discounted by 47-70% before they were cost effective. Only medication costs impacted the model results. If the generic price for abiraterone acetate is used, then triplet therapy with abiraterone is the best-value option. Similar results were obtained for analyses for the UK and Australian health sectors. CONCLUSIONS AND CLINICAL IMPLICATIONS Treatment intensification with ARSIs in men with mHSPC results in better quality-adjusted survival but is not cost effective according to standard thresholds. The costs of these medications would need to be heavily discounted before they are cost effective. The cost of generic ARSIs, once available, would render these strategies cost effective. PATIENT SUMMARY This report examines whether increasing the number of systemic drugs used to treat a patient's metastatic hormone-sensitive prostate cancer is cost effective for the health care system. We found that the additional cost of triplet therapy does not justify the increase in patient benefit.
Collapse
Affiliation(s)
- Niranjan J Sathianathen
- Department of Urology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia; Department of Urology, Western Health, Footscray, Australia.
| | - Nathan Lawrentschuk
- Department of Urology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia
| | | | - Arun A Azad
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Niall M Corcoran
- Department of Urology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia; Department of Urology, Western Health, Footscray, Australia; Victorian Comprehensive Cancer Centre Alliance, Parkville, Victoria
| | - Damien M Bolton
- Department of Surgery, Austin Health, The University of Melbourne, Parkville, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| |
Collapse
|
14
|
Agarwal DK, Mulholland C, Koye DN, Sathianathen N, Yao H, Dundee P, Moon D, Furrer M, Giudice C, Wang W, Simpson JA, Kearsley J, Norris B, Zargar H, Pan HY, Agarwal A, Lawrentschuk N, Corcoran NM. RPN (Radius, Position of tumour, iNvasion of renal sinus) Classification and Nephrometry Scoring System: An Internationally Developed Clinical Classification To Describe the Surgical Difficulty for Renal Masses for Which Robotic Partial Nephrectomy Is Planned. EUR UROL SUPPL 2023; 54:33-42. [PMID: 37545848 PMCID: PMC10397239 DOI: 10.1016/j.euros.2023.05.007] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 08/08/2023] Open
Abstract
Background The surgical difficulty of partial nephrectomy (PN) varies depending on the operative approach. Existing nephrometry classifications for assessment of surgical difficulty are not specific to the robotic approach. Objective To develop an international robotic-specific classification of renal masses for preoperative assessment of surgical difficulty of robotic PN. Design setting and participants The RPN classification (Radius, Position of tumour, iNvasion of renal sinus) considers three parameters: tumour size, tumour position, and invasion of the renal sinus. In an international survey, 45 experienced robotic surgeons independently reviewed de-identified computed tomography images of 144 patients with renal tumours to assess surgical difficulty of robot-assisted PN using a 10-point Likert scale. A separate data set of 248 patients was used for external validation. Outcome measurements and statistical analysis Multiple linear regression was conducted and a risk score was developed after rounding the regression coefficients. The RPN classification was correlated with the surgical difficulty score derived from the international survey. External validation was performed using a retrospective cohort of 248 patients. RPN classification was also compared with the RENAL (Radius; Exophytic/endophytic; Nearness; Anterior/posterior; Location), PADUA (Preoperative Aspects and Dimensions Used for Anatomic), and SPARE (Simplified PADUA REnal) scoring systems. Results and limitation The median tumour size was 38 mm (interquartile range 27-49). The majority (81%) of renal tumours were peripheral, followed by hilar (12%) and central (7.6%) locations. Noninvasive and semi-invasive tumours accounted for 37% each, and 26% of the tumours were invasive. The mean surgical difficulty score was 5.2 (standard deviation 1.9). Linear regression analysis indicated that the RPN classification correlated very well with the surgical difficulty score (R2 = 0.80). The R2 values for the other scoring systems were: 0.66 for RENAL, 0.75 for PADUA, and 0.70 for SPARE. In an external validation cohort, the performance of all four classification systems in predicting perioperative outcomes was similar, with low R2 values. Conclusions The proposed RPN classification is the first nephrometry system to assess the surgical difficulty of renal masses for which robot-assisted PN is planned, and is a useful tool to assist in surgical planning, training and data reporting. Patient summary We describe a simple classification system to help urologists in preoperative assessment of the difficulty of robotic surgery for partial kidney removal for kidney tumours.
Collapse
Affiliation(s)
- Dinesh K. Agarwal
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
- Department of Urology, Western Health, Melbourne, Australia
- Department of Urology, Mercy Health, Melbourne, Australia
| | - Clancy Mulholland
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Digsu N. Koye
- Centre for Epidemiology and Biostatics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Henry Yao
- Department of Urology, Western Health, Melbourne, Australia
| | - Philip Dundee
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Daniel Moon
- University of Melbourne, Royal Melbourne Clinical School, Melbourne, Australia
| | - Marc Furrer
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
- Urology Centre, Guy’s and St. Thomas’ Hospitals NHS Trust, London, UK
- Urology Unit, Die Berner Urologen AG, Bern, Switzerland
| | - Christina Giudice
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Wayland Wang
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Julie A. Simpson
- Centre for Epidemiology and Biostatics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jamie Kearsley
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Briony Norris
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Homi Zargar
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Henry Y.C. Pan
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Ashwin Agarwal
- St. Vincent’s Clinical School, University of Melbourne, Melbourne, Australia
| | - Nathan Lawrentschuk
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
- University of Melbourne, Royal Melbourne Clinical School, Melbourne, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - Niall M. Corcoran
- Department of Urology, The Royal Melbourne Hospital, Melbourne, Australia
- Department of Urology, Western Health, Melbourne, Australia
- University of Melbourne, Royal Melbourne Clinical School, Melbourne, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Australia
| |
Collapse
|
15
|
Houlahan KE, Livingstone J, Fox NS, Kurganovs N, Zhu H, Sietsma Penington J, Jung CH, Yamaguchi TN, Heisler LE, Jovelin R, Costello AJ, Pope BJ, Kishan AU, Corcoran NM, Bristow RG, Waszak SM, Weischenfeldt J, He HH, Hung RJ, Hovens CM, Boutros PC. A polygenic two-hit hypothesis for prostate cancer. J Natl Cancer Inst 2023; 115:468-472. [PMID: 36610996 PMCID: PMC10086625 DOI: 10.1093/jnci/djad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 08/03/2022] [Revised: 10/19/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
Prostate cancer is one of the most heritable cancers. Hundreds of germline polymorphisms have been linked to prostate cancer diagnosis and prognosis. Polygenic risk scores can predict genetic risk of a prostate cancer diagnosis. Although these scores inform the probability of developing a tumor, it remains unknown how germline risk influences the tumor molecular evolution. We cultivated a cohort of 1250 localized European-descent patients with germline and somatic DNA profiling. Men of European descent with higher genetic risk were diagnosed earlier and had less genomic instability and fewer driver genes mutated. Higher genetic risk was associated with better outcome. These data imply a polygenic "two-hit" model where germline risk reduces the number of somatic alterations required for tumorigenesis. These findings support further clinical studies of polygenic risk scores as inexpensive and minimally invasive adjuncts to standard risk stratification. Further studies are required to interrogate generalizability to more ancestrally and clinically diverse populations.
Collapse
Affiliation(s)
- Kathleen E Houlahan
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Institute for Precision Health, University of California, Los Angeles, CA, USA
- Ontario Institute for Cancer Research, Toronto, Canada
- Vector Institute, Toronto, Canada
| | - Julie Livingstone
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Institute for Precision Health, University of California, Los Angeles, CA, USA
- Department of Urology, University of California, Los Angeles, CA, USA
| | - Natalie S Fox
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Institute for Precision Health, University of California, Los Angeles, CA, USA
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Natalie Kurganovs
- Australian Prostate Cancer Research Centre Epworth, Richmond, VIC, Australia
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Helen Zhu
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Vector Institute, Toronto, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | | | - Chol-Hee Jung
- Melbourne Bioinformatics, The University of Melbourne, Parkville, VIC, Australia
| | - Takafumi N Yamaguchi
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Institute for Precision Health, University of California, Los Angeles, CA, USA
- Department of Urology, University of California, Los Angeles, CA, USA
| | | | | | - Anthony J Costello
- Division of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Bernard J Pope
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
- Melbourne Bioinformatics, The University of Melbourne, Parkville, VIC, Australia
- Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, Australia
- Department of Medicine, Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Amar U Kishan
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - Niall M Corcoran
- Australian Prostate Cancer Research Centre Epworth, Richmond, VIC, Australia
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
- Division of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Urology, Peninsula Health, Frankston, VIC, Australia
- The Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - Robert G Bristow
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Manchester Cancer Research Centre, Manchester, UK
| | - Sebastian M Waszak
- Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo, and Oslo University Hospital, Oslo, Norway
- Department of Pediatric Research, Division of Paediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Joachim Weischenfeldt
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- Finsen Laboratory, Rigshospitalet, Copenhagen, Denmark
- Department of Urology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Housheng H He
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Rayjean J Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Christopher M Hovens
- Australian Prostate Cancer Research Centre Epworth, Richmond, VIC, Australia
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia
| | - Paul C Boutros
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Institute for Precision Health, University of California, Los Angeles, CA, USA
- Ontario Institute for Cancer Research, Toronto, Canada
- Vector Institute, Toronto, Canada
- Department of Urology, University of California, Los Angeles, CA, USA
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| |
Collapse
|
16
|
Mulholland C, Soliman C, Furrer MA, Sathianathen N, Corcoran NM, Schramm B, Mertens E, Peters J, Costello A, Lawrentschuk N, Dundee P, Thomas B. Same day discharge for robot-assisted radical prostatectomy: a prospective cohort study documenting an Australian approach. ANZ J Surg 2023; 93:669-674. [PMID: 36637213 DOI: 10.1111/ans.18198] [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: 03/16/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND The introduction of robotic surgical systems has significantly impacted urological surgery, arguably more so than other surgical disciplines. The focus of our study was length of hospital stay - patients have traditionally been discharged day 1 post-robot-assisted radical prostatectomy (RARP), however, during the ongoing COVID-19 pandemic and consequential resource limitations, our centre has facilitated a cohort of same-day discharges with initial success. METHODS We conducted a prospective tertiary single-centre cohort study of a series of all patients (n = 28) - undergoing RARP between January and April 2021. All patients were considered for a day zero discharge pathway which consisted of strict inclusion criteria. At follow-up, each patient's perspective on their experience was assessed using a validated post-operative satisfaction questionnaire. Data were reviewed retrospectively for all those undergoing RARP over the study period, with day zero patients compared to overnight patients. RESULTS Overall, 28 patients 20 (71%) fulfilled the objective criteria for day zero discharge. Eleven patients (55%) agreed pre-operatively to day zero discharge and all were successfully discharged on the same day as their procedure. There was no statistically significant difference in age, BMI, ASA, Charlson score or disease volume. All patients indicated a high level of satisfaction with their procedure. Median time from completion of surgery to discharge was 426 min (7.1 h) in the day zero discharge cohort. CONCLUSION Day zero discharge for RARP appears to deliver high satisfaction, oncological and safety outcomes. Therefore, our study demonstrates early success with unsupported same-day discharge in carefully selected and pre-counselled patients.
Collapse
Affiliation(s)
- Clancy Mulholland
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Christopher Soliman
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Marc A Furrer
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, The Australian Medical Robotics Academy, Melbourne, Victoria, Australia
| | | | - Niall M Corcoran
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Belinda Schramm
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Evie Mertens
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Justin Peters
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, The Australian Medical Robotics Academy, Melbourne, Victoria, Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Anthony Costello
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, The Australian Medical Robotics Academy, Melbourne, Victoria, Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Nathan Lawrentschuk
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Philip Dundee
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, The Australian Medical Robotics Academy, Melbourne, Victoria, Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin Thomas
- Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, The Australian Medical Robotics Academy, Melbourne, Victoria, Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
17
|
Cmero M, Yuan K, Ong CS, Schröder J, Corcoran NM, Papenfuss T, Hovens CM, Markowetz F, Macintyre G. Author Correction: Inferring structural variant cancer cell fraction. Nat Commun 2022; 13:7568. [PMID: 36481724 PMCID: PMC9732297 DOI: 10.1038/s41467-022-32338-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Marek Cmero
- grid.416153.40000 0004 0624 1200Department of Surgery, Division of Urology, Royal Melbourne Hospital and University of Melbourne, Parkville, VIC 3050 Australia ,grid.414539.e0000 0001 0459 5396The Epworth Prostate Centre, Epworth Hospital, Richmond, VIC 3121 Australia ,grid.1008.90000 0001 2179 088XDepartment of Computing and Information Systems, University of Melbourne, Parkville, VIC 3010 Australia ,grid.1042.70000 0004 0432 4889Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC Australia ,grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville, VIC 3052 Australia
| | - Ke Yuan
- grid.8756.c0000 0001 2193 314XSchool of Computing Science, University of Glasgow, Sir Alwyn Williams Building, Glasgow, G12 8RZ UK ,grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE UK
| | - Cheng Soon Ong
- grid.1008.90000 0001 2179 088XElectrical and Electronic Engineering, University of Melbourne, Parkville, VIC 3010 Australia ,Machine Learning Research Group, Data61, Canberra, ACT 2601 Australia ,grid.1001.00000 0001 2180 7477Research School of Computer Science, Australian National University, Canberra, ACT 2601 Australia
| | - Jan Schröder
- grid.1042.70000 0004 0432 4889Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC Australia
| | | | - Niall M. Corcoran
- grid.416153.40000 0004 0624 1200Department of Surgery, Division of Urology, Royal Melbourne Hospital and University of Melbourne, Parkville, VIC 3050 Australia ,grid.414539.e0000 0001 0459 5396The Epworth Prostate Centre, Epworth Hospital, Richmond, VIC 3121 Australia
| | - Tony Papenfuss
- grid.1042.70000 0004 0432 4889Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC Australia
| | - Christopher M. Hovens
- grid.416153.40000 0004 0624 1200Department of Surgery, Division of Urology, Royal Melbourne Hospital and University of Melbourne, Parkville, VIC 3050 Australia ,grid.414539.e0000 0001 0459 5396The Epworth Prostate Centre, Epworth Hospital, Richmond, VIC 3121 Australia
| | - Florian Markowetz
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE UK
| | - Geoff Macintyre
- grid.1008.90000 0001 2179 088XDepartment of Computing and Information Systems, University of Melbourne, Parkville, VIC 3010 Australia ,grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE UK
| |
Collapse
|
18
|
Tran V, Hong A, Sutherland T, Taubman K, Lee SF, Lenaghan D, Sethi K, Corcoran NM, Lawrentschuk N, Woo H, Tarlinton L, Bolton D, Spelman T, Thomas L, Booth R, Hegarty J, Perry E, Wong LM. PEDAL protocol: a prospective single-arm paired comparison of multiparametric MRI and 18F-DCPFyl PSMA PET/CT to diagnose prostate cancer. BMJ Open 2022; 12:e061815. [PMID: 36123093 PMCID: PMC9486365 DOI: 10.1136/bmjopen-2022-061815] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has emerged as valuable imaging to assessing metastatic disease in prostate malignancy. However, there has been limited studies exploring the utility PSMA-PET as primary imaging assessing for index lesions prior to biopsy. The primary objective of this study is to compare the diagnostic accuracy of 18-fluorine PSMA (18F DCFPyL PSMA) PET scans to multiparametric MRI (mpMRI) to detect primary prostate cancer at prostate biopsy. METHODS AND ANALYSIS The PEDAL trial is a multicentre, prospective, single-arm, paired comparison, non-randomised phase III trial in subjects considered for diagnostic prostate biopsy. Subjects who are eligible for a diagnostic mpMRI prostate will undergo additional same-day 18 F DCFPyl PSMA PET/CT of the chest, abdomen and pelvis. Software coregistration of the mpMRI and PSMA-PET/CT images will be performed. The reporting of the mpMRI prostate, PSMA-PET/CT and PSMA PET/MRI coregistration will be performed blinded. The diagnostic accuracy of PSMA PET/CT alone, and in combination with mpMRI, to detect prostate cancer will be assessed. Histopathology at prostate biopsy will be used as the reference standard. Sample size calculations estimate that 240 subjects will need to be recruited to demonstrate 20% superiority of PSMA-PET/CT. The sensitivity, specificity, positive predictive value and negative predictive value of the combination of mpMRI prostate and PSMA PET/CT compared with targeted and systematic prostate biopsy will be evaluated. It is hypothesised that PSMA PET/CT combined with mpMRI prostate will have improved diagnostic accuracy compared with mpMRI prostate alone for detection of prostate cancer in biopsy-naïve men, resulting in a significant impact on patient management. ETHICS AND DISSEMINATION This study was approved by the independent Human Research Ethics Committee. Results will be published in peer-reviewed medical journals with eligible investigators will significantly contribute. TRIAL REGISTRATION NUMBER ACTRN12620000261910.
Collapse
Affiliation(s)
- Vy Tran
- Department of Urology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anne Hong
- Department of Urology, Austin Health, Heidelberg, Victoria, Australia
| | - Tom Sutherland
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Medical Imaging, St Vincent's Hospital Melbourne Pty Ltd, Melbourne, Victoria, Australia
| | - Kim Taubman
- Department of Nuclear Medicine, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
| | - Su-Faye Lee
- Department of Nuclear Medicine, St Vincent's Hospital Melbourne Pty Ltd, Melbourne, Victoria, Australia
| | - Daniel Lenaghan
- Department of Urology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
| | - Kapil Sethi
- Department of Urology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
- Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| | - Niall M Corcoran
- Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Urology, The Royal Melbourne Hospital City Campus, Parkville, Victoria, Australia
| | - Nathan Lawrentschuk
- Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Urology, The Royal Melbourne Hospital City Campus, Parkville, Victoria, Australia
| | - H Woo
- Department of Urology, Sydney Adventist Hospital, Wahroonga, New South Wales, Australia
- Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Tarlinton
- San Radiology and Nuclear Medicine, Sydney Adventist Hospital, Wahroonga, New South Wales, Australia
| | - Damien Bolton
- Department of Urology, Austin Health, Heidelberg, Victoria, Australia
- Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tim Spelman
- Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lauren Thomas
- Department of Nuclear Medicine, St Vincent's Hospital Melbourne Pty Ltd, Melbourne, Victoria, Australia
| | - Russell Booth
- Department of Nuclear Medicine, St Vincent's Hospital Melbourne Pty Ltd, Melbourne, Victoria, Australia
| | - Justin Hegarty
- Pacific Radiology Christchurch, Christchurch, Canterbury, New Zealand
| | - Elisa Perry
- Pacific Radiology Christchurch, Christchurch, Canterbury, New Zealand
| | - Lih-Ming Wong
- Department of Urology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
- Department of Urology, Austin Health, Heidelberg, Victoria, Australia
- Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
19
|
Jung CH, Boutros PC, Park DJ, Corcoran NM, Pope BJ, Hovens CM. Perish and publish: Dynamics of biomedical publications by deceased authors. PLoS One 2022; 17:e0273783. [PMID: 36103484 PMCID: PMC9473445 DOI: 10.1371/journal.pone.0273783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 08/15/2022] [Indexed: 11/18/2022] Open
Abstract
The question of whether it is appropriate to attribute authorship to deceased individuals of original studies in the biomedical literature is contentious. Authorship guidelines utilized by journals do not provide a clear consensus framework that is binding on those in the field. To guide and inform the implementation of authorship frameworks it would be useful to understand the extent of the practice in the scientific literature, but studies that have systematically quantified the prevalence of this phenomenon in the biomedical literature have not been performed to date. To address this issue, we quantified the prevalence of publications by deceased authors in the biomedical literature from the period 1990–2020. We screened 2,601,457 peer-reviewed papers from the full text Europe PubMed Central database. We applied natural language processing, stringent filtering and manual curation to identify a final set of 1,439 deceased authors. We then determined these authors published a total of 38,907 papers over their careers with 5,477 published after death. The number of deceased publications has been growing rapidly, a 146-fold increase since the year 2000. This rate of increase was still significant when accounting for the growing total number of publications and pool of authors. We found that more than 50% of deceased author papers were first submitted after the death of the author and that over 60% of these papers failed to acknowledge the deceased authors status. Most deceased authors published less than 10 papers after death but a small pool of 30 authors published significantly more. A pool of 266 authors published more than 90% of their total publications after death. Our analysis indicates that the attribution of deceased authorship in the literature is not an occasional occurrence but a burgeoning trend. A consensus framework to address authorship by deceased scientists is warranted.
Collapse
Affiliation(s)
- Chol-Hee Jung
- Melbourne Bioinformatics, The University of Melbourne, Melbourne, VIC, Australia
| | - Paul C. Boutros
- Department of Human Genetics, University of California, Los Angeles, CA, United States of America
- Department of Urology, University of California, Los Angeles, CA, United States of America
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, United States of America
- Institute for Precision Health, University of California, Los Angeles, CA, United States of America
| | - Daniel J. Park
- Melbourne Bioinformatics, The University of Melbourne, Melbourne, VIC, Australia
- Department of Biochemistry and Pharmacology, University of Melbourne, Melbourne, VIC, Australia
| | - Niall M. Corcoran
- Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Urology, Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Urology, Western Health, Footscray, VIC, Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
- Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - Bernard J. Pope
- Melbourne Bioinformatics, The University of Melbourne, Melbourne, VIC, Australia
- Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Christopher M. Hovens
- Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Urology, Royal Melbourne Hospital, Melbourne, VIC, Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
- * E-mail:
| |
Collapse
|
20
|
Williams IS, Perera S, Murphy DG, Corcoran NM, Bolton DM, Lawrentschuk N. Active surveillance versus enzalutamide for low-risk prostate cancer- was it really a trial we needed? BJU Int 2022; 130:580-581. [PMID: 35879832 DOI: 10.1111/bju.15860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Isabella Sc Williams
- Department of Urology and Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Australia
| | - Sachin Perera
- Department of Urology and Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Niall M Corcoran
- Department of Urology and Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Australia
| | - Damien M Bolton
- Department of Urology and Department of Surgery, Austin Hospital, University of Melbourne, Australia
| | - Nathan Lawrentschuk
- Department of Urology and Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Australia.,EJ Whitten Prostate Cancer Research Centre at Epworth, Melbourne, Australia
| |
Collapse
|
21
|
Dundee P, Furrer MA, Corcoran NM, Peters J, Pan H, Ballok Z, Ryan A, Guerrieri M, Costello AJ. Defining Prostatic Vascular Pedicle Recurrence and the Anatomy of Local Recurrence of Prostate Cancer on Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography. EUR UROL SUPPL 2022; 41:116-122. [PMID: 35813255 PMCID: PMC9257633 DOI: 10.1016/j.euros.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Accepted: 05/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background The term local recurrence in prostate cancer is considered to mean persistent local disease in the prostatic bed, most commonly at the site of the vesicourethral anastomosis (VUA). Since the introduction of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging for assessment of early biochemical recurrence (BCR), we have found histologically confirmed prostate cancer in the prostatic vascular pedicle (PVP). If a significant proportion of local recurrences are distant to the VUA, it may be possible to alter adjuvant and salvage radiation fields in order to reduce the potential morbidity of radiation in selected patients. Objective To describe PVP local recurrence and to map the anatomic pattern of prostate bed recurrence on PSMA PET/CT. Design, setting, and participants This was a retrospective multicentre study of 185 patients imaged with PSMA PET/CT following radical prostatectomy (RP) between January 2016 and November 2018. All patient data and clinical outcomes were prospectively collected. Recurrences were documented according to anatomic location. For patients presenting with local recurrence, the precise location of the recurrence within the prostate bed was documented. Intervention PSMA PET/CT for BCR following RP. Results and limitations A total of 43 local recurrences in 41/185 patients (22%) were identified. Tumour recurrence at the PVP was found in 26 (63%), VUA in 15 (37%), and within a retained seminal vesicle and along the anterior rectal wall in the region of the neurovascular bundle in one (2.4%) each. Histological and surgical evidence of PVP recurrence was acquired in two patients. The study is limited by its retrospective nature with inherent selection bias. This is an observational study reporting on the anatomy of local recurrence and does not include follow-up for patient outcomes. Conclusions Our study showed that prostate cancer can recur in the PVP and is distant to the VUA more commonly than previously thought. This may have implications for RP technique and for the treatment of selected patients in the local recurrence setting. Patient summary We investigated more precise identification of the location of tumour recurrence after removal of the prostate for prostate cancer. We describe a new definition of local recurrence in an area called the prostatic vascular pedicle. This new concept may alter the treatment recommended for recurrent disease.
Collapse
Affiliation(s)
- Philip Dundee
- Department of Urology, The University of Melbourne, Royal Melbourne Hospital, Grattan Street Parkville, Australia 3052
- The Australian Medical Robotics Academy, North Melbourne, Australia
- Australian Prostate Cancer Centre, North Melbourne, Australia
- Epworth Healthcare, Melbourne, Australia
- Corresponding author. Department of Urology, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia. Tel. +61 3 9342 7294.
| | - Marc A. Furrer
- Department of Urology, The University of Melbourne, Royal Melbourne Hospital, Grattan Street Parkville, Australia 3052
- The Australian Medical Robotics Academy, North Melbourne, Australia
- Epworth Healthcare, Melbourne, Australia
- Department of Urology, University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Niall M. Corcoran
- Department of Urology, The University of Melbourne, Royal Melbourne Hospital, Grattan Street Parkville, Australia 3052
- Australian Prostate Cancer Centre, North Melbourne, Australia
| | - Justin Peters
- Department of Urology, The University of Melbourne, Royal Melbourne Hospital, Grattan Street Parkville, Australia 3052
- The Australian Medical Robotics Academy, North Melbourne, Australia
- Australian Prostate Cancer Centre, North Melbourne, Australia
- Epworth Healthcare, Melbourne, Australia
| | - Henry Pan
- Department of Urology, University Hospital of Bern, University of Bern, Bern, Switzerland
| | | | - Andrew Ryan
- Healthcare Imaging Services, Melbourne, Australia
| | | | - Anthony J. Costello
- Department of Urology, The University of Melbourne, Royal Melbourne Hospital, Grattan Street Parkville, Australia 3052
- The Australian Medical Robotics Academy, North Melbourne, Australia
- Australian Prostate Cancer Centre, North Melbourne, Australia
- Epworth Healthcare, Melbourne, Australia
| |
Collapse
|
22
|
Soliman C, Thomas BC, Santaguida P, Lawrentschuk N, Mertens E, Giannarini G, Wuethrich PY, Wu M, Khan MS, Nair R, Thurairaja R, Challacombe B, Dasgupta P, Malde S, Corcoran NM, Spiess PE, Dundee P, Furrer MA. Active involvement of nursing staff in reporting and grading complication‐intervention events—Protocol and results of the CAMUS Pilot Nurse Delphi Study. BJUI Compass 2022; 3:466-483. [PMID: 36267199 PMCID: PMC9579890 DOI: 10.1002/bco2.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 11/28/2022] Open
Abstract
Objectives The aim of this study is to gain experienced nursing perspective on current and future complication reporting and grading in Urology, establish the CAMUS CCI and quality control the use of the Clavien‐Dindo Classification (CDC) in nursing staff. Subjects and Methods The 12‐part REDCap‐based Delphi survey was developed in conjunction with expert nurse, urologist and methodologist input. Certified local and international inpatient and outpatient nurses specialised in urology, perioperative nurses and urology‐specific advanced practice nurses/nurse practitioners will be included. A minimum sample size of 250 participants is targeted. The survey assesses participant demographics, nursing experience and opinion on complication reporting and the proposed CAMUS reporting recommendations; grading of intervention events using the existing CDC and the proposed CAMUS Classification; and rating various clinical scenarios. Consensus will be defined as ≥75% agreement. If consensus is not reached, subsequent Delphi rounds will be performed under Steering Committee guidance. Results Twenty participants completed the pilot survey. Median survey completion time was 58 min (IQR 40–67). The survey revealed that 85% of nursing participants believe nurses should be involved in future complication reporting and grading but currently have poor confidence and inadequate relevant background education. Overall, 100% of participants recognise the universal demand for reporting consensus and 75% hold a preference towards the CAMUS System. Limitations include variability in nursing experience, complexity of supplemental grades and survey duration. Conclusion The integration of experienced nursing opinion and participation in complication reporting and grading systems in a modern and evolving hospital infrastructure may facilitate the assimilation of otherwise overlooked safety data. Incorporation of focused teaching into routine nursing education will be essential to ensure quality control and stimulate awareness of complication‐related burden. This, in turn, has the potential to improve patient counselling and quality of care.
Collapse
Affiliation(s)
- Christopher Soliman
- Department of Urology, Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
| | - Benjamin C. Thomas
- Department of Urology, Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
| | - Pasqualina Santaguida
- Department of Health Research Methodology Evidence and Impact (HEI) McMaster University Hamilton Ontario Canada
| | - Nathan Lawrentschuk
- Department of Urology, Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
| | - Evie Mertens
- Department of Urology, Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
| | - Gianluca Giannarini
- Unit of Urology Santa Maria della Misericordia Academic Medical Centre Udine Italy
| | - Patrick Y. Wuethrich
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital University of Bern Bern Switzerland
| | - Michael Wu
- Department of Urology, Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
| | - Muhammad S. Khan
- Department of Urology Guy's and St. Thomas NHS Foundation Trust London UK
| | - Rajesh Nair
- Department of Urology Guy's and St. Thomas NHS Foundation Trust London UK
| | - Ramesh Thurairaja
- Department of Urology Guy's and St. Thomas NHS Foundation Trust London UK
| | | | - Prokar Dasgupta
- Department of Urology Guy's and St. Thomas NHS Foundation Trust London UK
| | - Sachin Malde
- Department of Urology Guy's and St. Thomas NHS Foundation Trust London UK
| | - Niall M. Corcoran
- Department of Urology, Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
- Department of Urology Western Health St Albans Victoria Australia
| | - Philippe E. Spiess
- Department of Genito‐Urinary Oncology H. Lee Moffitt Cancer Center and Research Institute Tampa Florida USA
| | - Philip Dundee
- Department of Urology, Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
| | - Marc A. Furrer
- Department of Urology, Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
- Department of Urology Guy's and St. Thomas NHS Foundation Trust London UK
- Department of Urology University of Bern Bern Switzerland
| |
Collapse
|
23
|
Yuen KC, Tran B, Anton A, Hamidi H, Costello AJ, Corcoran NM, Lawrentschuk N, Rainey N, Semira MCG, Gibbs P, Mariathasan S, Sandhu S, Kadel EE. Molecular classification of hormone-sensitive and castration-resistant prostate cancer, using nonnegative matrix factorization molecular subtyping of primary and metastatic specimens. Prostate 2022; 82:993-1002. [PMID: 35435276 PMCID: PMC9321082 DOI: 10.1002/pros.24346] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/12/2022] [Accepted: 03/14/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Despite the rapidly evolving therapeutic landscape, immunotherapy has demonstrated limited activity in prostate cancer. A greater understanding of the molecular landscape, particularly the expression of immune-related pathways, will inform future immunotherapeutic strategies. Consensus nonnegative matrix factorization (cNMF) is a novel model of molecular classification analyzing gene expression data, focusing on biological interpretation of metagenes and selecting meaningful clusters. OBJECTIVE We aimed to identify molecular subtypes of prostate cancer using cNMF and correlate these with existing biomarkers to inform future immunotherapeutic strategies. METHODS A cohort of archival tumor specimens from hormone-sensitive and castration-resistant disease was studied. Whole transcriptomic profiles were generated using TruSeq RNA Access technology and subjected to cNMF. Comprehensive genomic profiling was performed with the FoundationOne assay. NMF subtypes were characterized by gene expression pathways, genomic alterations and correlated with clinical data, then applied to The Cancer Genome Atlas data set. RESULTS We studied 164 specimens, including 52 castration-resistant and 13 paired primary/metastatic specimens. cNMF identified four distinct subtypes. NMF1 (19%) is enriched for immune-related and stromal-related pathways with transforming growth factor β (TGFβ) signature. NMF2 (36%) is associated with FOXO-mediated transcription signature and AKT signaling, NMF3 (26%) is enriched for ribosomal RNA processing, while NMF4 (19%) is enriched for cell cycle and DNA-repair pathways. The most common gene alterations included TMPRSS22 (42%), TP53 (23%), and DNA-repair genes (19%), occurring across all subtypes. NMF4 is significantly enriched for MYC and Wnt-signaling gene alterations. TMB, CD8 density, and PD-L1 expression were low overall. NMF1 and NMF4 were NMF2 was associated with superior overall survival. CONCLUSIONS Using cNMF, we identified four molecularly distinct subtypes which may inform treatment selection. NMF1 demonstrates the most inflammatory signature with asuppressive TGFβ signature, suggesting potential benefit with immunotherapy combination strategies targeting TGFβ and PD-(L)1. Prospective studies are required to evaluate the use of this novel model to molecularly stratify patients for optimal treatment selection.
Collapse
Affiliation(s)
- Kobe C. Yuen
- Department of Oncology Biomarker DevelopmentGenentech, Inc.South San FranciscoCaliforniaUSA
| | - Ben Tran
- Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
- Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
| | - Angelyn Anton
- Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
- Eastern HealthMelbourneVictoriaAustralia
| | - Habib Hamidi
- Department of Oncology Biomarker DevelopmentGenentech, Inc.South San FranciscoCaliforniaUSA
| | - Anthony J. Costello
- Royal Melbourne HospitalMelbourneVictoriaAustralia
- Department of SurgeryThe University of MelbourneMelbourneVictoriaAustralia
- Australian Prostate CentreNorth MelbourneVictoriaAustralia
| | - Niall M. Corcoran
- Royal Melbourne HospitalMelbourneVictoriaAustralia
- Department of SurgeryThe University of MelbourneMelbourneVictoriaAustralia
| | - Nathan Lawrentschuk
- Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
- Royal Melbourne HospitalMelbourneVictoriaAustralia
- Department of SurgeryThe University of MelbourneMelbourneVictoriaAustralia
| | - Natalie Rainey
- Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
| | - Marie C. G. Semira
- Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
| | - Peter Gibbs
- Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
| | - Sanjeev Mariathasan
- Department of Oncology Biomarker DevelopmentGenentech, Inc.South San FranciscoCaliforniaUSA
| | - Shahneen Sandhu
- Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Edward E. Kadel
- Department of Oncology Biomarker DevelopmentGenentech, Inc.South San FranciscoCaliforniaUSA
| |
Collapse
|
24
|
Burns D, Anokian E, Saunders EJ, Bristow RG, Fraser M, Reimand J, Schlomm T, Sauter G, Brors B, Korbel J, Weischenfeldt J, Waszak SM, Corcoran NM, Jung CH, Pope BJ, Hovens CM, Cancel-Tassin G, Cussenot O, Loda M, Sander C, Hayes VM, Dalsgaard Sorensen K, Lu YJ, Hamdy FC, Foster CS, Gnanapragasam V, Butler A, Lynch AG, Massie CE, Woodcock DJ, Cooper CS, Wedge DC, Brewer DS, Kote-Jarai Z, Eeles RA. Rare Germline Variants Are Associated with Rapid Biochemical Recurrence After Radical Prostate Cancer Treatment: A Pan Prostate Cancer Group Study. Eur Urol 2022; 82:201-211. [PMID: 35659150 DOI: 10.1016/j.eururo.2022.05.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/06/2022] [Accepted: 05/10/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Germline variants explain more than a third of prostate cancer (PrCa) risk, but very few associations have been identified between heritable factors and clinical progression. OBJECTIVE To find rare germline variants that predict time to biochemical recurrence (BCR) after radical treatment in men with PrCa and understand the genetic factors associated with such progression. DESIGN, SETTING, AND PARTICIPANTS Whole-genome sequencing data from blood DNA were analysed for 850 PrCa patients with radical treatment from the Pan Prostate Cancer Group (PPCG) consortium from the UK, Canada, Germany, Australia, and France. Findings were validated using 383 patients from The Cancer Genome Atlas (TCGA) dataset. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS A total of 15,822 rare (MAF <1%) predicted-deleterious coding germline mutations were identified. Optimal multifactor and univariate Cox regression models were built to predict time to BCR after radical treatment, using germline variants grouped by functionally annotated gene sets. Models were tested for robustness using bootstrap resampling. RESULTS AND LIMITATIONS Optimal Cox regression multifactor models showed that rare predicted-deleterious germline variants in "Hallmark" gene sets were consistently associated with altered time to BCR. Three gene sets had a statistically significant association with risk-elevated outcome when modelling all samples: PI3K/AKT/mTOR, Inflammatory response, and KRAS signalling (up). PI3K/AKT/mTOR and KRAS signalling (up) were also associated among patients with higher-grade cancer, as were Pancreas-beta cells, TNFA signalling via NKFB, and Hypoxia, the latter of which was validated in the independent TCGA dataset. CONCLUSIONS We demonstrate for the first time that rare deleterious coding germline variants robustly associate with time to BCR after radical treatment, including cohort-independent validation. Our findings suggest that germline testing at diagnosis could aid clinical decisions by stratifying patients for differential clinical management. PATIENT SUMMARY Prostate cancer patients with particular genetic mutations have a higher chance of relapsing after initial radical treatment, potentially providing opportunities to identify patients who might need additional treatments earlier.
Collapse
Affiliation(s)
| | | | | | - Robert G Bristow
- Manchester Cancer Research Centre and CRUK Manchester Institute, The University of Manchester, Manchester, UK
| | - Michael Fraser
- Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada; Computational Biology Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Jüri Reimand
- Computational Biology Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Department of Medical Biophysics & Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | | | - Guido Sauter
- University Medical Centre Hamburg - Eppendorf, Hamburg, Germany
| | - Benedikt Brors
- German Cancer Research Center (DKFZ), Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Jan Korbel
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Joachim Weischenfeldt
- Charité - Universitätsmedizin Berlin, Berlin, Germany; Biotech Research & Innovation Centre (BRIC) & Finsen Laboratory, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Sebastian M Waszak
- Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway; Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; Department of Pediatric Research, Division of Pediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Niall M Corcoran
- Department of Surgery, The University of Melbourne, Grattan Street, Parkville, Victoria, Australia; Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Melbourne Bioinformatics, The University of Melbourne, Grattan Street, Victoria, Australia
| | - Chol-Hee Jung
- The University of Melbourne, Grattan Street, Parkville, Victoria, Australia
| | - Bernard J Pope
- Department of Surgery, The University of Melbourne, Grattan Street, Parkville, Victoria, Australia; Royal Melbourne Hospital, Melbourne, Parwille, Victoria, Australia
| | - Chris M Hovens
- Melbourne Bioinformatics, The University of Melbourne, Grattan Street, Victoria, Australia; The University of Melbourne, Grattan Street, Parkville, Victoria, Australia; University of Melbourne Centre for Cancer Research, The Victorian Comprehensive Cancer Centre, Parkville, Victoria, Australia
| | - Géraldine Cancel-Tassin
- CeRePP, Hopital Tenon, Paris, France; Sorbonne Universite, GRC n°5 Predictive Onco-Urology, APHP, Tenon Hospital, Paris, France
| | - Olivier Cussenot
- CeRePP, Hopital Tenon, Paris, France; Sorbonne Universite, GRC n°5 Predictive Onco-Urology, APHP, Tenon Hospital, Paris, France
| | - Massimo Loda
- Department of Pathology & Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Chris Sander
- cBio Center, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Vanessa M Hayes
- Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia; School of Medical Sciences, University of Sydney, Charles Perkins Centre, Camperdown, NSW, Australia
| | - Karina Dalsgaard Sorensen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - Yong-Jie Lu
- Centre for Biomarker and Therapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK
| | | | | | - Adam Butler
- Wellcome Trust Sanger Institute, Genome Campus, Hinxton, Cambridge, UK
| | - Andy G Lynch
- School of Medicine, University of St Andrews, St Andrews, Fife, UK; School of Mathematics & Statistics, St Andrews, Fife, UK
| | - Charlie E Massie
- CRUK Cambridge Institute, Hutchison MRC Research Centre, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
| | -
- CR-UK/Prostate Cancer UK, ICGC, The Pan Prostate Cancer Group, UK
| | - Dan J Woodcock
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK
| | - Colin S Cooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - David C Wedge
- Manchester Cancer Research Centre, The University of Manchester, Manchester, UK
| | - Daniel S Brewer
- Norwich Medical School, University of East Anglia, Norwich, UK; The Earlham Institute, Norwich Research Park, Norwich, UK
| | | | - Rosalind A Eeles
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| |
Collapse
|
25
|
Conduit C, Guo C, Smith AB, Rincones O, Baenziger O, Thomas B, Goad J, Lenaghan D, Lawrentschuk N, Wong LM, Corcoran NM, Ross M, Gibbs P, O'Haire S, Anton A, Liow E, Lewin J, Tran B. Distress in People with Newly Diagnosed Testicular Cancer – Role for an Online Intervention to Alleviate Distress? (Preprint). JMIR Cancer 2022; 8:e39725. [DOI: 10.2196/39725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
|
26
|
Jiang Y, Meyers TJ, Emeka AA, Cooley LF, Cooper PR, Lancki N, Helenowski I, Kachuri L, Lin DW, Stanford JL, Newcomb LF, Kolb S, Finelli A, Fleshner NE, Komisarenko M, Eastham JA, Ehdaie B, Benfante N, Logothetis CJ, Gregg JR, Perez CA, Garza S, Kim J, Marks LS, Delfin M, Barsa D, Vesprini D, Klotz LH, Loblaw A, Mamedov A, Goldenberg SL, Higano CS, Spillane M, Wu E, Carter HB, Pavlovich CP, Mamawala M, Landis T, Carroll PR, Chan JM, Cooperberg MR, Cowan JE, Morgan TM, Siddiqui J, Martin R, Klein EA, Brittain K, Gotwald P, Barocas DA, Dallmer JR, Gordetsky JB, Steele P, Kundu SD, Stockdale J, Roobol MJ, Venderbos LD, Sanda MG, Arnold R, Patil D, Evans CP, Dall’Era MA, Vij A, Costello AJ, Chow K, Corcoran NM, Rais-Bahrami S, Phares C, Scherr DS, Flynn T, Karnes RJ, Koch M, Dhondt CR, Nelson JB, McBride D, Cookson MS, Stratton KL, Farriester S, Hemken E, Stadler WM, Pera T, Banionyte D, Bianco FJ, Lopez IH, Loeb S, Taneja SS, Byrne N, Amling CL, Martinez A, Boileau L, Gaylis FD, Petkewicz J, Kirwen N, Helfand BT, Xu J, Scholtens DM, Catalona WJ, Witte JS. Genetic Factors Associated with Prostate Cancer Conversion from Active Surveillance to Treatment. HGG Adv 2022; 3:100070. [PMID: 34993496 PMCID: PMC8725988 DOI: 10.1016/j.xhgg.2021.100070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/12/2021] [Indexed: 12/18/2022] Open
Abstract
Men diagnosed with low-risk prostate cancer (PC) are increasingly electing active surveillance (AS) as their initial management strategy. While this may reduce the side effects of treatment for prostate cancer, many men on AS eventually convert to active treatment. PC is one of the most heritable cancers, and genetic factors that predispose to aggressive tumors may help distinguish men who are more likely to discontinue AS. To investigate this, we undertook a multi-institutional genome-wide association study (GWAS) of 5,222 PC patients and 1,139 other patients from replication cohorts, all of whom initially elected AS and were followed over time for the potential outcome of conversion from AS to active treatment. In the GWAS we detected 18 variants associated with conversion, 15 of which were not previously associated with PC risk. With a transcriptome-wide association study (TWAS), we found two genes associated with conversion (MAST3, p = 6.9×10-7 and GAB2, p = 2.0×10-6). Moreover, increasing values of a previously validated 269-variant genetic risk score (GRS) for PC was positively associated with conversion (e.g., comparing the highest to the two middle deciles gave a hazard ratio [HR] = 1.13; 95% Confidence Interval [CI]= 0.94-1.36); whereas, decreasing values of a 36-variant GRS for prostate-specific antigen (PSA) levels were positively associated with conversion (e.g., comparing the lowest to the two middle deciles gave a HR = 1.25; 95% CI, 1.04-1.50). These results suggest that germline genetics may help inform and individualize the decision of AS-or the intensity of monitoring on AS-versus treatment for the initial management of patients with low-risk PC.
Collapse
Affiliation(s)
- Yu Jiang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Travis J. Meyers
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Adaeze A. Emeka
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Lauren Folgosa Cooley
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Phillip R. Cooper
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Nicola Lancki
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Irene Helenowski
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Linda Kachuri
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Daniel W. Lin
- Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Public Health Sciences, Seattle, WA 98109, USA
- Department of Urology, University of Washington, Seattle, WA 98195, USA
| | - Janet L. Stanford
- Fred Hutchinson Cancer Research Center, Cancer Epidemiology Program, Public Health Sciences, Seattle, WA 98109, USA
- Department of Epidemiology, University of Washington, School of Public Health, Seattle, WA 98195, USA
| | - Lisa F. Newcomb
- Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Public Health Sciences, Seattle, WA 98109, USA
- Department of Urology, University of Washington, Seattle, WA 98195, USA
| | - Suzanne Kolb
- Fred Hutchinson Cancer Research Center, Cancer Epidemiology Program, Public Health Sciences, Seattle, WA 98109, USA
- Department of Epidemiology, University of Washington, School of Public Health, Seattle, WA 98195, USA
| | - Antonio Finelli
- Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Neil E. Fleshner
- Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Maria Komisarenko
- Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - James A. Eastham
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Behfar Ehdaie
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nicole Benfante
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christopher J. Logothetis
- Departments of Genitourinary Medical Oncology and Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Justin R. Gregg
- Departments of Genitourinary Medical Oncology and Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cherie A. Perez
- Departments of Genitourinary Medical Oncology and Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sergio Garza
- Departments of Genitourinary Medical Oncology and Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeri Kim
- Departments of Genitourinary Medical Oncology and Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Leonard S. Marks
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Merdie Delfin
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Danielle Barsa
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Danny Vesprini
- Odette Cancer Centre, Sunnybrook Health and Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Laurence H. Klotz
- Odette Cancer Centre, Sunnybrook Health and Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Andrew Loblaw
- Odette Cancer Centre, Sunnybrook Health and Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Alexandre Mamedov
- Odette Cancer Centre, Sunnybrook Health and Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - S. Larry Goldenberg
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Celestia S. Higano
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Maria Spillane
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Eugenia Wu
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - H. Ballentine Carter
- Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christian P. Pavlovich
- Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mufaddal Mamawala
- Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tricia Landis
- Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter R. Carroll
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - June M. Chan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Matthew R. Cooperberg
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Janet E. Cowan
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Todd M. Morgan
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Javed Siddiqui
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Rabia Martin
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Eric A. Klein
- Glickman Urological and Kidney Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Karen Brittain
- Glickman Urological and Kidney Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Paige Gotwald
- Glickman Urological and Kidney Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Daniel A. Barocas
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeremiah R. Dallmer
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jennifer B. Gordetsky
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pam Steele
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shilajit D. Kundu
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jazmine Stockdale
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Monique J. Roobol
- Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Lionne D.F. Venderbos
- Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Martin G. Sanda
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Rebecca Arnold
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Dattatraya Patil
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Christopher P. Evans
- Department of Urologic Surgery, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Marc A. Dall’Era
- Department of Urologic Surgery, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Anjali Vij
- Department of Urologic Surgery, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Anthony J. Costello
- Department of Urology, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia
| | - Ken Chow
- Department of Urology, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia
| | - Niall M. Corcoran
- Department of Urology, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia
| | - Soroush Rais-Bahrami
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Courtney Phares
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Douglas S. Scherr
- Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | - Thomas Flynn
- Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | | | - Michael Koch
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Courtney Rose Dhondt
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Joel B. Nelson
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dawn McBride
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Michael S. Cookson
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kelly L. Stratton
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Stephen Farriester
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Erin Hemken
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Tuula Pera
- University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | | | | | | | - Stacy Loeb
- Departments of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Samir S. Taneja
- Departments of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Nataliya Byrne
- Departments of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | | | - Ann Martinez
- Department of Urology, Oregon Health and Science University, Portland, OR, USA
| | - Luc Boileau
- Department of Urology, Oregon Health and Science University, Portland, OR, USA
| | - Franklin D. Gaylis
- Genesis Healthcare Partners, Department of Urology, University of California, San Diego, CA, USA
| | | | - Nicholas Kirwen
- Division of Urology, NorthShore University Health System, Evanston, IL, USA
| | - Brian T. Helfand
- Division of Urology, NorthShore University Health System, Evanston, IL, USA
| | - Jianfeng Xu
- Division of Urology, NorthShore University Health System, Evanston, IL, USA
| | - Denise M. Scholtens
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - William J. Catalona
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - John S. Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Departments of Epidemiology and Population Health, Biomedical Data Science, and Genetics, Stanford University, Stanford, CA, USA
| |
Collapse
|
27
|
Furst L, Atkins RJ, Dinevska M, Stylli SS, Corcoran NM, Hovens CM, Mantamadiotis T. Identification and isolation of slow-cycling glioma stem cells. Methods Cell Biol 2022; 170:21-30. [DOI: 10.1016/bs.mcb.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
28
|
Pechlivanis M, Campbell BK, Hovens CM, Corcoran NM. Biomarkers of Response to Neoadjuvant Androgen Deprivation in Localised Prostate Cancer. Cancers (Basel) 2021; 14:cancers14010166. [PMID: 35008330 PMCID: PMC8750084 DOI: 10.3390/cancers14010166] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 09/28/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Prostate cancer is the second leading cause of cancer deaths in men. Attempts to improve patient outcomes include trials of neoadjuvant androgen deprivation therapy for patients with high-risk disease. Neoadjuvant treatment refers to androgen deprivation therapy that is administered prior to surgery (or radiation therapy). Patients typically respond well to this treatment regimen, showing a decrease in tumour size, but a significant proportion of patients eventually relapse and progress to metastatic disease. The mechanisms driving this resistance to neoadjuvant treatment are currently unknown. This review explores theories of resistance broadly, and their possible applications in the prostate cancer setting. Additionally, this review draws comparisons between breakthrough resistance and neoadjuvant resistance, and lastly investigates the current biomarkers for treatment sensitivity. Abstract Prostate cancer (PCa) is a hormone driven cancer, characterised by defects in androgen receptor signalling which drive the disease process. As such, androgen targeted therapies have been the mainstay for PCa treatment for over 70 years. High-risk PCa presents unique therapeutic challenges, namely in minimising the primary tumour, and eliminating any undetected micro metastases. Trials of neoadjuvant androgen deprivation therapy aim to address these challenges. Patients typically respond well to neoadjuvant treatment, showing regression of the primary tumour and negative surgical margins at the time of resection, however the majority of patients relapse and progress to metastatic disease. The mechanisms affording this resistance are largely unknown. This commentary attempts to explore theories of resistance more broadly, namely, clonal evolution, cancer stem cells, cell persistence, and drug tolerance. Moreover, it aims to explore the application of these theories in the PCa setting. This commentary also highlights the distinction between castration resistant PCa, and neoadjuvant resistant disease, and identifies the markers and characteristics of neoadjuvant resistant disease presented by current literature.
Collapse
Affiliation(s)
- Maree Pechlivanis
- Department of Surgery, University of Melbourne, Parkville, VIC 3050, Australia; (B.K.C.); (C.M.H.); (N.M.C.)
- Correspondence: ; Tel.: +61-3-9342-7294; Fax: +61-3-9342-8928
| | - Bethany K. Campbell
- Department of Surgery, University of Melbourne, Parkville, VIC 3050, Australia; (B.K.C.); (C.M.H.); (N.M.C.)
| | - Christopher M. Hovens
- Department of Surgery, University of Melbourne, Parkville, VIC 3050, Australia; (B.K.C.); (C.M.H.); (N.M.C.)
| | - Niall M. Corcoran
- Department of Surgery, University of Melbourne, Parkville, VIC 3050, Australia; (B.K.C.); (C.M.H.); (N.M.C.)
- Department of Urology, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Department of Urology, Western Health, Footscray, VIC 3011, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, VIC 3000, Australia
| |
Collapse
|
29
|
McCoy P, Mangiola S, Macintyre G, Hutchinson R, Tran B, Pope B, Georgeson P, Hong MKH, Kurganovs N, Lunke S, Clarkson MJ, Cmero M, Kerger M, Stuchbery R, Chow K, Haviv I, Ryan A, Costello AJ, Corcoran NM, Hovens CM. MSH2-deficient prostate tumours have a distinct immune response and clinical outcome compared to MSH2-deficient colorectal or endometrial cancer. Prostate Cancer Prostatic Dis 2021; 24:1167-1180. [PMID: 34108644 DOI: 10.1038/s41391-021-00379-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/13/2021] [Accepted: 04/28/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recent publications have shown patients with defects in the DNA mismatch repair (MMR) pathway driven by either MSH2 or MSH6 loss experience a significant increase in the incidence of prostate cancer. Moreover, this increased incidence of prostate cancer is accompanied by rapid disease progression and poor clinical outcomes. METHODS AND RESULTS We show that androgen-receptor activation, a key driver of prostate carcinogenesis, can disrupt the MSH2 gene in prostate cancer. We screened tumours from two cohorts (recurrent/non-recurrent) of prostate cancer patients to confirm the loss of MSH2 protein expression and identified decreased MSH2 expression in recurrent cases. Stratifying the independent TCGA prostate cancer cohort for MSH2/6 expression revealed that patients with lower levels of MSH2/6 had significant worse outcomes, in contrast, endometrial and colorectal cancer patients with lower MSH2/6 levels. MMRd endometrial and colorectal tumours showed the expected increase in mutational burden, microsatellite instability and enhanced immune cell mobilisation but this was not evident in prostate tumours. CONCLUSIONS We have shown that loss or reduced levels of MSH2/MSH6 protein in prostate cancer is associated with poor outcome. However, our data indicate that this is not associated with a statistically significant increase in mutational burden, microsatellite instability or immune cell mobilisation in a cohort of primary prostate cancers.
Collapse
Affiliation(s)
- Patrick McCoy
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia. .,Australian Prostate Cancer Research Centre, Melbourne, VIC, Australia.
| | - Stefano Mangiola
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia.,Australian Prostate Cancer Research Centre, Melbourne, VIC, Australia.,Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Geoff Macintyre
- Statistics and Computational Biology Group, Cambridge, UK.,Department of Computing and Information Systems, University of Melbourne, Parkville, VIC, Australia
| | - Ryan Hutchinson
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Pathology, University of Melbourne, Parkville, VIC, Australia
| | - Ben Tran
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Bernard Pope
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, Australia.,Melbourne Bioinformatics, The University of Melbourne, Carlton, VIC, Australia.,Department of Medicine, Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Parkville, VIC, Australia
| | - Peter Georgeson
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, Australia.,Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Parkville, VIC, Australia
| | - Matthew K H Hong
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Natalie Kurganovs
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia.,Ontario Institute for Cancer Research, Toronto, ON, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Sebastian Lunke
- Department of Pathology, University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Australian Genomics Health Alliance, Melbourne, VIC, Australia
| | - Michael J Clarkson
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Marek Cmero
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia.,Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Michael Kerger
- Australian Prostate Cancer Research Centre, Melbourne, VIC, Australia
| | - Ryan Stuchbery
- Australian Prostate Cancer Research Centre, Melbourne, VIC, Australia
| | - Ken Chow
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Izhak Haviv
- Faculty of Medicine in the Galilee, Bar Ilan University, Ramat Gan, Israel
| | - Andrew Ryan
- TissuPath Specialist Pathology, Mount Waverley, Melbourne, VIC, Australia
| | - Anthony J Costello
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia.,Australian Prostate Cancer Research Centre, Melbourne, VIC, Australia
| | - Niall M Corcoran
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia.,Department of Urology, Frankston Hospital, Frankston, VIC, Australia.,The Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - Christopher M Hovens
- Departments of Surgery and Urology, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia.,Australian Prostate Cancer Research Centre, Melbourne, VIC, Australia
| |
Collapse
|
30
|
Degeling K, Corcoran NM, Pereira-Salgado A, Hamid AA, Siva S, IJzerman MJ. Lifetime Health and Economic Outcomes of Active Surveillance, Radical Prostatectomy, and Radiotherapy for Favorable-Risk Localized Prostate Cancer. Value Health 2021; 24:1737-1745. [PMID: 34838271 DOI: 10.1016/j.jval.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/18/2021] [Accepted: 06/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To estimate the lifetime health and economic outcomes of selecting active surveillance (AS), radical prostatectomy (RP), or radiation therapy (RT) as initial management for low- or favorable-risk localized prostate cancer. METHODS A discrete-event simulation model was developed using evidence from published randomized trials. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Costs were included from a public payer perspective in Australian dollars. Outcomes were discounted at 5% over a lifetime horizon. Probabilistic and scenario analyses quantified parameter and structural uncertainty. RESULTS A total of 60% of patients in the AS arm eventually received radical treatment (surgery or radiotherapy) compared with 90% for RP and 91% for RT. Although AS resulted in fewer treatment-related complications, it led to increased clinical progression (AS 40.7%, RP 17.6%, RT 19.9%) and metastatic disease (AS 13.4%, RP 6.1%, RT 7.0%). QALYs were 10.88 for AS, 11.10 for RP, and 11.13 for RT. Total costs were A$17 912 for AS, A$15 609 for RP, and A$15 118 for RT. At a willingness to pay of A$20 000/QALY, RT had a 61.4% chance of being cost-effective compared to 38.5% for RP and 0.1% for AS. CONCLUSIONS Although AS resulted in fewer and delayed treatment-related complications, it was not found to be a cost-effective strategy for favorable-risk localized prostate cancer over a lifetime horizon because of an increase in the number of patients developing metastatic disease. RT was the dominant strategy yielding higher QALYs at lower cost although differences compared with RP were small.
Collapse
Affiliation(s)
- Koen Degeling
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
| | - Niall M Corcoran
- Department of Surgery, The University of Melbourne, Melbourne, Australia; Department of Urology, Frankston Hospital, Frankston, Australia; Division of Urology, Royal Melbourne Hospital, Melbourne, Australia
| | - Amanda Pereira-Salgado
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Anis A Hamid
- Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Shankar Siva
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Maarten J IJzerman
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; Department of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| |
Collapse
|
31
|
Hennes DMZB, Sewell J, Kerger M, Hovens CM, Peters JS, Costello AJ, Ryan A, Corcoran NM. The modified International Society of Urological Pathology system improves concordance between biopsy and prostatectomy tumour grade. BJU Int 2021; 128 Suppl 3:45-51. [PMID: 34310033 DOI: 10.1111/bju.15556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To assess the concordance between biopsy and radical prostatectomy (RP) specimens using the 2005 Gleason score (GS) and the International Society of Urological Pathology (ISUP) 2014/World Health Organization 2016 modified system, accounting for the introduction of transperineal biopsy and pre-biopsy multiparametric magnetic resonance imaging (mpMRI). PATIENTS AND METHODS Between 2002 and 2019, we identified 2431 patients with paired biopsy and RP histopathology from a prospectively recorded and maintained prostate cancer database. Biopsy specimens were graded according to the 2005 GS or ISUP 2014 modified system, according to the year of diagnosis. Multivariable logistic regression analysis was conducted to retrospectively assess the impact of prostate-specific antigen (PSA), PSA density, age, pre-biopsy mpMRI, and biopsy method, on the rate of upgraded disease. The kappa coefficient was used to establish the degree of change in concordance between groups. RESULTS Overall, 24% of patients had upgraded disease and 8% of patients had downgraded disease when using the modified ISUP 2014 criteria. Agreement in the updated ISUP 2014 cohort was 68%, compared with 55% in the 2005 GS group, which was validated by a kappa coefficient that was good (k = 0.5 ± 0.4) and poor (k = 0.3 ± 0.1), respectively. In multivariable models, a change in grading system independently improved overall disease concordance (P = 0.02), and there were no other co-segregated patient or pathological factors such as PSA, total number of cores, maximum cancer length, biopsy route or the use of mpMRI that impacted this finding. CONCLUSION The 2014 ISUP modifed system improves overall concordance between biopsy and surgical specimens, and thus allows more accurate prognostication and management in high-grade disease, independent of more extensive prostate sampling and the use of mpMRI.
Collapse
Affiliation(s)
- David M Z B Hennes
- Department of Urology, Melbourne Health, Royal Melbourne Hospital, Australia
| | - James Sewell
- Department of Urology, Melbourne Health, Royal Melbourne Hospital, Australia
| | - Michael Kerger
- Department of Surgery, University of Melbourne, Parkville, Australia
| | | | - Justin S Peters
- Department of Urology, Melbourne Health, Royal Melbourne Hospital, Australia
| | - Anthony J Costello
- Department of Urology, Melbourne Health, Royal Melbourne Hospital, Australia.,Department of Surgery, University of Melbourne, Parkville, Australia
| | | | - Niall M Corcoran
- Department of Urology, Melbourne Health, Royal Melbourne Hospital, Australia.,Department of Surgery, University of Melbourne, Parkville, Australia.,Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
| |
Collapse
|
32
|
Mangiola S, McCoy P, Modrak M, Souza-Fonseca-Guimaraes F, Blashki D, Stuchbery R, Keam SP, Kerger M, Chow K, Nasa C, Le Page M, Lister N, Monard S, Peters J, Dundee P, Williams SG, Costello AJ, Neeson PJ, Pal B, Huntington ND, Corcoran NM, Papenfuss AT, Hovens CM. Transcriptome sequencing and multi-plex imaging of prostate cancer microenvironment reveals a dominant role for monocytic cells in progression. BMC Cancer 2021; 21:846. [PMID: 34294073 PMCID: PMC8296706 DOI: 10.1186/s12885-021-08529-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/23/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Prostate cancer is caused by genomic aberrations in normal epithelial cells, however clinical translation of findings from analyses of cancer cells alone has been very limited. A deeper understanding of the tumour microenvironment is needed to identify the key drivers of disease progression and reveal novel therapeutic opportunities. RESULTS In this study, the experimental enrichment of selected cell-types, the development of a Bayesian inference model for continuous differential transcript abundance, and multiplex immunohistochemistry permitted us to define the transcriptional landscape of the prostate cancer microenvironment along the disease progression axis. An important role of monocytes and macrophages in prostate cancer progression and disease recurrence was uncovered, supported by both transcriptional landscape findings and by differential tissue composition analyses. These findings were corroborated and validated by spatial analyses at the single-cell level using multiplex immunohistochemistry. CONCLUSIONS This study advances our knowledge concerning the role of monocyte-derived recruitment in primary prostate cancer, and supports their key role in disease progression, patient survival and prostate microenvironment immune modulation.
Collapse
Affiliation(s)
- Stefano Mangiola
- Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick McCoy
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Martin Modrak
- Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Fernando Souza-Fonseca-Guimaraes
- University of Queensland Diamantina Institute, Translational Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Daniel Blashki
- The Peter Doherty Institute for Infection and Immunity, Parkville, Victoria, Australia
| | - Ryan Stuchbery
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Simon P Keam
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Michael Kerger
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Ken Chow
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Chayanica Nasa
- Flow Cytometry Facility, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Melanie Le Page
- Flow Cytometry Facility, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Natalie Lister
- Cancer Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
| | - Simon Monard
- Flow Cytometry Facility, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Justin Peters
- Epworth Center of Cancer Research, Clayton, Victoria, Australia
| | - Phil Dundee
- Epworth Center of Cancer Research, Clayton, Victoria, Australia
| | - Scott G Williams
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Anthony J Costello
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Paul J Neeson
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Bhupinder Pal
- The Olivia Newton-John Cancer Research Institute, Heidelberg, Melbourne, Australia
| | - Nicholas D Huntington
- Cancer Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
| | - Niall M Corcoran
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Urology, Frankston Hospital, Frankston, Victoria, Australia
| | - Anthony T Papenfuss
- Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia.
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.
- Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.
- School of Mathematics and Statistics, University of Melbourne, Melbourne, VIC, 3010, Australia.
| | - Christopher M Hovens
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| |
Collapse
|
33
|
Cmero M, Kurganovs NJ, Stuchbery R, McCoy P, Grima C, Ngyuen A, Chow K, Mangiola S, Macintyre G, Howard N, Kerger M, Dundee P, Ruljancich P, Clarke D, Grummet J, Peters JS, Costello AJ, Norden S, Ryan A, Parente P, Hovens CM, Corcoran NM. Loss of SNAI2 in Prostate Cancer Correlates With Clinical Response to Androgen Deprivation Therapy. JCO Precis Oncol 2021; 5:PO.20.00337. [PMID: 34322653 PMCID: PMC8238292 DOI: 10.1200/po.20.00337] [Citation(s) in RCA: 6] [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: 08/20/2020] [Revised: 03/29/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Androgen receptor (AR) signaling is important in prostate cancer progression, and therapies that target this pathway have been the mainstay of treatment for advanced disease for over 70 years. Tumors eventually progress despite castration through a number of well-characterized mechanisms; however, little is known about what determines the magnitude of response to short-term pathway inhibition. METHODS We evaluated a novel combination of AR-targeting therapies (degarelix, abiraterone, and bicalutamide) and noted that the objective patient response to therapy was highly variable. To investigate what was driving treatment resistance in poorly responding patients, as a secondary outcome we comprehensively characterized pre- and post-treatment samples using both whole-genome and RNA sequencing. RESULTS We find that resistance following short-term treatment differs molecularly from typical progressive castration-resistant disease, associated with transcriptional reprogramming, to a transitional epithelial-to-mesenchymal transition (EMT) phenotype rather than an upregulation of AR signaling. Unexpectedly, tolerance to therapy appears to be the default state, with treatment response correlating with the prevalence of tumor cells deficient for SNAI2, a key regulator of EMT reprogramming. CONCLUSION We show that EMT characterizes acutely resistant prostate tumors and that deletion of SNAI2, a key transcriptional regulator of EMT, correlates with clinical response.
Collapse
Affiliation(s)
- Marek Cmero
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.,Division of Bioinformatics, Walter and Eliza Hall Institute, Parkville, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Natalie J Kurganovs
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Ryan Stuchbery
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Patrick McCoy
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Corrina Grima
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Anne Ngyuen
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Ken Chow
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.,Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Stefano Mangiola
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.,Division of Bioinformatics, Walter and Eliza Hall Institute, Parkville, Victoria, Australia
| | - Geoff Macintyre
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas Howard
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael Kerger
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Philip Dundee
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Urology, Peninsula Health, Frankston, Victoria, Australia
| | - Paul Ruljancich
- Department of Urology, Box Hill Hospital, Box Hill, Victoria, Australia.,Epworth Eastern Hospital, Box Hill, Victoria, Australia
| | - David Clarke
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jeremy Grummet
- Department of Urology, Alfred Hospital, Prahan, Victoria, Australia.,Monash University, Clayton, Victoria, Australia
| | - Justin S Peters
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Anthony J Costello
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.,Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Sam Norden
- TissuPath, Mount Waverly, Victoria, Australia
| | - Andrew Ryan
- TissuPath, Mount Waverly, Victoria, Australia
| | - Phillip Parente
- Monash University, Clayton, Victoria, Australia.,Department of Medical Oncology, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Christopher M Hovens
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.,Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Niall M Corcoran
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.,Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Urology, Peninsula Health, Frankston, Victoria, Australia.,Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| |
Collapse
|
34
|
Chow K, Bedő J, Ryan A, Agarwal D, Bolton D, Chan Y, Dundee P, Frydenberg M, Furrer MA, Goad J, Gyomber D, Hanegbi U, Harewood L, King D, Lamb AD, Lawrentschuk N, Liodakis P, Moon D, Murphy DG, Peters JS, Ruljancich P, Verrill CL, Webb D, Wong LM, Zargar H, Costello AJ, Papenfuss AT, Hovens CM, Corcoran NM. Ductal variant prostate carcinoma is associated with a significantly shorter metastasis-free survival. Eur J Cancer 2021; 148:440-450. [PMID: 33678516 DOI: 10.1016/j.ejca.2020.12.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 09/03/2020] [Revised: 12/09/2020] [Accepted: 12/19/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Ductal adenocarcinoma is an uncommon prostate cancer variant. Previous studies suggest that ductal variant histology may be associated with worse clinical outcomes, but these are difficult to interpret. To address this, we performed an international, multi-institutional study to describe the characteristics of ductal adenocarcinoma, particularly focussing on the effect of presence of ductal variant cancer on metastasis-free survival. METHODS Patients with ductal variant histology from two institutional databases who underwent radical prostatectomies were identified and compared with an independent acinar adenocarcinoma cohort. After propensity score matching, the effect of the presence of ductal adenocarcinoma on time to biochemical recurrence, initiation of salvage therapy and the development of metastatic disease was determined. Deep whole-exome sequencing was performed for selected cases (n = 8). RESULTS A total of 202 ductal adenocarcinoma and 2037 acinar adenocarcinoma cases were analysed. Survival analysis after matching demonstrated that patients with ductal variant histology had shorter salvage-free survival (8.1 versus 22.0 months, p = 0.03) and metastasis-free survival (6.7 versus 78.6 months, p < 0.0001). Ductal variant histology was consistently associated with RB1 loss, as well as copy number gains in TAP1, SLC4A2 and EHHADH. CONCLUSIONS The presence of any ductal variant adenocarcinoma at the time of prostatectomy portends a worse clinical outcome than pure acinar cancers, with significantly shorter times to initiation of salvage therapies and the onset of metastatic disease. These features appear to be driven by uncoupling of chromosomal duplication from cell division, resulting in widespread copy number aberration with specific gain of genes implicated in treatment resistance.
Collapse
Affiliation(s)
- Ken Chow
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia.
| | - Justin Bedő
- Bioinformatics Division, Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Department of Computing and Information Systems, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Ryan
- TissuPath Specialist Pathology, Mount Waverley, Victoria, Australia
| | - Dinesh Agarwal
- Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Urology, Western Health, Footscray, Victoria, Australia
| | - Damien Bolton
- Department of Urology, Austin Health, Heidelberg, Victoria, Australia
| | - Yee Chan
- Department of Urology, Austin Health, Heidelberg, Victoria, Australia
| | - Philip Dundee
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Urology, Western Health, Footscray, Victoria, Australia
| | - Mark Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Cabrini Institute, Cabrini Health, Malvern, Victoria, Australia
| | - Marc A Furrer
- Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jeremy Goad
- Genitourinary Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Urology, St Vincent's Health, Fitzroy, Victoria, Australia
| | - Dennis Gyomber
- Department of Urology, Austin Health, Heidelberg, Victoria, Australia
| | - Uri Hanegbi
- Department of Urology, Alfred Health, Melbourne, Victoria, Australia
| | - Laurence Harewood
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Dennis King
- Department of Urology, Alfred Health, Melbourne, Victoria, Australia
| | - Alastair D Lamb
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Nathan Lawrentschuk
- Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Urology, Austin Health, Heidelberg, Victoria, Australia; Genitourinary Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Peter Liodakis
- Department of Urology, Austin Health, Heidelberg, Victoria, Australia
| | - Daniel Moon
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Genitourinary Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Genitourinary Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Justin S Peters
- Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | | | - Clare L Verrill
- Department of Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - David Webb
- Department of Urology, Austin Health, Heidelberg, Victoria, Australia
| | - Lih-Ming Wong
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Department of Urology, Austin Health, Heidelberg, Victoria, Australia; Department of Urology, St Vincent's Health, Fitzroy, Victoria, Australia
| | - Homayoun Zargar
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Urology, Western Health, Footscray, Victoria, Australia
| | - Anthony J Costello
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Australian Prostate Centre, North Melbourne, Victoria, Australia
| | - Anthony T Papenfuss
- Bioinformatics Division, Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia; School of Mathematics and Statistics, University of Melbourne, Parkville, Victoria, Australia
| | - Christopher M Hovens
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Niall M Corcoran
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia; Urology Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; Department of Urology, Frankston Hospital, Frankston, Victoria, Australia
| |
Collapse
|
35
|
Degeling K, Pereira-Salgado A, Corcoran NM, Boutros PC, Kuhn P, IJzerman MJ. Health Economic Evidence for Liquid- and Tissue-based Molecular Tests that Inform Decisions on Prostate Biopsies and Treatment of Localised Prostate Cancer: A Systematic Review. EUR UROL SUPPL 2021; 27:77-87. [PMID: 34337517 PMCID: PMC8317795 DOI: 10.1016/j.euros.2021.03.002] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 11/16/2022] Open
Abstract
Context Several liquid- and tissue-based biomarker tests (LTBTs) are available to inform the need for prostate biopsies and treatment of localised prostate cancer (PCa) through risk stratification, but translation into routine practice requires evidence of their clinical utility and economic impact. Objective To review and summarise the health economic evidence on the ability of LTBTs to inform decisions on prostate biopsies and treatment of localised PCa through risk stratification. Evidence acquisition A systematic search was performed in the EMBASE, MEDLINE, Health Technology Assessment, and National Health Service Health Economic Evaluation databases. Eligible publications were those presenting health economic evaluations of an LTBT to select individuals for biopsy or risk-stratify PCa patients for treatment. Data on the study objectives, context, methodology, clinical utility, and outcomes were extracted and summarised. Evidence synthesis Of the 22 studies included, 14 were focused on test-informed biopsies and eight on treatment selection. Most studies performed cost-effectiveness analyses (n = 7), followed by costing (n = 4) or budget impact analyses (n = 3). Most (18 of 22) studies concluded that biomarker tests could decrease health care costs or would be cost-effective. However, downstream consequences and long-term outcomes were typically not included in studies that evaluated LTBT to inform biopsies. Long-term effectiveness was modelled by linking evidence from different sources instead of using data from prospective studies. Conclusions Although studies concluded that LTBTs would probably be cost-saving or -effective, the strength of this evidence is disputable because of concerns around the validity and transparency of the assumptions made. This warrants prospective interventional trials to inform health economic analyses to ensure collection of direct evidence of clinical outcomes based on LTBT use. Patient summary We reviewed studies that evaluated whether blood, urine, and tissue tests can reduce the health and economic burden of prostate cancer. Results indicate that these tests could be cost-effective, but clinical studies of long-term outcomes are needed to confirm the findings.
Collapse
Affiliation(s)
- Koen Degeling
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.,Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Amanda Pereira-Salgado
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.,Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Niall M Corcoran
- Department of Urology, Frankston Hospital, Frankston, Australia.,Department of Surgery, The University of Melbourne, Melbourne, Australia.,Division of Urology, Royal Melbourne Hospital, Melbourne, Australia
| | - Paul C Boutros
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, CA, USA.,Institute for Precision Health, University of California, Los Angeles, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Centre, University of California, Los Angeles, Los Angeles, CA, USA.,Departments of Human Genetics and Urology, University of California, Los Angeles, Los Angeles, CA, USA.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Peter Kuhn
- USC Michelson Center for Convergent Biosciences, University of Southern California, Los Angeles, CA, USA.,Department of Biological Sciences, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Maarten J IJzerman
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.,Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.,Department of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| |
Collapse
|
36
|
Ranasinha N, Omer A, Philippou Y, Harriss E, Davies L, Chow K, Chetta PM, Erickson A, Rajakumar T, Mills IG, Bryant RJ, Hamdy FC, Murphy DG, Loda M, Hovens CM, Corcoran NM, Verrill C, Lamb AD. Ductal adenocarcinoma of the prostate: A systematic review and meta-analysis of incidence, presentation, prognosis, and management. BJUI Compass 2021; 2:13-23. [PMID: 35474657 PMCID: PMC8988764 DOI: 10.1002/bco2.60] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 01/22/2023] Open
Abstract
Context Ductal adenocarcinoma (DAC) is relatively rare, but is nonetheless the second most common subtype of prostate cancer. First described in 1967, opinion is still divided regarding its biology, prognosis, and outcome. Objectives To systematically interrogate the literature to clarify the epidemiology, diagnosis, management, progression, and survival statistics of DAC. Materials and methods We conducted a literature search of five medical databases from inception to May 04 2020 according to PRISMA criteria using search terms "prostate ductal adenocarcinoma" OR "endometriod adenocarcinoma of prostate" and variations of each. Results Some 114 studies were eligible for inclusion, presenting 2 907 170 prostate cancer cases, of which 5911 were DAC. [Correction added on 16 January 2021 after the first online publication: the preceding statement has been corrected in this current version.] DAC accounts for 0.17% of prostate cancer on meta-analysis (range 0.0837%-13.4%). The majority of DAC cases were admixed with predominant acinar adenocarcinoma (AAC). Median Prostate Specific Antigen at diagnosis ranged from 4.2 to 9.6 ng/mL in the case series.DAC was more likely to present as T3 (RR1.71; 95%CI 1.53-1.91) and T4 (RR7.56; 95%CI 5.19-11.01) stages, with far higher likelihood of metastatic disease (RR4.62; 95%CI 3.84-5.56; all P-values < .0001), compared to AAC. Common first treatments included surgery (radical prostatectomy (RP) or cystoprostatectomy for select cases) or radiotherapy (RT) for localized disease, and hormonal or chemo-therapy for metastatic disease. Few studies compared RP and RT modalities, and those that did present mixed findings, although cancer-specific survival rates seem worse after RP.Biochemical recurrence rates were increased with DAC compared to AAC. Additionally, DAC metastasized to unusual sites, including penile and peritoneal metastases. Where compared, all studies reported worse survival for DAC compared to AAC. Conclusion When drawing conclusions about DAC it is important to note the heterogenous nature of the data. DAC is often diagnosed incidentally post-treatment, perhaps due to lack of a single, universally applied histopathological definition. As such, DAC is likely underreported in clinical practice and the literature. Poorer prognosis and outcomes for DAC compared to AAC merit further research into genetic composition, evolution, diagnosis, and treatment of this surprisingly common prostate cancer sub-type. Patient summary Ductal prostate cancer is a rare but important form of prostate cancer. This review demonstrates that it tends to be more serious at detection and more likely to spread to unusual parts of the body. Overall survival is worse with this type of prostate cancer and urologists need to be aware of the presence of ductal prostate cancer to alter management decisions and follow-up.
Collapse
Affiliation(s)
- Nithesh Ranasinha
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- Department of UrologyOxford University Hospitals NHS Foundation Trust, Roosevelt DriveOxfordUK
| | - Altan Omer
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Yiannis Philippou
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Eli Harriss
- Bodleian Health Care LibrariesUniversity of OxfordOxfordUK
| | - Lucy Davies
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Ken Chow
- Department of SurgeryRoyal Melbourne HospitalUniversity of MelbourneMelbourneVICAustralia
| | | | - Andrew Erickson
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Timothy Rajakumar
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Ian G. Mills
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Richard J. Bryant
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- Department of UrologyOxford University Hospitals NHS Foundation Trust, Roosevelt DriveOxfordUK
| | - Freddie C. Hamdy
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- Department of UrologyOxford University Hospitals NHS Foundation Trust, Roosevelt DriveOxfordUK
| | - Declan G. Murphy
- Division of Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVICAustralia
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneParkvilleVICAustralia
| | - Massimo Loda
- Dana Farber Cancer InstituteHarvardMAUSA
- Weill Cornell Medical SchoolNew YorkNYUSA
| | - Christopher M. Hovens
- Department of SurgeryRoyal Melbourne HospitalUniversity of MelbourneMelbourneVICAustralia
| | - Niall M. Corcoran
- Department of SurgeryRoyal Melbourne HospitalUniversity of MelbourneMelbourneVICAustralia
| | - Clare Verrill
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- NIHR Oxford Biomedical Research CentreUniversity of Oxford, John Radcliffe HospitalOxfordUK
| | - Alastair D. Lamb
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- Department of UrologyOxford University Hospitals NHS Foundation Trust, Roosevelt DriveOxfordUK
| |
Collapse
|
37
|
Abstract
BACKGROUND Prostate cancer is a common tumour type in Australian men. OBJECTIVE The aim of this article is to review important changes in prostate cancer diagnosis and management over the past five years, particularly as they pertain to general practice. DISCUSSION The management of prostate cancer has changed significantly in recent years, particularly the use of imaging, with the introduction of prostate magnetic resonance imaging as routine in the diagnostic pathway, and the increasing use of prostate-specific membrane antigen positron emission tomography for early stratification in the salvage setting for failure of primary treatment in localised disease. In addition, upfront combinations of androgen deprivation therapy with other systemic treatments have yielded significant gains in overall survival for patients with metastatic disease. There has also been an increasing recognition of the association between germline DNA repair defects and progressive disease, and interest in the potential to identify patients for therapies that target these defects. There have been significant changes in how prostate cancer is diagnosed and managed in the past five years, with the introduction of new clinical pathways that were unprecedented just a decade previously.
Collapse
Affiliation(s)
| | - Niall M Corcoran
- MB, BCh, BAO, PhD, FRACS (Urol), Urological Surgeon, Royal Melbourne Hospital, Frankston Hospital, Vic; Principal Research Fellow, Department of Surgery, University of Melbourne, Vic; Research and Education Lead, GU-oncology, Victorian Comprehensive Cancer Centre, Vic
| |
Collapse
|
38
|
Lau E, McCoy P, Reeves F, Chow K, Clarkson M, Kwan EM, Packwood K, Northen H, He M, Kingsbury Z, Mangiola S, Kerger M, Furrer MA, Crowe H, Costello AJ, McBride DJ, Ross MT, Pope B, Hovens CM, Corcoran NM. Detection of ctDNA in plasma of patients with clinically localised prostate cancer is associated with rapid disease progression. Genome Med 2020; 12:72. [PMID: 32807235 PMCID: PMC7430029 DOI: 10.1186/s13073-020-00770-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 04/19/2020] [Accepted: 07/30/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND DNA originating from degenerate tumour cells can be detected in the circulation in many tumour types, where it can be used as a marker of disease burden as well as to monitor treatment response. Although circulating tumour DNA (ctDNA) measurement has prognostic/predictive value in metastatic prostate cancer, its utility in localised disease is unknown. METHODS We performed whole-genome sequencing of tumour-normal pairs in eight patients with clinically localised disease undergoing prostatectomy, identifying high confidence genomic aberrations. A bespoke DNA capture and amplification panel against the highest prevalence, highest confidence aberrations for each individual was designed and used to interrogate ctDNA isolated from plasma prospectively obtained pre- and post- (24 h and 6 weeks) surgery. In a separate cohort (n = 189), we identified the presence of ctDNA TP53 mutations in preoperative plasma in a retrospective cohort and determined its association with biochemical- and metastasis-free survival. RESULTS Tumour variants in ctDNA were positively identified pre-treatment in two of eight patients, which in both cases remained detectable postoperatively. Patients with tumour variants in ctDNA had extremely rapid disease recurrence and progression compared to those where variants could not be detected. In terms of aberrations targeted, single nucleotide and structural variants outperformed indels and copy number aberrations. Detection of ctDNA TP53 mutations was associated with a significantly shorter metastasis-free survival (6.2 vs. 9.5 years (HR 2.4; 95% CIs 1.2-4.8, p = 0.014). CONCLUSIONS CtDNA is uncommonly detected in localised prostate cancer, but its presence portends more rapidly progressive disease.
Collapse
Affiliation(s)
- Edmund Lau
- Department of Surgery, University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia.,Melbourne Bioinformatics, The University of Melbourne, Carlton, VIC, 3053, Australia
| | - Patrick McCoy
- Department of Surgery, University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia
| | - Fairleigh Reeves
- Department of Surgery, University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia
| | - Ken Chow
- Department of Surgery, University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia
| | - Michael Clarkson
- Department of Surgery, University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia
| | - Edmond M Kwan
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, 3800, Australia.,Department of Medical Oncology, Monash Health, Melbourne, VIC, 3168, Australia
| | - Kate Packwood
- Illumina Cambridge Ltd., Great Abington, Cambridge, UK
| | - Helen Northen
- Illumina Cambridge Ltd., Great Abington, Cambridge, UK
| | - Miao He
- Illumina Cambridge Ltd., Great Abington, Cambridge, UK
| | | | - Stefano Mangiola
- Division of Bioinformatics, Walter and Eliza Hall Institute, Parkville, VIC, 3052, Australia
| | - Michael Kerger
- Australian Prostate Cancer Centre, North Melbourne, VIC, 3195, Australia
| | - Marc A Furrer
- Department of Urology, Royal Melbourne Hospital, Melbourne, VIC, 3050, Australia.,Department of Urology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Helen Crowe
- Australian Prostate Cancer Centre, North Melbourne, VIC, 3195, Australia
| | - Anthony J Costello
- Australian Prostate Cancer Centre, North Melbourne, VIC, 3195, Australia
| | | | - Mark T Ross
- Illumina Cambridge Ltd., Great Abington, Cambridge, UK
| | - Bernard Pope
- Department of Surgery, University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia.,Melbourne Bioinformatics, The University of Melbourne, Carlton, VIC, 3053, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, 3800, Australia.,Department of Clinical Pathology, The University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Christopher M Hovens
- Department of Surgery, University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia
| | - Niall M Corcoran
- Department of Surgery, University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia. .,Australian Prostate Cancer Centre, North Melbourne, VIC, 3195, Australia. .,Department of Urology, Royal Melbourne Hospital, Melbourne, VIC, 3050, Australia. .,Department of Urology, Peninsula Health, Frankston, VIC, 3199, Australia. .,Victorian Comprehensive Cancer Centre, Melbourne, VIC, 3000, Australia.
| |
Collapse
|
39
|
Anton A, Kamel Hasan O, Ballok Z, Bowden P, Costello AJ, Harewood L, Corcoran NM, Dundee P, Peters JS, Lawrentschuk N, Troy A, Webb D, Chan Y, See A, Siva S, Murphy D, Hofman MS, Tran B. Use of prostate-specific membrane antigen positron-emission tomography/CT in response assessment following upfront chemohormonal therapy in metastatic prostate cancer. BJU Int 2020; 126:433-435. [PMID: 32579772 DOI: 10.1111/bju.15151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Angelyn Anton
- Walter and Eliza Hall Institute, Melbourne, Vic., Australia
| | - Olfat Kamel Hasan
- Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.,Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Zita Ballok
- Healthcare Imaging Services, Melbourne, Vic., Australia
| | | | - Anthony J Costello
- Royal Melbourne Hospital, Melbourne, Vic., Australia.,Australian Prostate Centre, Melbourne, Vic., Australia
| | - Laurence Harewood
- Royal Melbourne Hospital, Melbourne, Vic., Australia.,Epworth Healthcare, Melbourne, Vic., Australia.,Department of Surgery, University of Melbourne, Melbourne, Vic., Australia
| | - Niall M Corcoran
- Royal Melbourne Hospital, Melbourne, Vic., Australia.,Australian Prostate Centre, Melbourne, Vic., Australia.,Department of Surgery, University of Melbourne, Melbourne, Vic., Australia
| | - Phil Dundee
- Royal Melbourne Hospital, Melbourne, Vic., Australia.,Australian Prostate Centre, Melbourne, Vic., Australia
| | | | - Nathan Lawrentschuk
- Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.,Epworth Healthcare, Melbourne, Vic., Australia
| | - Andrew Troy
- Epworth Healthcare, Melbourne, Vic., Australia
| | - David Webb
- Epworth Healthcare, Melbourne, Vic., Australia
| | - Yee Chan
- Epworth Healthcare, Melbourne, Vic., Australia
| | - Andrew See
- ICON Cancer Care, Melbourne, Vic., Australia
| | - Shankar Siva
- Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.,ICON Cancer Care, Melbourne, Vic., Australia
| | - Declan Murphy
- Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Vic., Australia
| | - Michael S Hofman
- Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Vic., Australia
| | - Ben Tran
- Walter and Eliza Hall Institute, Melbourne, Vic., Australia.,Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.,Epworth Healthcare, Melbourne, Vic., Australia
| |
Collapse
|
40
|
Cipponi A, Goode DL, Bedo J, McCabe MJ, Pajic M, Croucher DR, Rajal AG, Junankar SR, Saunders DN, Lobachevsky P, Papenfuss AT, Nessem D, Nobis M, Warren SC, Timpson P, Cowley M, Vargas AC, Qiu MR, Generali DG, Keerthikumar S, Nguyen U, Corcoran NM, Long GV, Blay JY, Thomas DM. MTOR signaling orchestrates stress-induced mutagenesis, facilitating adaptive evolution in cancer. Science 2020; 368:1127-1131. [PMID: 32499442 DOI: 10.1126/science.aau8768] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/09/2019] [Accepted: 04/10/2020] [Indexed: 12/12/2022]
Abstract
In microorganisms, evolutionarily conserved mechanisms facilitate adaptation to harsh conditions through stress-induced mutagenesis (SIM). Analogous processes may underpin progression and therapeutic failure in human cancer. We describe SIM in multiple in vitro and in vivo models of human cancers under nongenotoxic drug selection, paradoxically enhancing adaptation at a competing intrinsic fitness cost. A genome-wide approach identified the mechanistic target of rapamycin (MTOR) as a stress-sensing rheostat mediating SIM across multiple cancer types and conditions. These observations are consistent with a two-phase model for drug resistance, in which an initially rapid expansion of genetic diversity is counterbalanced by an intrinsic fitness penalty, subsequently normalizing to complete adaptation under the new conditions. This model suggests synthetic lethal strategies to minimize resistance to anticancer therapy.
Collapse
Affiliation(s)
- Arcadi Cipponi
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia. .,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - David L Goode
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Justin Bedo
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Computing and Information Systems, the University of Melbourne, Parkville, VIC, Australia.,Peter MacCallum Cancer Centre, Parkville, VIC, Australia
| | - Mark J McCabe
- St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia.,Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Marina Pajic
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - David R Croucher
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Alvaro Gonzalez Rajal
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Simon R Junankar
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Darren N Saunders
- School of Medical Sciences, University of New South Wales, NSW, Australia
| | | | - Anthony T Papenfuss
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Computing and Information Systems, the University of Melbourne, Parkville, VIC, Australia.,Peter MacCallum Cancer Centre, Parkville, VIC, Australia.,Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia
| | - Danielle Nessem
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Max Nobis
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Sean C Warren
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Paul Timpson
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Mark Cowley
- St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia.,Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Ana C Vargas
- Douglass Hanly Moir Pathology, Turramurra, NSW, Australia
| | - Min R Qiu
- St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia.,Anatomical and Molecular Oncology Pathology, SYDPATH, St. Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Daniele G Generali
- Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy.,Breast Cancer Unit and Translational Research Unit, ASST Cremona, Cremona, Italy
| | - Shivakumar Keerthikumar
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Uyen Nguyen
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Niall M Corcoran
- Division of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia.,Department of Urology, Peninsula Health, Frankston, VIC, Australia.,Department of Surgery, University of Melbourne, VIC, Australia
| | - Georgina V Long
- Melanoma Institute Australia, Wollstonecraft, NSW, Australia.,The University of Sydney, Sydney, NSW, Australia.,Royal North Shore Hospital and Mater Hospital, Sydney, NSW, Australia.,Crown Princess Mary Cancer Centre Westmead Hospital, Sydney, NSW, Australia
| | - Jean-Yves Blay
- Centre Leon Berard and Université Claude Bernard Lyon, Lyon, France.,UNICANCER, Paris, France
| | - David M Thomas
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia. .,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
41
|
Owen KL, Gearing LJ, Zanker DJ, Brockwell NK, Khoo WH, Roden DL, Cmero M, Mangiola S, Hong MK, Spurling AJ, McDonald M, Chan C, Pasam A, Lyons RJ, Duivenvoorden HM, Ryan A, Butler LM, Mariadason JM, Giang Phan T, Hayes VM, Sandhu S, Swarbrick A, Corcoran NM, Hertzog PJ, Croucher PI, Hovens C, Parker BS. Prostate cancer cell-intrinsic interferon signaling regulates dormancy and metastatic outgrowth in bone. EMBO Rep 2020; 21:e50162. [PMID: 32314873 PMCID: PMC7271653 DOI: 10.15252/embr.202050162] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/15/2020] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
The latency associated with bone metastasis emergence in castrate-resistant prostate cancer is attributed to dormancy, a state in which cancer cells persist prior to overt lesion formation. Using single-cell transcriptomics and ex vivo profiling, we have uncovered the critical role of tumor-intrinsic immune signaling in the retention of cancer cell dormancy. We demonstrate that loss of tumor-intrinsic type I IFN occurs in proliferating prostate cancer cells in bone. This loss suppresses tumor immunogenicity and therapeutic response and promotes bone cell activation to drive cancer progression. Restoration of tumor-intrinsic IFN signaling by HDAC inhibition increased tumor cell visibility, promoted long-term antitumor immunity, and blocked cancer growth in bone. Key findings were validated in patients, including loss of tumor-intrinsic IFN signaling and immunogenicity in bone metastases compared to primary tumors. Data herein provide a rationale as to why current immunotherapeutics fail in bone-metastatic prostate cancer, and provide a new therapeutic strategy to overcome the inefficacy of immune-based therapies in solid cancers.
Collapse
|
42
|
Cmero M, Yuan K, Ong CS, Schröder J, Corcoran NM, Papenfuss T, Hovens CM, Markowetz F, Macintyre G. Inferring structural variant cancer cell fraction. Nat Commun 2020; 11:730. [PMID: 32024845 PMCID: PMC7002525 DOI: 10.1038/s41467-020-14351-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/16/2019] [Indexed: 12/14/2022] Open
Abstract
We present SVclone, a computational method for inferring the cancer cell fraction of structural variant (SV) breakpoints from whole-genome sequencing data. SVclone accurately determines the variant allele frequencies of both SV breakends, then simultaneously estimates the cancer cell fraction and SV copy number. We assess performance using in silico mixtures of real samples, at known proportions, created from two clonal metastases from the same patient. We find that SVclone's performance is comparable to single-nucleotide variant-based methods, despite having an order of magnitude fewer data points. As part of the Pan-Cancer Analysis of Whole Genomes (PCAWG) consortium, which aggregated whole-genome sequencing data from 2658 cancers across 38 tumour types, we use SVclone to reveal a subset of liver, ovarian and pancreatic cancers with subclonally enriched copy-number neutral rearrangements that show decreased overall survival. SVclone enables improved characterisation of SV intra-tumour heterogeneity.
Collapse
Affiliation(s)
- Marek Cmero
- Department of Surgery, Division of Urology, Royal Melbourne Hospital and University of Melbourne, Parkville, VIC, 3050, Australia.
- The Epworth Prostate Centre, Epworth Hospital, Richmond, VIC, 3121, Australia.
- Department of Computing and Information Systems, University of Melbourne, Parkville, VIC, 3010, Australia.
- Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
- Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.
| | - Ke Yuan
- School of Computing Science, University of Glasgow, Sir Alwyn Williams Building, Glasgow, G12 8RZ, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Cheng Soon Ong
- Electrical and Electronic Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
- Machine Learning Research Group, Data61, Canberra, ACT, 2601, Australia
- Research School of Computer Science, Australian National University, Canberra, ACT, 2601, Australia
| | - Jan Schröder
- Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Niall M Corcoran
- Department of Surgery, Division of Urology, Royal Melbourne Hospital and University of Melbourne, Parkville, VIC, 3050, Australia
- The Epworth Prostate Centre, Epworth Hospital, Richmond, VIC, 3121, Australia
| | - Tony Papenfuss
- Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Christopher M Hovens
- Department of Surgery, Division of Urology, Royal Melbourne Hospital and University of Melbourne, Parkville, VIC, 3050, Australia
- The Epworth Prostate Centre, Epworth Hospital, Richmond, VIC, 3121, Australia
| | - Florian Markowetz
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Geoff Macintyre
- Department of Computing and Information Systems, University of Melbourne, Parkville, VIC, 3010, Australia.
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK.
| |
Collapse
|
43
|
Mangiola S, Stuchbery R, McCoy P, Chow K, Kurganovs N, Kerger M, Papenfuss A, Hovens CM, Corcoran NM. Androgen deprivation therapy promotes an obesity-like microenvironment in periprostatic fat. Endocr Connect 2019; 8:547-558. [PMID: 30959474 PMCID: PMC6499921 DOI: 10.1530/ec-19-0029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 04/04/2019] [Indexed: 12/18/2022]
Abstract
Prostate cancer is a leading cause of morbidity and cancer-related death worldwide. Androgen deprivation therapy (ADT) is the cornerstone of management for advanced disease. The use of these therapies is associated with multiple side effects, including metabolic syndrome and truncal obesity. At the same time, obesity has been associated with both prostate cancer development and disease progression, linked to its effects on chronic inflammation at a tissue level. The connection between ADT, obesity, inflammation and prostate cancer progression is well established in clinical settings; however, an understanding of the changes in adipose tissue at the molecular level induced by castration therapies is missing. Here, we investigated the transcriptional changes in periprostatic fat tissue induced by profound ADT in a group of patients with high-risk tumours compared to a matching untreated cohort. We find that the deprivation of androgen is associated with a pro-inflammatory and obesity-like adipose tissue microenvironment. This study suggests that the beneficial effect of therapies based on androgen deprivation may be partially counteracted by metabolic and inflammatory side effects in the adipose tissue surrounding the prostate.
Collapse
Affiliation(s)
- Stefano Mangiola
- Bioinformatics Division, Walter and Eliza Hall Institute, Parkville, Victoria, Australia
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Ryan Stuchbery
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick McCoy
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Ken Chow
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Natalie Kurganovs
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Australian Prostate Cancer Research Centre Epworth, Richmond, Victoria, Australia
- Ontario Institute for Cancer Research, Toronto, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Michael Kerger
- Australian Prostate Cancer Research Centre Epworth, Richmond, Victoria, Australia
| | - Anthony Papenfuss
- Bioinformatics Division, Walter and Eliza Hall Institute, Parkville, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Department of Mathematics and Statistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher M Hovens
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Niall M Corcoran
- Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Urology, Frankston Hospital, Frankston, Victoria, Australia
| |
Collapse
|
44
|
Reeves FA, Battye S, Roth H, Peters JS, Hovens C, Costello AJ, Corcoran NM. Prostatic nerve subtypes independently predict biochemical recurrence in prostate cancer. J Clin Neurosci 2019; 63:213-219. [PMID: 30772200 DOI: 10.1016/j.jocn.2019.01.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/20/2018] [Accepted: 01/31/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To describe nerve subtypes involved by perineural invasion (PNI) in prostate cancer and their relationship with clinicopathological parameters and recurrence risk. METHODS 141 prostatectomy specimens from men with localized prostate cancer and known perineural invasion were analyzed. Index tumor blocks were stained for perineural invasion and sympathetic/parasympathetic markers. For 98 patients with complete staining, nerves from up to three hotspot regions of intraprostatic perineural invasion were classified according to autonomic subtype and perineural invasion status. Findings were correlated with prospectively collected clinicopathological data. Biochemical recurrence predictors were tested in univariable and multivariable models. RESULTS Most intra-prostatic nerves contained sympathetic and parasympathetic fibres, irrespective of perineural invasion status. A fraction was purely sympathetic (5% PNI, 2% non-PNI) or double-negative (non-adrenergic, non-nitrergic; 1% PNI, 1% non-PNI). Perineural invasion nerve count was associated with higher pathological stage. Although total perineural invasion or non-perineural invasion nerve count did not predict biochemical recurrence, two subtypes were found to be independent predictors: pure sympathetic non-perineural invasion nerves (HR 6.79, p = 0.03) and non-adrenergic, non-nitrergic PNI nerves (HR 10.56, p < 0.005). CONCLUSIONS Pure sympathetic nerve density without tumour invasion and perineural invasion specifically involving non-adrenergic, non-nitrergic fibres are independent predictors of biochemical recurrence post prostatectomy, supporting a role for the autonomic nervous system in prostate cancer progression.
Collapse
Affiliation(s)
- Fairleigh A Reeves
- Department of Surgery, Division of Urology, University of Melbourne, Royal Melbourne Hospital, Australia; Urology Unit, Department of Surgery, Peninsula Health, Australia.
| | | | - Hedley Roth
- Urology Unit, Department of Surgery, Peninsula Health, Australia
| | - Justin S Peters
- Department of Surgery, Division of Urology, University of Melbourne, Royal Melbourne Hospital, Australia; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia
| | - Christopher Hovens
- Department of Surgery, Division of Urology, University of Melbourne, Royal Melbourne Hospital, Australia; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia
| | - Anthony J Costello
- Department of Surgery, Division of Urology, University of Melbourne, Royal Melbourne Hospital, Australia; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia
| | - Niall M Corcoran
- Department of Surgery, Division of Urology, University of Melbourne, Royal Melbourne Hospital, Australia; Urology Unit, Department of Surgery, Peninsula Health, Australia; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia
| |
Collapse
|
45
|
Fraser M, Koontz B, Emmenegger U, De Meerleer G, Khoo V, Feng F, Corcoran NM, Hovens CM, Tran PT, Ost P, Boutros PC. What Is Oligometastatic Prostate Cancer? Eur Urol Focus 2019; 5:159-161. [PMID: 30642810 DOI: 10.1016/j.euf.2018.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 10/22/2018] [Revised: 12/06/2018] [Accepted: 12/20/2018] [Indexed: 11/25/2022]
Abstract
Advanced prostate cancer patients can present with both widely metastatic or oligometastatic disease. Accumulating clinical evidence suggests that patients with oligometastatic disease have improved clinical responses from metastasis-directed therapy. This suggests that tumours that give rise to the oligometastatic state are distinct biologically and genetically from those that induce widely metastatic lesions. Detailed genomic analysis of the oligometastatic state will identify the molecular events that distinguish localised from metastatic disease, defining the molecular signatures of curability. The GAP6 consortium is well poised to address this question. PATIENT SUMMARY: In this report, we have reviewed the evidence that prostate cancer patients with only a small number of distant tumour deposits have cancers that are driven by genetic and biological changes, which are distinct from those tumours that readily spread to many distant sites. So far, the evidence is not clear cut; however, in-depth studies to answer this question are underway.
Collapse
Affiliation(s)
| | - Bridget Koontz
- Department of Radiation Oncology, Duke Cancer Institute, Durham, North Carolina, USA
| | - Urban Emmenegger
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada; Biological Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Gert De Meerleer
- Department of Radiation Oncology, University Hospitals, Leuven, Belgium
| | - Vincent Khoo
- Department of Clinical Oncology, Royal Marsden Hospital, London, UK; Department of Medicine, University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia
| | - Felix Feng
- Department of Radiation Oncology, University of California at San Francisco, San Francisco, California, USA; Department of Urology, University of California at San Francisco, San Francisco, CA, USA; Department of Medicine, University of California at San Francisco, San Francisco, CA, USA
| | - Niall M Corcoran
- Department of Urology, Royal Melbourne and Frankston Hospitals, Melbourne, Australia; Department of Surgery, University of Melbourne, Melbourne, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - Christopher M Hovens
- Department of Surgery, University of Melbourne, Melbourne, Australia; Australian Prostate Cancer Research Centre, Epworth, Richmond, Victoria, Australia.
| | - Phuoc T Tran
- Department of Radiation Oncology & Molecular Radiation Sciences, Program in Cellular and Molecular Medicine, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Oncology and Urology, Program in Cellular and Molecular Medicine, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Piet Ost
- Department of Radiation Oncology, Ghent University Hospital, Ghent, East Flanders, Belgium
| | - Paul C Boutros
- Department of Human Genetics, University of California, Los Angeles, CA, USA; Department of Urology, University of California, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Centre, University of California, Los Angeles, CA, USA; Institute for Precision Health, University of California, Los Angeles, CA, USA
| | | |
Collapse
|
46
|
Atkins RJ, Stylli SS, Kurganovs N, Mangiola S, Nowell CJ, Ware TM, Corcoran NM, Brown DV, Kaye AH, Morokoff A, Luwor RB, Hovens CM, Mantamadiotis T. Cell quiescence correlates with enhanced glioblastoma cell invasion and cytotoxic resistance. Exp Cell Res 2019; 374:353-364. [DOI: 10.1016/j.yexcr.2018.12.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 12/12/2022]
|
47
|
Cardoso BR, Roberts BR, Malpas CB, Vivash L, Genc S, Saling MM, Desmond P, Steward C, Hicks RJ, Callahan J, Brodtmann A, Collins S, Macfarlane S, Corcoran NM, Hovens CM, Velakoulis D, O'Brien TJ, Hare DJ, Bush AI. Supranutritional Sodium Selenate Supplementation Delivers Selenium to the Central Nervous System: Results from a Randomized Controlled Pilot Trial in Alzheimer's Disease. Neurotherapeutics 2019; 16:192-202. [PMID: 30215171 PMCID: PMC6361071 DOI: 10.1007/s13311-018-0662-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [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] [Indexed: 12/17/2022] Open
Abstract
Insufficient supply of selenium to antioxidant enzymes in the brain may contribute to Alzheimer's disease (AD) pathophysiology; therefore, oral supplementation may potentially slow neurodegeneration. We examined selenium and selenoproteins in serum and cerebrospinal fluid (CSF) from a dual-dose 24-week randomized controlled trial of sodium selenate in AD patients, to assess tolerability, and efficacy of selenate in modulating selenium concentration in the central nervous system (CNS). A pilot study of 40 AD cases was randomized to placebo, nutritional (0.32 mg sodium selenate, 3 times daily), or supranutritional (10 mg, 3 times daily) groups. We measured total selenium, selenoproteins, and inorganic selenium levels, in serum and CSF, and compared against cognitive outcomes. Supranutritional selenium supplementation was well tolerated and yielded a significant (p < 0.001) but variable (95% CI = 13.4-24.8 μg/L) increase in CSF selenium, distributed across selenoproteins and inorganic species. Reclassifying subjects as either responsive or non-responsive based on elevation in CSF selenium concentrations revealed that responsive group did not deteriorate in Mini-Mental Status Examination (MMSE) as non-responsive group (p = 0.03). Pooled analysis of all samples revealed that CSF selenium could predict change in MMSE performance (Spearman's rho = 0.403; p = 0.023). High-dose sodium selenate supplementation is well tolerated and can modulate CNS selenium concentration, although individual variation in selenium metabolism must be considered to optimize potential benefits in AD. The Vel002 study is listed on the Australian and New Zealand Clinical Trials Registry ( http://www.anzctr.org.au /), ID: ACTRN12611001200976.
Collapse
Affiliation(s)
- Barbara R Cardoso
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Blaine R Roberts
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, Victoria, 3052, Australia
| | - Charles B Malpas
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Departments of Neuroscience and Neurology, The Central Clinical School and The Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Lucy Vivash
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Departments of Neuroscience and Neurology, The Central Clinical School and The Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Sila Genc
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael M Saling
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia Desmond
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher Steward
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Rodney J Hicks
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Molecular Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jason Callahan
- Centre for Molecular Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Amy Brodtmann
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, Victoria, 3052, Australia
- Eastern Cognitive Disorders Clinic, Department of Neurology, Eastern Health, Monash University, Melbourne, Victoria, Australia
| | - Steven Collins
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Clinical Neurosciences and Neurological Research, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | | | - Niall M Corcoran
- Department of Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | | | - Dennis Velakoulis
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - Terence J O'Brien
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Departments of Neuroscience and Neurology, The Central Clinical School and The Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Dominic J Hare
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, Victoria, 3052, Australia.
| | - Ashley I Bush
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, Victoria, 3052, Australia
| |
Collapse
|
48
|
Hamid AA, Gray KP, Shaw G, MacConaill LE, Evan C, Bernard B, Loda M, Corcoran NM, Van Allen EM, Choudhury AD, Sweeney CJ. Compound Genomic Alterations of TP53, PTEN, and RB1 Tumor Suppressors in Localized and Metastatic Prostate Cancer. Eur Urol 2018; 76:89-97. [PMID: 30553611 DOI: 10.1016/j.eururo.2018.11.045] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/23/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND TP53, PTEN, and RB1 tumor suppressor genes (TSGs) are recurrently altered in treatment-resistant prostate cancer. Cooperative loss of two or more TSGs may drive more aggressive disease. OBJECTIVE To determine clinical outcomes of single and compound TSG alterations across the spectrum of prostate cancer. DESIGN, SETTING, AND PARTICIPANTS Massively parallel targeted sequencing using castration-sensitive prostate cancer (CSPC; localized [L] and metastatic [M1]) and castration-resistant prostate cancer (CRPC) specimens (n=285). TSG altered (TSG-alt) was any copy number loss or deleterious mutation of one or more TSGs (TP53, PTEN, and RB1). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS For L-CSPC, event-free survival (EFS) and time to CRPC were estimated. For M1-CSPC and M1-CRPC, overall survival (OS) was estimated. Cox regression models assessed the association between cumulative TSG hits (zero hits vs one hit vs two to three hits) and outcomes with multivariable analyses adjusted for clinicopathological factors. RESULTS AND LIMITATIONS TSG variants increased with advanced disease (L-CSPC: 39%; M1-CSPC: 63%, M1-CRPC: 92%). TSG-alt L-CSPC had shorter EFS (median 2.6yr, hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.22-3.13) and time to CRPC (median 9.5mo, HR 3.36, 95% CI 1.01-11.16). Cumulative gene hits led to an incremental risk of relapse (EFS: one gene, HR 1.69, 95% CI 0.99-2.87; two to three genes, HR 2.70, 95% CI 1.43-5.08; both versus zero genes, p=0.004). There was evidence of inferior OS with increasing TSG hits in the metastatic cohorts. Only four (8%) patients in the M1-CRPC cohort were TSG-neg, one of whom died after 5.2yr. Multivariable analyses adjusting for mutational and copy number burden did not demonstrate a significant independent association of increasing gene hits and poorer outcomes. CONCLUSIONS Deleterious TSG variants are associated with an increased risk of relapse (L) and death (M1) in CSPC. Poorer outcomes are seen with compound gene hits in both early and advanced disease, and this may in part reflect increasing global genomic instability. PATIENT SUMMARY Men with prostate tumors with compound tumor suppressor gene mutations have poorer outcomes. These findings help identify patients with aggressive features who may benefit from intensified treatment.
Collapse
Affiliation(s)
- Anis A Hamid
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kathryn P Gray
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Grace Shaw
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Laura E MacConaill
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Carolyn Evan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Brandon Bernard
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Massimo Loda
- Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boson, MA, USA
| | - Niall M Corcoran
- Department of Surgery, University of Melbourne and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Eliezer M Van Allen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Atish D Choudhury
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | |
Collapse
|
49
|
Chow K, McCoy P, Stuchbery R, Corcoran NM, Hovens CM. Developments in oligometastatic hormone-sensitive prostate cancer. World J Urol 2018; 37:2549-2555. [PMID: 30382379 DOI: 10.1007/s00345-018-2542-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/17/2018] [Accepted: 10/21/2018] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To review the current understanding and recent developments regarding the concept of oligometastases in hormone-sensitive prostate cancer. METHODS A comprehensive literature search of electronic databases, including PubMed and Embase was conducted for the search term 'oligometastases' in combinations with 'prostate cancer', 'hormone sensitive', 'genetics', and 'molecular'. All articles relating to these search terms have been taken into account. RESULTS Prostate cancer remains a major cause of morbidity and mortality worldwide. The majority of these cancer-related deaths result from metastases. Currently, there is a dichotomy in prostate cancer management where it is only deemed curable if it is localized, while any signs of metastasis relegate patients to systemic therapies to delay their inevitable death. A growing body of evidence supports the notion that aggressive treatments during the stable 'oligometastatic' state can have significant clinical benefits and potentially 'reset' prostate cancer to an earlier time point in cancer progression. This concept of oligometastases has been adopted in other cancer settings such as colorectal and non-small-cell lung cancers. CONCLUSION Multiple clinical and molecular biological studies have been influential in the support of a stable state in metastatic cancer progression coined 'oligometastases'. As our understanding of oligometastases in hormone-sensitive prostate cancer develops, we will be able to molecularly define the oligometastatic state and develop clinically available diagnostic tests. In doing so, prostate cancer patients will experience significant clinical benefits and the burden of prostate cancer worldwide will likely be reduced.
Collapse
Affiliation(s)
- Ken Chow
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, Australia.,Department of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Patrick McCoy
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, Australia
| | - Ryan Stuchbery
- Australian Prostate Cancer Research Centre Epworth, Richmond, VIC, Australia
| | - Niall M Corcoran
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, Australia.,Department of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia.,Australian Prostate Cancer Research Centre Epworth, Richmond, VIC, Australia
| | - Christopher M Hovens
- Department of Surgery, The University of Melbourne, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, Australia. .,Australian Prostate Cancer Research Centre Epworth, Richmond, VIC, Australia.
| |
Collapse
|
50
|
Chow K, Herrera P, Stuchbery R, Peters JS, Costello AJ, Hovens CM, Corcoran NM. Late biochemical recurrence after radical prostatectomy is associated with a slower rate of progression. BJU Int 2018; 123:976-984. [DOI: 10.1111/bju.14556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Ken Chow
- Departments of Urology and Surgery; Royal Melbourne Hospital; The University of Melbourne; Parkville Victoria, Australia
| | - Pia Herrera
- Departments of Urology and Surgery; Royal Melbourne Hospital; The University of Melbourne; Parkville Victoria, Australia
| | - Ryan Stuchbery
- Australian Prostate Cancer Research Centre Epworth; Richmond Victoria, Australia
| | - Justin S. Peters
- Departments of Urology and Surgery; Royal Melbourne Hospital; The University of Melbourne; Parkville Victoria, Australia
| | - Anthony J. Costello
- Departments of Urology and Surgery; Royal Melbourne Hospital; The University of Melbourne; Parkville Victoria, Australia
- Australian Prostate Cancer Research Centre Epworth; Richmond Victoria, Australia
| | - Christopher M. Hovens
- Departments of Urology and Surgery; Royal Melbourne Hospital; The University of Melbourne; Parkville Victoria, Australia
- Australian Prostate Cancer Research Centre Epworth; Richmond Victoria, Australia
| | - Niall M. Corcoran
- Departments of Urology and Surgery; Royal Melbourne Hospital; The University of Melbourne; Parkville Victoria, Australia
- Australian Prostate Cancer Research Centre Epworth; Richmond Victoria, Australia
- Department of Urology; Frankston Hospital; Frankston Victoria Australia
| |
Collapse
|