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Spratt DE, Dorff T, McKay RR, Lowentritt BH, Fallick M, Gatoulis SC, Flanders SC, Ross AE. Evaluating relugolix for the treatment of prostate cancer in real-world settings of care: the OPTYX study protocol. Future Oncol 2024; 20:727-738. [PMID: 38488039 DOI: 10.2217/fon-2023-0748] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
OPTYX is a multi-center, prospective, observational study designed to further understand the actual experience of patients with advanced prostate cancer treated with relugolix (ORGOVYX®), an oral androgen deprivation therapy (ADT), by collecting clinical and patient-reported outcomes from routine care settings. The study aims to enroll 1000 consented patients with advanced prostate cancer from community, academic and government operated clinical practices across the USA. At planned timepoints, real-world data analysis on treatment patterns, adherence and safety as well as health outcomes and health-related quality-of-life (HRQOL) after treatment discontinuation will be published in scientific peer-reviewed journals and presented at relevant conferences. This study will provide real-world data for practitioners and researchers in their understanding of the safety and effectiveness of relugolix. Clinical Trial Registration: NCT05467176 (ClinicalTrials.gov).
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Affiliation(s)
- Daniel E Spratt
- Radiation Oncology, UH Seidman Cancer Center/Case Western Reserve University, Cleveland, OH 441062, USA
| | - Tanya Dorff
- Medical Oncology, City of Hope, Duarte, CA 910103, USA
| | - Rana R McKay
- Medical Oncology, UC San Diego, La Jolla, CA 920374, USA
| | | | | | | | - Scott C Flanders
- Myovant Sciences Inc., Brisbane, CA & Sumitomo Pharma America Inc., Marlborough, MA 017528, USA
| | - Ashley E Ross
- Urology, Northwestern Medicine, Chicago, IL 60611, USA
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Nguyen N, Franz RD, Mohammed O, Huynh R, Son CK, Khan RN, Ahmed B. A systematic review of primary large cell neuroendocrine carcinoma of the prostate. Front Oncol 2024; 14:1341794. [PMID: 38515575 PMCID: PMC10955467 DOI: 10.3389/fonc.2024.1341794] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/30/2024] [Indexed: 03/23/2024] Open
Abstract
Background Large cell neuroendocrine carcinoma (LCNEC) is a rare subtype of prostate cancer. The pathogenesis, clinical manifestation, treatment options, and prognosis are uncertain and underreported. Materials and methods A systematic search was conducted in April 2022 through PubMed, Embase, and Cochrane. We reviewed cases of LCNEC developed either from de novo or transformation from prostate adenocarcinoma and summarized the relevant pathophysiological course, treatment options, and outcomes. Results A total of 25 patients with a mean age of 70.4 (range 43 87 years old) from 18 studies were included in this review. 13 patients were diagnosed with de novo LCNEC of the prostate. 12 patients were from the transformation of adenocarcinoma post-hormonal therapy treatment. Upon initial diagnosis, patients diagnosed with de novo prostatic LCNEC had a mean serum PSA value of 24.6 ng/ml (range: 0.09-170 ng/ml, median 5.5 ng/ml), while transformation cases were significantly lower at 3.3 ng/ml (range: 0-9.3 ng/ml, median 0.05 ng/ml). The pattern of metastasis closely resembles prostate adenocarcinoma. Six out of twenty-three cases displayed brain metastasis matching the correlation between neuroendocrine tumors and brain metastasis. Three notable paraneoplastic syndromes included Cushings syndrome, dermatomyositis, and polycythemia. Most patients with advanced metastatic disease received conventional platinum-based chemotherapy with a mean survival of 5 months. There was one exception in the transformation cohort with a somatic BRCA2 mutation who was treated with a combination of M6620 and platinum-based chemotherapy with an impressive PFS of 20 months. Patients with pure LCNEC phenotype have worse survival outcomes when compared to those with mixed LCNEC and adenocarcinoma phenotypes. It is unclear whether there is a survival benefit to administering ADT in pure pathologies. Conclusion LCNEC of the prostate is a rare disease that can occur de novo or transformation from prostatic adenocarcinoma. Most patients present at an advanced stage with poor prognosis and are treated with conventional chemotherapy regimens. Patients who had better outcomes were those who were diagnosed at an early stage and received treatment with surgery or radiation and androgen deprivation therapy (ADT). There was one case with an exceptional outcome that included a treatment regimen of M6620 and chemotherapy.
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Affiliation(s)
- Ngan Nguyen
- Hematology and Medical Oncology, The Oncology Institute of Hope and Innovation, Riverside, CA, United States
| | - Ronald Dean Franz
- College of Medicine, The University of Tennessee Health Science Center (UTHSC), Memphis, TN, United States
| | - Omar Mohammed
- Department of Hematology and Oncology, The University of Tennessee Health Science Center (UTHSC), Memphis, TN, United States
| | - Richard Huynh
- Department of Internal Medicine, The University of Tennessee Health Science Center (UTHSC), Memphis, TN, United States
| | - Christine Kim Son
- Department of Hematology and Oncology, The University of Tennessee Health Science Center (UTHSC), Memphis, TN, United States
| | - Rida Nusrat Khan
- College of Medicine, The University of Tennessee Health Science Center (UTHSC), Memphis, TN, United States
| | - Bilawal Ahmed
- Department of Hematology and Oncology, The University of Tennessee Health Science Center (UTHSC), Memphis, TN, United States
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Mahaveer Chand N, Tekumalla PK, Rosenberg MT, Dobi A, Ali A, Miller GM, Aristizabal-Henao JJ, Granger E, Freedland SJ, Kellogg MD, Srivastava S, McLeod DG, Narain NR, Kiebish MA. Filamin A Is a Prognostic Serum Biomarker for Differentiating Benign Prostatic Hyperplasia from Prostate Cancer in Caucasian and African American Men. Cancers (Basel) 2024; 16:712. [PMID: 38398103 PMCID: PMC10887407 DOI: 10.3390/cancers16040712] [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: 01/12/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Prostate cancer represents a significant health risk to aging men, in which diagnostic challenges to the identification of aggressive cancers remain unmet. Prostate cancer screening is driven by the prostate-specific antigen (PSA); however, in men with benign prostatic hyperplasia (BPH) due to an enlarged prostate and elevated PSA, PSA's screening utility is diminished, resulting in many unnecessary biopsies. To address this issue, we previously identified a cleaved fragment of Filamin A (FLNA) protein (as measured with IP-MRM mass spectrometry assessment as a prognostic biomarker for stratifying BPH from prostate cancer and subsequently evaluated its expanded utility in Caucasian (CA) and African American (AA) men. All men had a negative digital rectal examination (DRE) and PSA between 4 and 10 ng/mL and underwent prostate biopsy. In AA men, FLNA serum levels exhibited diagnostic utility for stratifying BPH from patients with aggressive prostate cancer (0.71 AUC and 12.2 OR in 48 men with BPH and 60 men with PCa) and outperformed PSA (0.50 AUC, 2.2 OR). In CA men, FLNA serum levels also exhibited diagnostic utility for stratifying BPH from patients with aggressive prostate cancer (0.74 AUC and 19.4 OR in 191 men with BPH and 109 men with PCa) and outperformed PSA (0.46 AUC, 0.32 OR). Herein, we established FLNA alone as a serum biomarker for stratifying men with BPH vs. those with high Gleason (7-10) prostate cancers compared to the current diagnostic paradigm of using PSA. This approach demonstrates clinical actionability of FLNA alone without the requirement of prostate volume measurement as a test with utility in AA and CA men and represents a significant opportunity to decrease the number of unnecessary biopsies in aggressive prostate cancer diagnoses.
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Affiliation(s)
| | | | | | - Albert Dobi
- Center for Prostate Disease Research, John P. Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD 20817, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Amina Ali
- Center for Prostate Disease Research, John P. Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD 20817, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | | | | | | | - Stephen J Freedland
- Center for Integrated Research in Cancer and Lifestyle, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Mark D Kellogg
- Department of Laboratory Medicine, Boston Children's Hospital Department of Pathology, Harvard Medical School, Boston, MA 02115, USA
| | - Shiv Srivastava
- Department of Biochemistry and Molecular & Cell Biology, Georgetown University School of Medicine, Washington, DC 20057, USA
| | - David G McLeod
- Center for Prostate Disease Research, John P. Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD 20817, USA
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4
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Gallagher BDT, Chiam K, Bang A, Patel MI, Kench JG, Edwards S, Nair-Shalliker V, Smith DP. Descriptive analysis of prostate cancer pathology data from diagnosis and surgery in men from the 45 and Up Study. Pathology 2024; 56:39-46. [PMID: 38104002 DOI: 10.1016/j.pathol.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/12/2023] [Accepted: 09/19/2023] [Indexed: 12/19/2023]
Abstract
Information available from the New South Wales Cancer Registry (NSWCR) about the aggressiveness of prostate cancer is limited to the summary stage variable 'degree of spread', which contains a high proportion of cases defined as 'unknown'. In this study we demonstrate the feasibility of obtaining and analysing prostate cancer pathology data from stored pathology records. Pathology data were extracted from stored pathology records of incident prostate cancer cases in men participating in the 45 and Up Study, a large Australian prospective cohort study, who were diagnosed between January 2006 and December 2013. Baseline questionnaires from the 45 and Up Study were linked to the NSWCR. Demographic and pathology items were tabulated and associations described. We evaluated the completeness of pathological characteristics by degree of spread of cancer at diagnosis. Among the 123,921 men enrolled in the 45 and Up Study, 5,091 had incident prostate cancer and 5,085 were linked to a pathology record. The most complete variables included grade group of diagnostic (85.8%) and surgical (99.8%) specimens, margin status (98.1%), extraprostatic extension (95.1%) and seminal vesicle invasion (96.8%). Most diagnostic specimens were grade group 1 (26.6%) or 2 (23.5%). Of the 5,085 cases, 30.8% were classified by the NSWCR with unknown degree of spread; a pathology record could be extracted for 99.4% of these. The unknown degree of spread cases had similar levels of completeness and distribution of diagnostic and surgical pathology features to those with a localised degree of spread. This study demonstrated the feasibility of obtaining and analysing data derived from pathology reports from centralised state-based cancer registry notifications. Supplementing degree of spread information with pathology data from diagnosis and surgery will improve both the quality of research and policy aimed at improving the lives of men with prostate cancer.
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Affiliation(s)
- Benjamin D T Gallagher
- Faculty of Medicine and Health, Sydney School of Public Health, Camperdown, NSW, Australia; The Daffodil Centre, University of Sydney, Sydney, NSW, Australia.
| | - Karen Chiam
- Faculty of Medicine and Health, Sydney School of Public Health, Camperdown, NSW, Australia; The Daffodil Centre, University of Sydney, Sydney, NSW, Australia
| | - Albert Bang
- The Daffodil Centre, University of Sydney, Sydney, NSW, Australia
| | - Manish I Patel
- Department of Urology, Westmead Hospital, Specialty of Surgery, University of Sydney, Sydney, NSW, Australia
| | - James G Kench
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Sue Edwards
- Cancer Services and Information, Cancer Institute NSW, Sydney, NSW, Australia
| | - Visalini Nair-Shalliker
- The Daffodil Centre, University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health Science, Macquarie University, Sydney, NSW, Australia
| | - David P Smith
- The Daffodil Centre, University of Sydney, Sydney, NSW, Australia; Menzies Health Institute Queensland, Griffith University, Southport, Qld, Australia; School of Public Health and Preventative Medicine, Monash University, Melbourne, Vic, Australia
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5
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Li J, Yang C, Xiang K. Association between oxidative balance score and prostate specific antigen among older US adults. Front Public Health 2024; 11:1336657. [PMID: 38317687 PMCID: PMC10838971 DOI: 10.3389/fpubh.2023.1336657] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024] Open
Abstract
Objective Oxidative Balance Score (OBS) is an index affecting the oxidative stress of dietary and lifestyle factors. We aimed to explore the association of OBS with prostate specific antigen (PSA) among older males. Methods A total of 5,136 samples were collected in this study to investigate the relationship between OBS and PSA from the National Health and Nutrition Examination Survey. Logistic regression models and restricted cubic spline were used to assess the associations between OBS and PSA. Results Compared with the Q1 group, the odds ratios for the association between OBS and PSA were 1.005 (1.003, 1.009), 1.003 (1.001, 1.006), and 1.001 (0.978, 1.022) for Q2, Q3, and Q4, respectively. In the age-specific analyses, the association was significant among individuals aged 65 years old and over: the odds ratios for the association between OBS and PSA were 1.019 (1.005, 1.028), 1.028 (1.018, 1.039), and 1.038 (1.022, 1.049) for Q2, Q3, and Q4, respectively. But it was not significant among individuals aged less than 65 years old: the odds ratios for the association between OBS and PSA were 1.016 (0.995, 1.026), 1.015 (0.985, 1.022), and 0.988 (0.978, 1.016) for Q2, Q3, and Q4, respectively. The restricted cubic splines also indicated a nonlinear relationship between OBS and PSA among individuals aged 65 years old and over (Poverall = 0.006, Pnonlinear = 0.021). Conclusion Our findings provide evidence that OBS is positively associated with higher levels of PSA among older adults. Further large-scale prospective cohort studies are needed to verify our findings.
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Affiliation(s)
- Jintao Li
- The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China
| | - Chao Yang
- The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China
| | - Kui Xiang
- The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China
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6
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Li H, Zheng J, Dong W, Huang Y, Su Z, Jiang X. Association of ulcerative colitis and acute gastroenteritis with prostate specific antigen: results from National Health and Nutrition Examination Survey from (2009 to 2010) and Mendelian randomization analyses. Front Nutr 2023; 10:1265014. [PMID: 38111604 PMCID: PMC10725916 DOI: 10.3389/fnut.2023.1265014] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Background An increasing number of studies have demonstrated that gastrointestinal inflammation may increase prostate cancer risk and raise the prostate-specific antigen (PSA) level. However, the association between ulcerative colitis (UC) and acute gastroenteritis (AGE) with PSA remains unclear and complicated. Herein, we evaluated the relationship between UC and AGE with PSA concentration using the National Health and Nutrition Examination Survey (NHANES) database and Mendelian randomization (MR) analyses. Materials and methods A total of 1,234 participants fit into the study after conducting the screening based on the NHANES survey conducted from 2009 to 2010. UC and AGE were the independent variables, and PSA was the dependent variable. Weighted multiple linear regressions were utilized to estimate the association of UC and AGE with PSA concentration. To detect the causal relationship between UC and AGE with PSA, a two-sample Mendelian randomized analysis was conducted. Results After controlling for all covariates, PSA (log2 transform) concentrations in the UC group were increased by 0.64 (0.07, 1.21). AGE was not independently associated with PSA levels after adjusting potential confounders. In patients with coronary artery disease, AGE promotes elevated PSA (log2 transform) concentrations (β = 1.20, 95% CI: 0.21-2.20, p < 0.001). Moreover, an IVW MR analysis indicated that genetically predicted UC was associated with increased PSA, and that AGE was not associated with PSA. Conclusion This study indicated that a positive causal association exists between UC and the PSA level. However, there is no evidence to support the relationship between AGE and the PSA level.
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Affiliation(s)
| | | | | | | | | | - Xianhan Jiang
- Key Laboratory of Biological Targeting Diagnosis, Department of Urology, Therapy and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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7
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Zhang C, Zhang Y, Niu N, Fu G. Predictive Value of Preoperative Prostate Health Index and Serum Testosterone Testing for Biochemical Recurrence after Radical Prostatectomy for Non-Metastatic Prostate Cancer. ARCH ESP UROL 2023; 76:787-795. [PMID: 38186072 DOI: 10.56434/j.arch.esp.urol.20237610.95] [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] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To analyse the predictive value of prostate health index (PHI) combined with serum testosterone after radical prostatectomy (RP) for prostate cancer (PCa). METHODS A total of 132 PCa patients who received RP treatment from January 2016 to December 2019 were selected, retrospectively. And then these patients were divided into biochemical recurrence (BCR) group (n = 51) and non-biochemical recurrence (non-BCR) group (n = 81) based on whether BCR was present after RP. Basic data of PCa patients were collected, and preoperative prostate health index (PHI) and serum testosterone levels were measured in both groups. Logistic regression analysis was used to analyse the influencing factors of BCR after RP. The predictive value of PHI and serum testosterone on BCR after RP was analysed using the receiver operating characteristic (ROC) curve. The Kaplan-Meier method was used to plot survival curves, and log rank test was used to analyse the differences between survival curves. RESULTS The BCR rate of patients in this study was 38.64% (51/132). Single-factor analysis showed that BCR after RP in PCa patients was associated with prostate-specific antigen (PSA), Gleason score, pathological stage, postoperative adjuvant therapy, testosterone and PHI (p < 0.05). Logistics regression analysis showed that PSA >20 ng/mL, Gleason score (8 scores), pathological stage pT3, increased PHI and increased testosterone were independent risk factors for BCR after RP. ROC curve analysis showed that the area under curve (AUC) of PHI and serum testosterone predicting BCR after RP alone and in combination were 0.769, 0.725 and 0.906, respectively. Kaplan-Meier survival analysis showed that preoperative high PHI and low testosterone are negatively correlated with recurrence-free survival rate. CONCLUSIONS Preoperative PHI and testosterone can serve as simple prognostic indicators for postoperative BCR in PCa patients undergoing RP. PCa patients with higher PHI levels and lower testosterone levels may be more prone to developing BCR. The combination of PHI and testosterone has a higher value in predicting BCR after RP.
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Affiliation(s)
- Chao Zhang
- Department of Clinical Laboratory, Qingdao Municipal Hospital (Group), Qingdao Geriatric Hospital, 266002 Qingdao, Shandong, China
| | - Yuying Zhang
- Department of Clinical Laboratory, Qingdao Municipal Hospital (Group), Qingdao Geriatric Hospital, 266002 Qingdao, Shandong, China
| | - Niu Niu
- Department of Clinical Laboratory, Qingdao Municipal Hospital (Group), Qingdao Geriatric Hospital, 266002 Qingdao, Shandong, China
| | - Guixia Fu
- Department of Clinical Laboratory, Qingdao Municipal Hospital (Group), Qingdao Geriatric Hospital, 266002 Qingdao, Shandong, China
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Spyratou V, Freyhult E, Bergh A, Thellenberg-Karlsson C, Wikström P, Welén K, Josefsson A. Ki67 and prostate specific antigen are prognostic in metastatic hormone naïve prostate cancer. Acta Oncol 2023; 62:1698-1706. [PMID: 37713321 DOI: 10.1080/0284186x.2023.2254480] [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: 03/22/2023] [Accepted: 08/28/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND For metastatic hormone naïve prostate cancer patients, androgen deprivation therapy (ADT) with escalation therapy including docetaxel and/or androgen targeting drugs is the standard therapy. However, de-escalation is preferable to avoid unnecessary side effects, especially from docetaxel, but markers to identify these patients are lacking. The purpose of the present study was to investigate the potential of PSA and Ki67 immunoreactive scores as prognostic and treatment-predictive markers. MATERIAL AND METHODS Prostate biopsies from 92 patients with metastatic hormone naïve PC (PSA > 80 ng/mL or clinical metastases) were immunohistochemically evaluated for PSA and Ki67. Gene expression analysis was performed with Clariom D microarrays to identify the phenotypic profile associated with the immunohistochemistry scores of biopsies. Cox regression analysis for progression free survival after ADT adjustment for age, ISUP, and serum PSA and Kaplan-Meier analyses were performed to assess prognostic values of Ki67, PSA, and the Ki67/PSA ratio. RESULTS The immunohistochemical score for PSA was the strongest prognostic factor for progression-free and overall survival after ADT. Consequently, the ratio between Ki67 and PSA displayed a stronger prognostic value than Ki67 itself. Further, mRNA expression data analysis showed an association between high Ki67/PSA ratio, cell-cycle regulation, and DNA damage repair. In an exploratory sub-analysis of 12 patients treated with early docetaxel as addition to ADT and matched controls, a high Ki67/PSA ratio showed potential to identify those who benefit from docetaxel. CONCLUSION PSA and Ki67 immunoreactive scores are prognostic in the metastatic hormone-sensitive setting, with PSA being superior. The combination of Ki67 and PSA did not give additional prognostic value. The results suggest immunohistochemical scoring of PSA to have potential to improve identification of patients responding well to ADT alone.
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Affiliation(s)
- Vasiliki Spyratou
- Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Eva Freyhult
- Department of Cell and Molecular Biology, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Anders Bergh
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | | | - Pernilla Wikström
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Karin Welén
- Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Center for Cancer Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Josefsson
- Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
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Mattlet A, Limani K, Alexandre P, Hawaux E, Abou Zahr R, Aoun F, Diamand R. External validation of biochemical recurrence definition to predict oncologic outcomes following focal therapy for localized prostate cancer using high intensity focused ultrasound. Prostate 2023; 83:1564-1571. [PMID: 37574824 DOI: 10.1002/pros.24614] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 07/09/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE This is an external validation of several biochemical recurrence definitions based on prostate specific antigen criteria (PSA). The purpose is to predict the need of additional treatment and failure after focal therapy using high intensity focused ultrasound (HIFU) for localized prostate cancer (PCa). MATERIALS AND METHODS A total of 343 consecutive patients who underwent HIFU with Ablatherm® and Focal One® devices between June 2001 and November 2020 were identified. Treatment failure was defined as clinically significant PCa on postoperative biopsy, the need for salvage radical or systematic treatment, metastasis, or PCa-related death. The biochemical recurrence definitions tested were PSA nadir, time to PSA nadir, percentage of PSA reduction, Huber et al. criteria defined as PSA nadir + 1 ng/mL at 12 months or PSA nadir + 1.5 ng/mL at 24-36 months. Multivariable Cox regression analysis and decision-curve analysis were used to validate and compare criteria. Kaplan-Meier analysis was used to assess criteria associated with the highest accuracy. RESULTS One hundred seventy-eight patients met the inclusion criteria and were analyzed. Overall, 61 (34%) and 41 (23%) patients had an additional treatment and failure with a median follow-up of 52 months. At multivariable analysis, model including Huber et al. criteria exhibited the highest Harrell's C-index for the prediction of the need of additional treatment (hazard ratio [HR]: 10, p < 0.001, c-index: 84%) and treatment failure (HR: 9.1, p < 0.001, c-index: 82%) as well as higher net benefit. The 60-months need of additional treatment and treatment failure-free survival were 89% and 98% compared to 26% and 49%, respectively, when stratified according to Huber et al. criteria (Log-rank test, p < 0.001). Similar results were found after excluding patient with non-clinically significant PCa at initial biopsy. CONCLUSIONS We report an external validation of biochemical recurrence definitions predicting the need of additional treatment and failure after focal therapy using HIFU for localized PCa. Huber et al. criteria were identified as the most accurate and could be used to guide clinicians toward further evaluation and salvage treatments.
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Affiliation(s)
- Aurore Mattlet
- Urology Department, Jules Bordet Institute, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Ksenija Limani
- Urology Department, Jules Bordet Institute, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Peltier Alexandre
- Urology Department, Jules Bordet Institute, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Eric Hawaux
- Urology Department, Jules Bordet Institute, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Rawad Abou Zahr
- Urology Department, Jules Bordet Institute, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Fouad Aoun
- Urology Department, Jules Bordet Institute, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Romain Diamand
- Urology Department, Jules Bordet Institute, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
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10
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Garg S, Sachdeva A, Peeters M, McClements J. Point-of-Care Prostate Specific Antigen Testing: Examining Translational Progress toward Clinical Implementation. ACS Sens 2023; 8:3643-3658. [PMID: 37830899 PMCID: PMC10616866 DOI: 10.1021/acssensors.3c01402] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023]
Abstract
Prostate cancer (PCa) is the second most common male cancer and is attributable to over 375,000 deaths annually. Prostate specific antigen (PSA) is a key biomarker for PCa and therefore measuring patient PSA levels is an important aspect of the diagnostic pathway. Automated immunoassays are currently utilized for PSA analysis, but they require a laboratory setting with specialized equipment and trained personnel. This results in high diagnostic costs, extended therapeutic turnaround times, and restrictions on testing capabilities in resource-limited settings. Consequently, there is a strong drive to develop point-of-care (PoC) PSA tests that can offer accurate, low-cost, and rapid results at the time and place of the patient. However, many emerging PoC tests experience a trade-off between accuracy, affordability, and accessibility which distinctly limits their translational potential. This review comprehensively assesses the translational advantages and limitations of emerging laboratory-level and commercial PoC tests for PSA determination. Electrochemical and optical PSA sensors from 2013 to 2023 are systematically examined. Furthermore, we suggest how the translational potential of emerging tests can be optimized to achieve clinical implementation and thus improve PCa diagnosis globally.
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Affiliation(s)
- Saweta Garg
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
- Department
of Chemical Engineering and Analytical Science, School of Engineering, University of Manchester, Manchester M20 4BX, U.K.
| | - Ashwin Sachdeva
- Division
of Cancer Sciences, University of Manchester, Wilmslow Road, Manchester M20 4BX, U.K.
- Department
of Urology, The Christie NHS Foundation
Trust, Manchester M20 4BX, U.K.
| | - Marloes Peeters
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
| | - Jake McClements
- Merz
Court, School of Engineering, Newcastle
University, Claremont Road, NE1 7RU Newcastle upon Tyne, U.K.
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11
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Giovanella L, Garo ML, Cuzzocrea M, Paone G, Herrmann K. Prognostic role of early prostate specific antigen changes after [ 177 Lu]Lu-PSMA radioligand therapy of metastasized prostate cancer: A meta-analysis. Eur J Clin Invest 2023; 53:e14014. [PMID: 37194605 DOI: 10.1111/eci.14014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/29/2023] [Accepted: 04/29/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Approximately 10%-20% of prostate cancers progress to metastatic and castration-resistant forms (mCRPC). Radioligand (RLT) therapy with [177 Lu]Lu-prostate-specific membrane antigen (PSMA) is an emerging treatment for metastasized mCRPC and its efficacy is assessed not only but also by prostate specific antigen (PSA) measurement after 12 weeks or more after treatment. Our aim was to evaluate the role of early PSA measurement after RLT in predicting overall survival (OS) of mCRPC patients. METHODS A systematic search on PubMed, Web Of Science and Scopus was performed from January to December 2022. PRISMA guidelines for prognostic studies was adopted. Risk of bias was assessed using quality of prognostic studies (QUIPS). RESULTS Twelve studies at low-intermediate risk of bias, were included in the meta-analysis (1646 patients, mean age 70 years). About 50% of patients showed a PSA decline after 1-2 of [177 Lu]Lu-PSMA, and more than 30% reported a PSA decline ≥50%. The median OS range for patients with any PSA decline was 13-20 months, while for patients with stable or increased PSA, the median OS fell to 6-12 months. The OS rate for a PSA decline after the one-two [177 Lu]Lu-PSMA cycles was 0.39 (95% CI: 0.31-0.50), while OS for a PSA decline ≥50% was 0.69 (95% CI: 0.57-0.83). CONCLUSIONS A PSA decline is observed in almost 50% of mCRPC patients after 1-2 [177 Lu]Lu-PSMA cycles, with a significantly longer OS compared to stable or increased PSA levels, respectively. Accordingly, any PSA decline after 1-2 cycles of therapy should be regarded as a favourable prognostic factor for OS.
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Affiliation(s)
- Luca Giovanella
- Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Clinic for Nuclear Medicine, University Hospital of Zürich, Zürich, Switzerland
| | - Maria Luisa Garo
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Cardiac Surgery, Department of Cardiovascular Surgery, Università Campus Bio-Medico, Rome, Italy
| | - Marco Cuzzocrea
- Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Gaetano Paone
- Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Ken Herrmann
- Clinic for Nuclear Medicine, Essen University Hospital, Essen, Germany
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12
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Livingston AJ, Dvergsten T, Morgan TN. Initial Postoperative Prostate Specific Antigen and PSA Velocity Are Important Indicators of Underlying Malignancy After Simple Prostatectomy. J Endourol 2023; 37:1057-1062. [PMID: 37376750 DOI: 10.1089/end.2023.0101] [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] [Indexed: 06/29/2023] Open
Abstract
Background: There is a paucity of guidelines for prostate-specific antigen (PSA) monitoring after simple prostatectomy (SP) despite these patients remaining at risk for prostate cancer (PCa). Our objective was to determine if PSA kinetics can be a potential indicator of PCa after SP. Methods: A retrospective review was performed of all simple prostatectomies at our institution from 2014 to 2022. All patients who met criteria were included in the study. Relevant clinical variables were collected preoperatively, including PSA value, prostate size, and voiding symptoms. Surgical and urinary function outcomes were analyzed. Results: A total of 92 patients were divided into two groups based on malignancy status. Sixty-eight patients did not have PCa, while 24 patients had known PCa before surgery (14) or were diagnosed as having incidental PCa from the pathological specimen (10). Patients with benign prostates had an initial postoperative PSA value of 0.76 ng/mL compared with 1.68 ng/mL for those with cancer (p < 0.01). PSA velocity for the first 24 months after surgery was 0.042 ± 1.61 ng/(mL·year) for the benign cohort compared with 1.29 ± 1.02 ng/(mL·year) for the malignant cohort (p = 0.01). Voiding improvements were noted by objective (postvoid residual and flow rate) and subjective (American Urological Association symptom score and quality of life score) measures in both groups. Conclusions: PSA interpretation and monitoring after SP have not been well established. Our study indicates that initial postoperative PSA value and PSA velocity are important indicators of underlying malignancy in patients after SP. Further efforts are needed to establish threshold values and formal guidelines.
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Affiliation(s)
- Austin J Livingston
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Thomas Dvergsten
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Tara N Morgan
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
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13
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Alhamdan WA, Alsulaiman TA, Alsabti RI, Abdulmowla OM, Elnaggar SE, Alendijani Y. Association between body mass index and hemoglobin A1c with serum prostate-specific antigen level: A retrospective cohort study. Saudi Med J 2023; 44:870-874. [PMID: 37717968 PMCID: PMC10505297 DOI: 10.15537/smj.2023.44.9.20230384] [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: 05/24/2023] [Accepted: 08/01/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVES To assess the association between body mass index (BMI) and hemoglobin A1c (HbA1c) with serum prostate-specific antigen (PSA) level. METHODS A retrospective cohort study was carried out at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia, from January 2016 to December 2021. Data were collected from the medical records of patients who visited the family medicine clinics, including demographics, smoking status, BMI value, index PSA level, testosterone level, digital rectal exam findings, prostate biopsy status, fasting blood glucose (FBG), HbA1c, diabetes duration, chronic comorbidities (namely, hypertension, dyslipidemia, or chronic kidney disease), and medication history. RESULTS The mean PSA level was 1.89±4.02 ng/dL and mean HbA1c was 6.59±2.69%. Of the participants, 41.8% were overweight, 54.3% were non-diabetics, and 85.3% were nonsmokers. Only 11 (1.6%) participants had undergone a prostate biopsy after taking a PSA test. There was a positive correlation between PSA level and age, a negative correlation between PSA level and BMI, and no correlation between PSA level and HbA1c or FBG. CONCLUSION Prostate-specific antigen levels were higher in older people and those with low BMIs. No correlations were found between PSA levels and HbA1c or FBG, even after adjusting for other variables. Moreover, no correlations were found between PSA levels and other comorbidities such as dyslipidemia, chronic kidney disease, and hypertension.
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Affiliation(s)
- Wejdan A. Alhamdan
- From the Department of Family Medicine and Polyclinics (Alhamdan, Alsulaiman, Alsabti, Alendijani), King Faisal Specialist Hospital and Research Center, and from the College of Medicine (Abdulmowla, Elnaggar), Al Faisal University, Riyadh, Kingdom of Saudi Arabia
| | - Thamer A. Alsulaiman
- From the Department of Family Medicine and Polyclinics (Alhamdan, Alsulaiman, Alsabti, Alendijani), King Faisal Specialist Hospital and Research Center, and from the College of Medicine (Abdulmowla, Elnaggar), Al Faisal University, Riyadh, Kingdom of Saudi Arabia
| | - Razan I. Alsabti
- From the Department of Family Medicine and Polyclinics (Alhamdan, Alsulaiman, Alsabti, Alendijani), King Faisal Specialist Hospital and Research Center, and from the College of Medicine (Abdulmowla, Elnaggar), Al Faisal University, Riyadh, Kingdom of Saudi Arabia
| | - Ola M. Abdulmowla
- From the Department of Family Medicine and Polyclinics (Alhamdan, Alsulaiman, Alsabti, Alendijani), King Faisal Specialist Hospital and Research Center, and from the College of Medicine (Abdulmowla, Elnaggar), Al Faisal University, Riyadh, Kingdom of Saudi Arabia
| | - Somayh E. Elnaggar
- From the Department of Family Medicine and Polyclinics (Alhamdan, Alsulaiman, Alsabti, Alendijani), King Faisal Specialist Hospital and Research Center, and from the College of Medicine (Abdulmowla, Elnaggar), Al Faisal University, Riyadh, Kingdom of Saudi Arabia
| | - Yaser Alendijani
- From the Department of Family Medicine and Polyclinics (Alhamdan, Alsulaiman, Alsabti, Alendijani), King Faisal Specialist Hospital and Research Center, and from the College of Medicine (Abdulmowla, Elnaggar), Al Faisal University, Riyadh, Kingdom of Saudi Arabia
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Sidhu A, Khan N, Phillips C, Briones J, Kapoor A, Zalewski P, Fleshner NE, Chow E, Emmenegger U. Prevalence and Prognostic Implications of PSA Flares during Radium-223 Treatment among Men with Metastatic Castration Resistant Prostate Cancer. J Clin Med 2023; 12:5604. [PMID: 37685670 PMCID: PMC10488545 DOI: 10.3390/jcm12175604] [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: 07/19/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Radium-223 (Ra233) prolongs the survival of men with symptomatic bone-predominant metastatic castration-resistant prostate cancer (mCRPC). However, prostate-specific antigen (PSA) response patterns are not closely associated with Ra223 therapy outcomes. Herein, we sought to analyze the impact of Ra223-induced PSA flares on patient outcome. Using a retrospective cohort study of Ra223 treatment in four Ontario/Canada cancer centres, we identified 134 patients grouped into sub-cohorts according to distinct PSA response patterns: (i) initial PSA flare followed by eventual PSA decline; (ii) PSA response (≥30% PSA decrease within 12 weeks of treatment); and (iii) PSA non-response. We analyzed patient characteristics and outcome measures, including overall survival (OS), using the Kaplan-Meier method and log-rank testing. PSA flares were observed in 27 (20.2%), PSA responses in 11 (8.2%), and PSA non-responses in 96 (71.6%) patients. Amongst PSA flare patients, 12 presented with post-flare PSA decreases below baseline and 15 with PSA decreases below the flare peak but above baseline. Although only six flare patients achieved ≥30% PSA decreases below baseline, the median OS of all flare patients (16.8 months, 95% CI 14.9-18.7) was comparable to that of PSA responders and non-responders (p = 0.349). In summary, around 20% of mCRPC patients experience Ra223-induced PSA flares, whose outcome is similar to that of men with or without PSA responses. Further studies are needed regarding suitable biochemical surrogate markers of response to Ra223.
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Affiliation(s)
- Amanjot Sidhu
- Sunnybrook Odette Cancer Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (N.K.); (C.P.); (J.B.); (E.C.)
| | - Nabeeha Khan
- Sunnybrook Odette Cancer Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (N.K.); (C.P.); (J.B.); (E.C.)
| | - Cameron Phillips
- Sunnybrook Odette Cancer Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (N.K.); (C.P.); (J.B.); (E.C.)
| | - Juan Briones
- Sunnybrook Odette Cancer Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (N.K.); (C.P.); (J.B.); (E.C.)
| | - Anil Kapoor
- Juravinski Cancer Centre, Hamilton, ON L8V 5C2, Canada;
| | - Pawel Zalewski
- Durham Regional Cancer Centre, Oshawa, ON L1G 2B9, Canada;
| | | | - Edward Chow
- Sunnybrook Odette Cancer Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (N.K.); (C.P.); (J.B.); (E.C.)
| | - Urban Emmenegger
- Sunnybrook Odette Cancer Centre, Toronto, ON M4N 3M5, Canada; (A.S.); (N.K.); (C.P.); (J.B.); (E.C.)
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15
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Premo H, Gordee A, Lee HJ, Scales CD, Moul JW, Peterson A. Disparities in Prostate Cancer Screening for Transgender Women: An Analysis of the MarketScan Database. Urology 2023; 176:237-242. [PMID: 36972765 PMCID: PMC10330039 DOI: 10.1016/j.urology.2023.03.016] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/19/2023] [Accepted: 03/13/2023] [Indexed: 03/28/2023]
Abstract
OBJECTIVE To describe the prevalence of PSA screening amongst transgender women. A transgender individual is someone whose gender identity differs from their birth sex or the societal norms of that assigned sex. There are no formal guidelines regarding PSA screening in transgender women, even though they retain prostatic tissue throughout the gender-affirming process, and there is a lack of existing data to adequately inform clinical practice. METHODS We identified a cohort of transgender women in the IBM MarketScan dataset using ICD codes. The patient...s eligibility for inclusion was determined on an annual basis for the years 2013-2019. For each year, we required continuous enrollment, 3 months of post-transgender diagnosis follow-up, and aged 40-80 without a prior diagnosis of prostate malignancy. This cohort was compared to cisgender men with similar eligibility criteria. The proportions of individuals undergoing PSA screening were compared using log-binomial regression. RESULTS A group of 2957 transgender women met the inclusion criteria. We saw significantly lower PSA screening rates among transgender individuals for ages 40-54 and 55-69, but higher rates within the age group 70-80 (P.ß<.ß.001 for all). CONCLUSION This is the first study evaluating PSA screening rates for insured transgender women. While the rates for screening in transgender women over the age of 70 are higher, the overall rate of screening for all other age groups lags below the general population in this dataset. Further investigation is necessary to provide equitable care for the transgender community.
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Affiliation(s)
| | - Alexander Gordee
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC; Surgery Center for Outcomes Research and Equity in Surgery, Duke University, Durham, NC
| | - Hui-Jie Lee
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC; Surgery Center for Outcomes Research and Equity in Surgery, Duke University, Durham, NC
| | - Charles D Scales
- Surgery Center for Outcomes Research and Equity in Surgery, Duke University, Durham, NC; Department of Population Health Sciences, Duke University, Durham, NC; Department of Surgery, Division of Urology, Duke University, Durham, NC
| | - Judd W Moul
- Department of Surgery, Division of Urology, Duke University, Durham, NC; Duke Cancer Institute, Duke University, Durham, NC
| | - Andrew Peterson
- Department of Surgery, Division of Urology, Duke University, Durham, NC
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16
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Chen C, Wang YL, Lin X, Ma SH, Cao JT, Liu YM. Cu-MOFs/GOx Bifunctional Probe-Based Synergistic Signal Amplification Strategy: Toward Highly Sensitive Closed Bipolar Electrochemiluminescence Immunoassay. ACS Appl Mater Interfaces 2023; 15:22959-22966. [PMID: 37147771 DOI: 10.1021/acsami.3c02381] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A closed bipolar electrochemiluminescence (BP-ECL) platform for sensitive prostate specific antigen (PSA) detection was proposed based on a novel synergistic signal amplification strategy. Specifically, glucose oxidase-loaded Cu-based metal-organic frameworks (Cu-MOFs/GOx) as bifunctional probes were bridged on the anodic interface with the target PSA as the intermediate unit. In virtue of the large loading capacity of Cu-MOFs, a large amount of a co-reactant, i.e., H2O2 in this L-012-based ECL system and gluconic acid were generated on the anodic pole in the presence of glucose. The generated gluconic acid could effectively degrade the Cu-MOFs to release Cu2+ which greatly accelerates the formation of highly active intermediates from co-reactant H2O2, boosting the ECL intensity. As for the cathodic pole, K3Fe(CN)6 with a lower reduction potential is used to reduce the driving voltage and speed up the reaction rate, further strengthening the ECL intensity. Thanks to the synergistic signal amplification effect at both two electrode poles of the BP-ECL system, highly sensitive detection of PSA was realized with a detection limit of 5.0 × 10-14 g/mL and a wide linear range of 1.0 × 10-13-1.0 × 10-7 g/mL. The strategy provides a novel way for signal amplification in the BP-ECL biosensing field.
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Affiliation(s)
- Chen Chen
- College of Chemistry and Chemical Engineering, Xinyang Key Laboratory of Functional Nanomaterials for Bioanalysis, Xinyang Normal University, Xinyang 464000, China
| | - Yu-Ling Wang
- College of Chemistry and Chemical Engineering, Xinyang Key Laboratory of Functional Nanomaterials for Bioanalysis, Xinyang Normal University, Xinyang 464000, China
| | - Xiao Lin
- College of Chemistry and Chemical Engineering, Xinyang Key Laboratory of Functional Nanomaterials for Bioanalysis, Xinyang Normal University, Xinyang 464000, China
| | - Shu-Hui Ma
- Xinyang Central Hospital, Xinyang 464000, China
| | - Jun-Tao Cao
- College of Chemistry and Chemical Engineering, Xinyang Key Laboratory of Functional Nanomaterials for Bioanalysis, Xinyang Normal University, Xinyang 464000, China
| | - Yan-Ming Liu
- College of Chemistry and Chemical Engineering, Xinyang Key Laboratory of Functional Nanomaterials for Bioanalysis, Xinyang Normal University, Xinyang 464000, China
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17
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Myint ZW, St. Clair WH, Strup SE, Yan D, Li N, Allison DB, McLouth LE, Ellis CS, Wang P, James AC, Hensley PJ, Otto DE, Arnold SM, DiPaola RS, Kolesar JM. A Phase I Dose Escalation and Expansion Study of Epidiolex (Cannabidiol) in Patients with Biochemically Recurrent Prostate Cancer. Cancers (Basel) 2023; 15:2505. [PMID: 37173971 PMCID: PMC10177512 DOI: 10.3390/cancers15092505] [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: 02/23/2023] [Revised: 04/09/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
PURPOSE Cannabinoids (CBD) have anti-tumor activity against prostate cancer (PCa). Preclinical studies have demonstrated a significant decrease in prostate specific antigen (PSA) protein expression and reduced tumor growth in xenografts of LNCaP and DU-145 cells in athymic mice when treated with CBD. Over-the-counter CBD products may vary in activity without clear standardization, and Epidiolex is a standardized FDA-approved oral CBD solution for treatment of certain types of seizures. We aimed to assess the safety and preliminary anti-tumor activity of Epidiolex in patients with biochemically recurrent (BCR) PCa. EXPERIMENTAL DESIGN This was an open-label, single center, phase I dose escalation study followed by a dose expansion in BCR patients after primary definitive local therapy (prostatectomy +/- salvage radiotherapy or primary definitive radiotherapy). Eligible patients were screened for urine tetrahydrocannabinol prior to enrollment. The starting dose level of Epidiolex was 600 mg by mouth once daily and escalated to 800 mg daily with the use of a Bayesian optimal interval design. All patients were treated for 90 days followed by a 10-day taper. The primary endpoints were safety and tolerability. Changes in PSA, testosterone levels, and patient-reported health-related quality of life were studied as secondary endpoints. RESULTS Seven patients were enrolled into the dose escalation cohort. There were no dose-limiting toxicities at the first two dose levels (600 mg and 800 mg). An additional 14 patients were enrolled at the 800 mg dose level into the dose expansion cohort. The most common adverse events were 55% diarrhea (grade 1-2), 25% nausea (grade 1-2), and 20% fatigue (grade 1-2). The mean PSA at baseline was 2.9 ng/mL. At the 12-week landmark time-point, 16 out of 18 (88%) had stable biochemical disease, one (5%) had partial biochemical response with the greatest measurable decline being 41%, and one (5%) had PSA progression. No statistically significant changes were observed in patient-reported outcomes (PROs), but PROs changed in the direction of supporting the tolerability of Epidiolex (e.g., emotional functioning improved). CONCLUSION Epidiolex at a dose of 800 mg daily appears to be safe and tolerable in patients with BCR prostate cancer supporting a safe dose for future studies.
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Affiliation(s)
- Zin W. Myint
- Department of Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY 40536, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
| | - William H. St. Clair
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Radiation Medicine, University of Kentucky, Lexington, KY 40536, USA
| | - Stephen E. Strup
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Urology, University of Kentucky, Lexington, KY 40536, USA
| | - Donglin Yan
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY 40536, USA
| | - Ning Li
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY 40536, USA
| | - Derek B. Allison
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY 40536, USA
| | - Laurie E. McLouth
- Department of Behavioral Science, University of Kentucky, Lexington, KY 40536, USA
| | - Carleton S. Ellis
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA
| | - Peng Wang
- Department of Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY 40536, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
| | - Andrew C. James
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Urology, University of Kentucky, Lexington, KY 40536, USA
| | - Patrick J. Hensley
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Urology, University of Kentucky, Lexington, KY 40536, USA
| | - Danielle E. Otto
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA
| | - Susanne M. Arnold
- Department of Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY 40536, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
| | - Robert S. DiPaola
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
| | - Jill M. Kolesar
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA
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Desbène C, Boissan M, Loric S, Lamy PJ, Piéroni L. [Immuno-analytical characteristics of PSA and derived biomarkers (total PSA, free PSA, p2PSA)]. Ann Biol Clin (Paris) 2023; 81:7-23. [PMID: 36757372 DOI: 10.1684/abc.2023.1782] [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] [Indexed: 02/10/2023]
Abstract
Prostate-specific antigen (PSA) is the recommended tumor marker for individual screening and follow-up of prostate cancer. This paper reviews main structural and physiological data about prostate specific antigen isoforms: total PSA, free PSA, [-2]proPSA (also named p2PSA). It describes the pre-, per- and post-analytical conditions for these different parameters. It presents the interpretation of results and derived calculated indices (free/total PSA ratio, Prostate Health Index or PHI) for the management of prostate cancer (initial diagnosis and follow-up).
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Affiliation(s)
- Cédric Desbène
- Laboratoire de Biochimie-Site Tenon, DMU BioGeM, AP-HP-Sorbonne Université, Département de Biochimie-Hormonologie-Suivi Thérapeutique, Hôpital Tenon, 4 rue de la Chine 75020 Paris, France
| | - Mathieu Boissan
- Laboratoire de Biochimie-Site Tenon, DMU BioGeM, AP-HP-Sorbonne Université, Département de Biochimie-Hormonologie-Suivi Thérapeutique, Hôpital Tenon, 4 rue de la Chine 75020 Paris, France, Sorbonne Universités, UPMC Univ Paris 6, INSERM, UMR_S 938, Centre de Recherche Saint-Antoine, Paris, France
| | - Sylvain Loric
- INSERM, UMR_S 938, Biologie et thérapeutiques du cancer, Centre de Recherche Saint-Antoine, Paris, France
| | - Pierre-Jean Lamy
- Institut d'Analyse Génomique, Imagenome, Labosud-Groupe INOVIE, Montpellier. France, Unité de Recherche Clinique. Clinique Beau Soleil, Montpellier, France
| | - Laurence Piéroni
- Laboratoire de Biochimie-Site Tenon, DMU BioGeM, AP-HP-Sorbonne Université, Département de Biochimie-Hormonologie-Suivi Thérapeutique, Hôpital Tenon, 4 rue de la Chine 75020 Paris, France
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Juracek J, Madrzyk M, Stanik M, Ruckova M, Trachtova K, Malcikova H, Lzicarova E, Barth DA, Pichler M, Slaby O. A tissue miRNA expression pattern is associated with disease aggressiveness of localized prostate cancer. Prostate 2023; 83:340-351. [PMID: 36478451 DOI: 10.1002/pros.24466] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Prostate cancer (PCa) is a heterogeneous malignancy with high variability in clinical course. Insufficient stratification according to the aggressiveness at the time of diagnosis causes unnecessary or delayed treatment. Current stratification systems are not effective enough because they are based on clinical, surgical or biochemical parameters, but do not take into account molecular factors driving PCa cancerogenesis. MicroRNAs (miRNAs) are important players in molecular pathogenesis of PCa and could serve as valuable biomarkers for the assessment of disease aggressiveness and its prognosis. METHODS In the study, in total, 280 PCa patients were enrolled. The miRNA expression profiles were analyzed in FFPE PCa tissue using the miRCURY LNA miRNA PCR System. The expression levels of candidate miRNAs were further verified by two-level validation using the RT-qPCR method and evaluated in relation to PCa stratification reflecting the disease aggressiveness. RESULTS MiRNA profiling revealed 172 miRNAs dysregulated between aggressive (ISUP 3-5) and indolent PCa (ISUP 1) (p < 0.05). In the training and validation cohort, miR-15b-5p and miR-106b-5p were confirmed to be significantly upregulated in tissue of aggressive PCa when their level was associated with disease aggressiveness. Furthermore, we established a prognostic score combining the level of miR-15b-5p and miR-106b-5p with serum PSA level, which discriminated indolent PCa from an aggressive form with even higher analytical parameters (AUC being 0.9338 in the training set and 0.8014 in the validation set, respectively). The score was also associated with 5-year biochemical progression-free survival (bPFS) of PCa patients. CONCLUSIONS We identified a miRNA expression pattern associated with disease aggressiveness in prostate cancer patients. These miRNAs may be of biological interest as the focus can be also set on their specific role within the molecular pathology and the molecular mechanism that underlies the aggressivity of prostate cancer.
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Affiliation(s)
- Jaroslav Juracek
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Marie Madrzyk
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Michal Stanik
- Department of Urologic Oncology, Clinic of Surgical Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Michaela Ruckova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Karolina Trachtova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Hana Malcikova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Eva Lzicarova
- Department of Oncological Pathology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Dominik A Barth
- Department of Internal Medicine, Division of Oncology, Medical University of Graz, Graz, Austria
| | - Martin Pichler
- Department of Internal Medicine, Division of Oncology, Medical University of Graz, Graz, Austria
| | - Ondrej Slaby
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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20
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Höti N, Lih TS, Dong M, Zhang Z, Mangold L, Partin AW, Sokoll LJ, Kay Li Q, Zhang H. Urinary PSA and Serum PSA for Aggressive Prostate Cancer Detection. Cancers (Basel) 2023; 15:cancers15030960. [PMID: 36765916 PMCID: PMC9913326 DOI: 10.3390/cancers15030960] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 02/05/2023] Open
Abstract
Serum PSA, together with digital rectal examination and imaging of the prostate gland, have remained the gold standard in urological practices for the management of and intervention for prostate cancer. Based on these adopted practices, the limitations of serum PSA in identifying aggressive prostate cancer has led us to evaluate whether urinary PSA levels might have any clinical utility in prostate cancer diagnosis. Utilizing the Access Hybritech PSA assay, we evaluated a total of n = 437 urine specimens from post-DRE prostate cancer patients. In our initial cohort, PSA tests from a total of one hundred and forty-six (n = 146) urine specimens were obtained from patients with aggressive (Gleason Score ≥ 8, n = 76) and non-aggressive (Gleason Score = 6, n = 70) prostate cancer. A second cohort, with a larger set of n = 291 urine samples from patients with aggressive (GS ≥ 7, n = 168) and non-aggressive (GS = 6, n = 123) prostate cancer, was also utilized in our study. Our data demonstrated that patients with aggressive disease had lower levels of urinary PSA compared to the non-aggressive patients, while the serum PSA levels were higher in patients with aggressive prostate disease. The discordance between serum and urine PSA levels was further validated by immuno-histochemistry (IHC) assay in biopsied tumors and in metastatic lesions (n = 62). Our data demonstrated that aggressive prostate cancer was negatively correlated with the PSA in prostate cancer tissues, and, unlike serum PSA, urinary PSA might serve a better surrogate for capitulating tissue milieus to detect aggressive prostate cancer. We further explored the utility of urine PSA as a cancer biomarker, either alone and in combination with serum PSA, and their ratio (serum to urine PSA) to predict disease status. Comparing the AUCs for the urine and serum PSA alone, we found that urinary PSA had a higher predictive power (AUC= 0.732) in detecting aggressive disease. Furthermore, combining the ratios between serum to urine PSA with urine and serum assay enhanced the performance (AUC = 0.811) in predicting aggressive prostate disease. These studies support the role of urinary PSA in combination with serum for detecting aggressive prostate cancer.
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Affiliation(s)
- Naseruddin Höti
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pathology, University of Maryland Medical Center, Baltimore, MD 21201, USA
| | - Tung-Shing Lih
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Mingming Dong
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Zhen Zhang
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Leslie Mangold
- Department of Urology, The Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Alan W. Partin
- Department of Urology, The Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Lori J. Sokoll
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
- Department of Urology, The Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Qing Kay Li
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Hui Zhang
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
- Department of Urology, The Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Correspondence: ; Tel.: +410-502-8149; Fax: +443-287-6388
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21
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Rushworth LK, Loveridge C, Salji M, MacLeod M, Mui E, Sumpton D, Neilson M, Hedley A, Alexander L, McCartney E, Patel R, Wallace J, Delles C, Jones R, Leung HY. Phase II proof-of-concept study of atorvastatin in castration-resistant prostate cancer. BJU Int 2023; 131:236-243. [PMID: 35844167 PMCID: PMC10087532 DOI: 10.1111/bju.15851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To test for evidence of statin-mediated effects in patients with castration-resistant prostate cancer (CRPC) as post-diagnosis use of statins in patients with prostate cancer is associated with favourable survival outcome. PATIENTS AND METHODS The SPECTRE trial was a 6-weeks-long proof-of-concept single-arm Phase II treatment trial, combining atorvastatin and androgen deprivation therapy in patients with CRPC (regardless of metastatic status), designed to test for evidence of statin-mediated effects in patients with CRPC. The primary study endpoint was the proportion of patients achieving a ≥50% drop from baseline in prostate-specific antigen (PSA) levels at any time over the 6-week period of atorvastatin medication (PSA response). Exploratory endpoints include PSA velocity and serum metabolites identified by mass spectrometry . RESULTS At the scheduled interim analysis, one of 12 patients experienced a ≥50% drop in PSA levels (primary endpoint), with ≥2 patients satisfying the primary endpoint required for further recruitment. All 12 patients experienced substantial falls in serum cholesterol levels following statin treatment. While all patients had comparable pre-study PSA velocities, six of 12 patients showed decreased PSA velocities after statin treatment, suggestive of disease stabilization. Unbiased metabolomics analysis on serial weekly blood samples identified tryptophan to be the dominant metabolite associated with patient response to statin. CONCLUSIONS Data from the SPECTRE study provide the first evidence of statin-mediated effects on CRPC and early sign of disease stabilization. Our data also highlight the possibility of altered tryptophan metabolism being associated with tumour response.
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Affiliation(s)
- Linda K. Rushworth
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| | - Carolyn Loveridge
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| | - Mark Salji
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| | - Martin MacLeod
- Beatson West of Scotland Cancer CentreGlasgowUK
- CRUK West of Scotland Clinical Trials UnitGlasgowUK
| | - Ernest Mui
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
| | | | | | | | - Laura Alexander
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK West of Scotland Clinical Trials UnitGlasgowUK
| | - Elaine McCartney
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK West of Scotland Clinical Trials UnitGlasgowUK
| | | | - Jan Wallace
- Beatson West of Scotland Cancer CentreGlasgowUK
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Rob Jones
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- Beatson West of Scotland Cancer CentreGlasgowUK
- CRUK West of Scotland Clinical Trials UnitGlasgowUK
| | - Hing Y. Leung
- Institute of Cancer Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- CRUK Beatson InstituteGlasgowUK
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22
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Pan Y, Shen C, Chen X, Cao D, Jiang J, Xu W, Ji C, Pan X, Zheng B. bpMRI and mpMRI for detecting prostate cancer: A retrospective cohort study. Front Surg 2023; 9:1096387. [PMID: 36726941 PMCID: PMC9885087 DOI: 10.3389/fsurg.2022.1096387] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/13/2022] [Indexed: 01/17/2023] Open
Abstract
Background We aimed to compare the detection rates of prostate cancer (PCa) and clinically significant prostate cancer(csPCa) by biparametric (bp-) and multiparameter magnetic resonance imaging (mpMRI). Materials and Methods A total of 699 patients who underwent transperineal prostate biopsy in the Department of Urology, the Second Affiliated Hospital of Nantong University from January 2018 to December 2021 were retrospectively reviewed. Multivariate analysis was used to explore the influencing factors associated with the detection rates of PCa and csPCa. According to MRI examination before biopsy, the patients were divided into bpMRI group and mpMRI group. The detection rates of PCa and csPCa by bpMRI and mpMRI were compared. Furthermore, stratified analysis was performed for patients in these two groups to compare the detection rates of PCa and csPCa at different tPSA intervals, different prostate volume (PV) intervals and different PI-RADS V2 scores. Results A total of 571 patients were finally analyzed in this study after exclusion, and the overall detection rate of PCa was 54.5%. Multivariate analysis showed that patient age, tPSA level, prostate volume and PI-RADS V2 score were independent risk factors affecting the detection rates of PCa and csPCa. The detection rates of PCa and csPCa by bpMRI and mpMRI were comparable (51.3% vs. 57.9%, 44.0% vs. 48.0%, both P > 0.05), with no statistical significance. In the tPSA 10-20 ng/ml interval, the detection rates of PCa (59.72% vs. 40.35%, P = 0.011) and csPCa (51.39% vs. 28.82%, P = 0.005) by mpMRI were significantly higher than those by bpMRI, while in other tPSA interval (tPSA < 4 ng/ml, 4-10 ng/ml, 20-100 ng/ml), different PVs (≤30 ml, 30-60 ml, >60 ml) and different PI-RADS V2 scores (3, 4, and 5), the detection rates of PCa and csPCa were comparable between the two groups. Conclusion For detecting PCa and csPCa, bpMRI and mpMRI had similar diagnostic efficacies, whereas mpMRI detected more PCa and csPCa in the tPSA interval of 10-20 ng/ml.
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Affiliation(s)
- Yongsheng Pan
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Cheng Shen
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China,Medical Research Center, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Xinfeng Chen
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Dongliang Cao
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Jie Jiang
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Wei Xu
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China,Medical Research Center, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Chen Ji
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Xiaodong Pan
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Bing Zheng
- Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China,Correspondence: Bing Zheng
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23
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Chang LW, Wang SS, Yang CK, Lu K, Chen CS, Cheng CL, Hung SC, Chiu KY, Hsu CY, Li JR. Risk Analysis of Prostate Cancer Development Following Five-alpha Reductase Inhibitor Treatment for Benign Prostate Hyperplasia. Anticancer Res 2023; 43:485-491. [PMID: 36585197 DOI: 10.21873/anticanres.16185] [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: 09/13/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND/AIM The clinical hazard of prostate cancer development after five-alpha reductase inhibitors (5ARI) treatment among benign prostate hyperplasia (BPH) patients is still controversial. The aim of this study was to evaluate the epidemiological features of BPH patients treated in a single institute to identify risk factors associated with prostate cancer development. PATIENTS AND METHODS We retrospectively analyzed patients who were diagnosed with BPH and received alpha blockers (AB) only or 5ARI between January 2007 and December 2012 and followed up until death or December 2020. The primary study outcome was prostate cancer and high-grade prostate cancer. RESULTS Of the 5,122 included patients, 14.9% (762/5,122) received 5ARI during their BPH treatment. The median age, initial prostate specific antigen (PSA) levels and the PSA change were significantly higher in the 5ARI group compared to those of the AB group. The prostate cancer diagnosis rate was higher in the 5ARI group, and the percentage of high-grade prostate cancer was not different between the two groups. In total, 1,715 (33.5%) patients were recorded dead, and the median follow-up period was longer in the 5ARI group. In Cox regression analysis, only age and initial PSA levels were significantly associated with prostate cancer. Late PSA was the only independent factor associated with high-grade prostate cancer development. CONCLUSION Our real-world data revealed that age, initial PSA, and late PSA levels were associated with prostate cancer and high-grade prostate cancer diagnosis among BPH patients. Furthermore, 5ARI use had no effect on prostate cancer patient survival. However, PSA assessment during follow-up is still required in our institutional practice to avoid delayed diagnosis.
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Affiliation(s)
- Li-Wen Chang
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Shian-Shiang Wang
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.,Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan, R.O.C
| | - Cheng-Kuang Yang
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Kevin Lu
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Chuan-Shu Chen
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
| | - Chen-Li Cheng
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
| | - Sheng-Chun Hung
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
| | - Kun-Yuan Chiu
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.,Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan, R.O.C
| | - Chiann Yi Hsu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Jian-Ri Li
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.; .,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.,Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan, R.O.C.,Division of Surgical Intensive Care Unit, Department of Intensive Care, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.,Department of Medicine and Nursing, Hungkuang University, Taichung, Taiwan, R.O.C.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan, R.O.C
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24
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Bakhshandeh N, Mohammadi M, Mohammadi P, Nazari E, Damchi M, Khodabandelu S, Mokhtari H. Increased expression of androgen receptor and PSA genes in LNCaP (prostate cancer) cell line due to high concentrations of EGCG, an active ingredient in green tea. Horm Mol Biol Clin Investig 2022:hmbci-2022-0054. [PMID: 36578191 DOI: 10.1515/hmbci-2022-0054] [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: 06/02/2022] [Accepted: 12/11/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Androgen receptor (AR) play a key role in the onset and progression of prostate cancer. Epigallocatechin-3-gallate (EGCG) is a polyphenolic compound and the active ingredient in green tea, which is involved in modulating gene expression through epigenetic alterations. Previous studies have shown that EGCG at low concentrations reduces the expression of AR and prostate-specific antigen (PSA) in the LNCaP cell line of prostate cancer. In this study, the effect of higher EGCG concentrations on AR and PSA expression in LNCaP prostate cancer cell line was investigated. METHODS In this study, LNCaP prostate cancer cell line was used and after MTT test, concentrations of 40, 60 and 80 μg/mL EGCG were used for treatment. Then, the expression of AR and PSA genes was evaluated by RT-PCR. AR protein expression was also assessed by Western blotting. RESULTS The present study showed that treatment of LNCaPs cells by EGCG reduces cell proliferation. The IC50 value was 42.7 μg/mL under experimental conditions. It was also observed that EGCG at concentrations of 40 and 80 μg/mL increased the expression of AR and PSA (p<0.05). CONCLUSIONS The present study showed that the effect of EGCG on AR expression was different at different concentrations, so that unlike previous studies, higher concentrations of EGCG (80 and 40 μg/mL) increased AR and PSA expression. It seems that due to the toxic effects of EGCG in high concentrations on cancer cells and the possibility of its effect on normal cells, more caution should be exercised in its use.
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Affiliation(s)
- Nadereh Bakhshandeh
- Department of Medical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Mohammadi
- Health System Research, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Parisa Mohammadi
- Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Elahe Nazari
- Department of Biology, Islamic Azad University, Gorgan Branch, Gorgan, Iran
| | - Mehdi Damchi
- Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Sajad Khodabandelu
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hossein Mokhtari
- Amol Faculty of Paramedicine, Mazandaran University of Medical Sciences, Sari, Iran
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25
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Sadeghi A, Saedisomeolia A, Jalili-Baleh L, Khoobi M, Soleimani M, Fakhr Yasseri AM, Yekaninejad MS, Farzin A, Amini E, Nowroozi MR. FruHis significantly increases the anti-benign prostatic hyperplasia effect of lycopene: A double-blinded randomized controlled clinical trial. Front Nutr 2022; 9:1011836. [PMID: 36407517 PMCID: PMC9668902 DOI: 10.3389/fnut.2022.1011836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/04/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND For decades, lycopene was considered the main compound of tomato protecting benign prostatic hyperplasia (BPH). Recent animal studies suggest that a newly discovered compound "FruHis" boosts lycopene for its action. This study aimed to determine whether FruHis enhances the action of lycopene to modify the laboratory parameters and clinical outcomes of patients with BPH. MATERIALS AND METHODS Current study was conducted on 52 BPH patients, who were randomly assigned into four groups of treatments: lycopene plus FruHis (n = 11, 25 mg/day lycopene and 10 mg/day FruHis), lycopene (n = 12, 25 mg/day lycopene), FruHis (n = 12, 10 mg/day FruHis), and placebo (n = 13). Patients received these supplements for 8 weeks. RESULTS FruHis intake strengthened the reducing effects of lycopene on insulin-like growth factor-1 (IGF-1) (-54.47 ± 28.36 ng/mL in the lycopene + FruHis group vs. -30.24 ± 46.69 ng/mL in the lycopene group), total prostate-specific antigen (TPSA) (-1.49 ± 4.78 ng/mL in the lycopene + FruHis group vs. -0.64 ± 2.02 ng/mL in the lycopene group), and symptom score (-4.45 ± 4.03 in the lycopene + FruHis group vs. -1.66 ± 5.41 in the lycopene group) in BPH patients. Such findings were also seen for body mass index (BMI) and waist circumference (WC). However, except for IGF-1, these reductions were not statistically significant compared with the placebo, and the intakes of lycopene and FruHis alone, however, were clinically important. Such effects of lycopene and FruHis were not seen for free PSA (FPSA) and FPSA/TPSA ratio. CONCLUSION Despite the non-significant effects of lycopene and FruHis, it seems that FruHis intake strengthens the beneficial effects of lycopene on IGF-1, TPSA, and symptom scores among BPH patients. CLINICAL TRIAL REGISTRATION [www.irct.ir], identifier [IRCT20190522043669N1].
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Affiliation(s)
- Alireza Sadeghi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ahmad Saedisomeolia
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Leili Jalili-Baleh
- Department of Medical Chemistry, Faculty of Pharmacy and Pharmaceutical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Khoobi
- Department of Radiopharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Department of Urology, Modares University Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirreza Farzin
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Amini
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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26
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Jia L, Strand DW, Goueli RS, Gahan JC, Roehrborn CG, Mauck RJ. PSA density is associated with BPH cellular composition. Prostate 2022; 82:1162-1169. [PMID: 35652548 PMCID: PMC9329225 DOI: 10.1002/pros.24367] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/23/2022] [Accepted: 04/20/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Current AUA guidelines recommend 5 alpha reductase inhibitor (5ARI) treatment for patients with obstructive benign prostatic hyperplasia (BPH) that display prostate volume ≥30 cc and total prostate specific antigen (PSA) ≥1.5 ng/ml. However, BPH is highly pleomorphic and response to 5ARIs is highly variable. An understanding of cellular composition based on a noninvasive PSA density test could lead to improved clinical decision making. METHODS The histological composition of 307 BPH specimens was scored by a pathologist for stromo-glandular content and associated with total PSA, prostate volume, PSA density and other clinical variables using univariate and multivariate linear regression. RESULTS The percentage of glandular composition in prostates of 5ARI-naïve men was positively and independently associated with PSA and PSA density. It was determined through statistical modeling that a PSA density ≤0.05 ng/ml2 associated with a glandular composition of ≤30% with 76% sensitivity. CONCLUSIONS PSA density could provide a decisive variable for estimating BPH cellular content and may eventually improve selection of patients for 5ARI treatment. Further work is needed to demonstrate that patients with higher glandular content are more responsive to 5ARI treatment.
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Affiliation(s)
- Liwei Jia
- Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Douglas W Strand
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Ramy S Goueli
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jeffrey C Gahan
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Claus G Roehrborn
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Ryan J Mauck
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas, USA
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27
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Abstract
In response to an urgent need for advanced formulations for the delivery of anti-retrovirals, a stimuli-sensitive hydrogel formulation that intravaginally delivers HIV-1 entry inhibitor upon being exposed to a specific protease was developed. The hydrogel formulation consists of PEG-azide and PEG-DBCO covalently linked to the entry inhibitor peptide, enfuvirtide, via substrate linker that is designed to undergo proteolysis by prostate specific antigen (PSA) present in seminal fluid and release innate enfuvirtide. Of the tested PSA substrate linkers (HSSKLQYY, GISSFYSSK, AYLMYY, and AYLMGRR), HSSKLQ was found to be an optimal candidate for PEG-based hydrogel with kcat/KM of 2.2 M-1 s-1. The PEG-based hydrogel displayed a pseudoplastic, thixotropic behavior with overall viscosity varying between 1516 and 2.2 Pa.s, within the biologically relevant shear rates of 0.01-100 s-1. It also exhibited viscoelastic properties appropriate for uniform spreading and being retained in vagina. PEG-based hydrogels were loaded with N3-HSSKLQ-enfuvirtide (HF42) that is customarily synthesized enfuvirtide prodrug with its N-terminus connected to HSSKLQ linker. The stimuli-sensitive PEG-based hydrogel formulations upon being exposed to PSA released 36.5 ± 4.8% of enfuvirtide over 24 h in human ejaculate mimic of vaginal simulant fluid and seminal simulant fluid mixed in 1:3 ratio, which is significantly greater than its IC50. The PEG-based hydrogel was non-cytotoxic to both vaginal epithelial cells (VK2/E6E7) and murine macrophages (RAW 264.7) and did not significantly induce the production of nitric oxide, an inflammatory mediator. The PEG-based hydrogel is found to have suitable physicochemical properties for an intravaginal formulation of the PSA substrate-linked anti-retrovirals and is safe towards vaginal epithelium. It is capable of delivering enfuvirtide with effective concentrations to prevent women from HIV-1 infection.
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Affiliation(s)
- Taj Yeruva
- Division of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Missouri, 2464 Charlotte Street, HSB 4242, Kansas City, MO, 64108, USA
| | - Chi H Lee
- Division of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Missouri, 2464 Charlotte Street, HSB 4242, Kansas City, MO, 64108, USA.
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Kanabolo D, True L, Vakar-Lopez F, Tretiakova M, Nyame YA. Prostate Specific Antigen (PSA) Screening and a Lifesaving Cardiac Transplant. Urology 2022; 168:e1-e2. [PMID: 35914586 DOI: 10.1016/j.urology.2022.07.033] [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] [Received: 04/25/2022] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Diboro Kanabolo
- Department of Urology, University of Washington Medical Center, Seattle, WA.
| | - Lawrence True
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Funda Vakar-Lopez
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Maria Tretiakova
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Yaw A Nyame
- Department of Urology, University of Washington Medical Center, Seattle, WA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center
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Tasmeera E, Bawinile H, Colleen A, Tinarwo P, Nyakale N. Segmented linear correlations between bone scan index and prostate cancer biomarkers, alkaline phosphatase, and prostate specific antigen in patients with a Gleason score ≥7. Medicine (Baltimore) 2022; 101:e29515. [PMID: 35758394 PMCID: PMC9276229 DOI: 10.1097/md.0000000000029515] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/06/2022] [Indexed: 11/27/2022] Open
Abstract
Technetium-99m methyl diphosphonate bone scintigraphy is relatively easily accessible for detecting bone metastases in prostate cancer patients. However, it is subjective and can be challenging to compare images taken at different time points. The bone scan index (BSI) is a more objective evaluation and allows for better comparison of images. Its correlation with other biomarkers of prostate cancer metastases such as prostate specific antigen (PSA) and alkaline phosphatase (ALP) is not clearly understood. This study thus aimed to compare the BSI correlation to PSA against that of BSI to ALP levels in patients with a Gleason score ≥7.A retrospective analysis of the medical records of 50 prostate cancer patients with a Gleason score of ≥7 referred for a bone scan between January 1, 2015 and December 31, 2018 was undertaken. Bone scans were interpreted visually, and using a semi-automated computer programme to quantify the BSI and its relation to PSA and ALP measurements.For the metastasis positive measurements, there was a statistically significant moderate positive overall linear correlation between BSI and PSA. For ALP and BSI, there were 2 segmented strong positive linear relationships between them. The first segment consisted of ALP < 375 IU/L and BSI >10%, where ALP and BSI were strongly and positively correlated. The other segment tended to have generally low BSI measurements (<10%) and also had a strong and positive correlation.The BSI was found to be better linearly correlated with ALP than PSA.
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Affiliation(s)
- Ebrahim Tasmeera
- Department of Nuclear Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Nuclear Medicine, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Hadebe Bawinile
- Department of Nuclear Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Nuclear Medicine, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Aldous Colleen
- College of Health Sciences, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Partson Tinarwo
- Department of Biostatistics, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Nozipho Nyakale
- Department of Nuclear Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Nuclear Medicine, Sefako Makgatho Health Sciences University and Dr George Mukhari Academic Hospital, Pretoria, South Africa
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Feng Y, Liu G, Zhang C, Li J, Li Y, Liu L. Fluorescent Immunoassay with a Copper Polymer as the Signal Label for Catalytic Oxidation of O-Phenylenediamine. Molecules 2022; 27:3675. [PMID: 35744801 DOI: 10.3390/molecules27123675] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 01/08/2023]
Abstract
This work suggested that Cu2+ ion coordinated by the peptide with a histidine (His or H) residue in the first position from the free N-terminal reveals oxidase-mimicking activity. A biotinylated polymer was prepared by modifying His residues on the side chain amino groups of lysine residues (denoted as KH) to chelate multiple Cu2+ ions. The resulting biotin-poly-(KH-Cu)20 polymer with multiple catalytic sites was employed as the signal label for immunoassay. Prostate specific antigen (PSA) was determined as the model target. The captured biotin-poly-(KH-Cu)20 polymer could catalyze the oxidation of o-phenylenediamine (OPD) to produce fluorescent 2,3-diaminophenazine (OPDox). The signal was proportional to PSA concentration from 0.01 to 2 ng/mL, and the detection limit was found to be eight pg/mL. The high sensitivity of the method enabled the assays of PSA in real serum samples. The work should be valuable for the design of novel biosensors for clinical diagnosis.
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31
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Wald NJ, Bestwick JP, Morris JK. Multi-marker risk-based screening for prostate cancer. J Med Screen 2022; 29:123-133. [PMID: 35255236 PMCID: PMC9087319 DOI: 10.1177/09691413221076415] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 12/21/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine prostate cancer screening performance using prostate specific antigen (PSA) along with other markers, expressing markers in age-specific multiples of the median (MoM), and age. METHODS A prospective nested case-control study used stored serum from 571 men who died of, or with history of, prostate cancer (cases), and 2169 matched controls. Total, free and intact PSA, human kallikrein-related peptidase 2 (hK2), and microseminoprotein were measured and converted into MoM values. Screening marker distribution parameters were estimated in cases and controls. Monte Carlo simulation used these in a risk-based algorithm to estimate screening performance (detection rates [DRs] and false-positive rates [FPRs]). RESULTS Almost all (99%) cases occurred aged ≥55. Marker values were similar in cases who did and did not die of prostate cancer. Combining age, total PSA and hK2 MoM values (other markers added little or no discrimination) yielded a 1.2% FPR (95% CI 0.2-4.8%) for a 90% DR (59-98%) in men who died of or with a prostate cancer diagnosis within 5 years of blood collection (risk cut-off 1 in 20), two-thirds less than the 4.5% FPR using total PSA alone measured in ng/ml for the same 90% DR (cut-off 3.1 ng/ml). Screening performance over 10 years yielded a 33% (22-46%) FPR for a 90% DR. CONCLUSION Screening performed up to every 5 years from age 55 using the multi-marker risk-based screening algorithm for future prostate cancer achieves a high DR and a much lower FPR than using PSA alone, resulting in reductions in overdiagnosis and overtreatment.
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Affiliation(s)
- Nicholas J Wald
- Institute of Health Informatics, University College London, London, UK
- Population Health Research Institute, St George’s University of
London, London, UK
| | - Jonathan P Bestwick
- Wolfson Institute of Population Health, Queen Mary University of
London, London, UK
| | - Joan K Morris
- Population Health Research Institute, St George’s University of
London, London, UK
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Ferraro S, Biganzoli EM, Plebani M. Reply to: Spurious results for total and free prostate-specific antigen (PSA); sometimes really "a riddle wrapped in a mystery inside an enigma". Clin Chem Lab Med 2022; 60:e95-e96. [PMID: 35258238 DOI: 10.1515/cclm-2022-0088] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Simona Ferraro
- Endocrinology Laboratory Unit, "Luigi Sacco" University Hospital, Milan, Italy
| | - Elia Mario Biganzoli
- Medical Statistics Unit, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Mario Plebani
- Department of Medicine-DIMED, University of Padova, Padova, Italy
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Zacharouli K, Vageli DP, Koukoulis GK, Ioannou M. Patient with prostatic adenocarcinoma with plasmacytoid features and an aberrant immunohistochemical phenotype diagnosed by biopsy and a mini-review of plasmacytoid features in the genitourinary system: A case report. Mol Clin Oncol 2022; 16:67. [PMID: 35154707 DOI: 10.3892/mco.2022.2500] [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: 11/15/2021] [Accepted: 12/31/2021] [Indexed: 11/05/2022] Open
Abstract
Prostate cancer is one of the most commonly diagnosed malignancies in men. Most of these tumors are adenocarcinomas. Plasmacytoid is a rare variant of adenocarcinoma described by previous studies in the genitourinary system and is characterized by the plasmacytoid appearance of tumor cells with abundant cytoplasm and abnormally placed hyperchromatic nuclei. However, to the best of our knowledge, plasmacytoid adenocarcinoma has rarely been described in the prostate. This report describes a new case of plasmacytoid adenocarcinoma of the prostate diagnosed by biopsy and summarizes the known literature on plasmacytoid features in the genitourinary system. A 62-year-old male patient presented to the hospital with urinary retention, hematuria, weakness and weight loss. The digital rectal examination revealed an irregular enlargement. Laboratory findings showed elevated levels of prostate specific antigen (PSA; 43.6 ng/ml). Transrectal ultrasound showed invasion of the right seminal vesicle. Prostate tumor core biopsies were collected and sent for diagnosis. Histological examination revealed a high-grade prostatic adenocarcinoma Gleason score of 5+5 (total score 10). The tumor cells had a plasmacytoid appearance with abundant cytoplasm and abnormally placed hyperchromatic nuclei. The immunohistochemical phenotype was characterized by abundant positivity for cytokeratin (CK)AE1/AE3 and PSA. By contrast, tumor cells were negative for p63, CK 34BE12 and GATA binding protein 3 (urothelial markers), synaptophysin (neuroendocrine marker). Tumor cells were also negative for E-cadherin, which is particularly indicative of CDH1 alterations. To the best of our knowledge, this is the first description of a plasmacytoid adenocarcinoma of the prostate diagnosed by biopsy, showing an irregular immunophenotype that may indicate somatic CDH1 alterations. The presentation of a novel rare variant of prostatic carcinoma that differs from other neoplasms of the genitourinary system may contribute to an improved understanding of this uncommonly found histological pattern that may also be mandatory due to the clinical and prognostic implications of this diagnosis.
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Affiliation(s)
- Konstantina Zacharouli
- Department of Pathology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41500 Larissa, Greece
| | - Dimitra P Vageli
- Department of Pathology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41500 Larissa, Greece
| | - George K Koukoulis
- Department of Pathology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41500 Larissa, Greece
| | - Maria Ioannou
- Department of Pathology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41500 Larissa, Greece
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Aktary ML, Ghebrial M, Wang Q, Shack L, Robson PJ, Kopciuk KA. Health-Related and Behavioral Factors Associated With Lung Cancer Stage at Diagnosis: Observations From Alberta's Tomorrow Project. Cancer Control 2022; 29:10732748221091678. [PMID: 35392690 PMCID: PMC9016563 DOI: 10.1177/10732748221091678] [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] [Indexed: 12/24/2022] Open
Abstract
Background Lung cancer is the leading cause of cancer death in Canada, with stage at
diagnosis among the top predictors of lung cancer survival. Identifying
factors associated with stage at diagnosis can help reduce lung cancer
morbidity and mortality. This study used data from a prospective cohort
study of adults living in Alberta, Canada to examine factors associated with
lung cancer stage at diagnosis. Methods This cohort study used data from adults aged 35–69 years enrolled in
Alberta’s Tomorrow Project. Partial Proportional Odds models were used to
examine associations between sociodemographic characteristics and
health-related factors and subsequent lung cancer stage at diagnosis. Results A total of 221 participants (88 males and 133 females) developed lung cancer
over the study period. Nearly half (48.0%) of lung cancers were diagnosed at
a late stage (stage IV), whereas 30.8 % and 21.3% were diagnosed at stage
I/II and III, respectively. History of sunburn in the past year was
protective against late-stage lung cancer diagnosis (odds ratio (OR) .40,
P=.005). In males, a higher number of lifetime prostate specific antigen
tests was associated with reduced odds of late-stage lung cancer diagnosis
(odds ratio .66, P=.02). Total recreational physical activity was associated
with increased odds of late-stage lung cancer diagnosis (OR 1.08,
P=.01). Discussion Lung cancer stage at diagnosis remains a crucial determinant of prognosis.
This study identified important factors associated with lung cancer stage at
diagnosis. Study findings can inform targeted cancer prevention initiatives
towards improving early detection of lung cancer and lung cancer
survival.
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Affiliation(s)
- Michelle L Aktary
- Faculty of Kinesiology, 2129University of Calgary, Calgary, Alberta, Canada
| | - Monica Ghebrial
- Cumming School of Medicine, 2129University of Calgary, Calgary, Alberta, Canada
| | - Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, 3146Alberta Health Services, Calgary, Alberta, Canada
| | - Lorraine Shack
- Cancer Surveillance and Reporting, 3146Alberta Health Services, Calgary, Alberta, Canada
| | - Paula J Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Cancer Care Alberta, 3146Alberta Health Services, Edmonton, Alberta, Canada
| | - Karen A Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, 3146Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology, Community Health Sciences and Mathematics and Statistics, 2129University of Calgary, Calgary, Alberta, Canada
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35
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Zapała P, Kozikowski M, Dybowski B, Zapała Ł, Dobruch J, Radziszewski P. External validation of a magnetic resonance imaging-based algorithm for prediction of side-specific extracapsular extension in prostate cancer. Cent European J Urol 2021; 74:327-333. [PMID: 34729221 PMCID: PMC8552930 DOI: 10.5173/ceju.2021.0128.r2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Received: 05/03/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction Recently developed algorithm for prediction of side-specific extracapsular extension (ECE) of prostate cancer required validation before being recommended to use. The algorithm assumed that ECE on a particular side was not likely with same side maximum tumor diameter (MTD) <15 mm AND cancerous tissue in ipsilateral biopsy <15% AND PSA <20 ng/mL (both sides condition). The aim of the study was to validate this predictive tool in patients from another department. Material and methods Data of 154 consecutive patients (308 prostatic lateral lobes) were used for validation. Predictive factors chosen in the development set of patients were assessed together with other preoperative parameters using logistic regression to check for their significance. Sensitivity, specificity, negative and positive predictive values were calculated for bootstrapped risk-stratified validation dataset. Results Validation cohort did not differ significantly from development cohort regarding PSA, PSA density, Gleason score (GS), MTD, age, ECE and seminal vesicle invasion rate. In bootstrapped data set (n = 200 random sampling) algorithm revealed 70.2% sensitivity (95% confidence interval (CI) 58.8–83.0%), 49.9% specificity (95%CI: 42.0–57.7%), 83.9% negative predictive value (NPV; 95%CI: 76.1–91.4%) and 31.1% positive predictive value (PPV; 95%CI: 19.6–39.7%). When limiting analysis to high-risk patients (Gleason score >7) the algorithm improved its performance: sensitivity 91%, specificity 47%, PPV 53%, NPV 89%. Conclusions Analyzed algorithm is useful for identifying prostate lobes without ECE and deciding on ipsilateral nerve-sparing technique during radical prostatectomy, especially in patients with GS >7. Due to significant number of false positives in case of: MTD ≥15 mm OR cancer in biopsy ≥15% OR PSA ≥20 ng/mL additional evaluation is necessary to aid decision-making.
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Affiliation(s)
- Piotr Zapała
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Poland
| | - Mieszko Kozikowski
- Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Bartosz Dybowski
- Department of Urology, Roefler Memorial Hospital, Pruszków, Poland.,Faculty of Medicine, Lazarski University, Warsaw, Poland
| | - Łukasz Zapała
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Poland
| | - Jakub Dobruch
- Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Piotr Radziszewski
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Poland
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Jambor I, Martini A, Falagario UG, Ettala O, Taimen P, Knaapila J, Syvänen KT, Steiner A, Verho J, Perez IM, Merisaari H, Vainio P, Lamminen T, Saunavaara J, Carrieri G, Boström PJ, Aronen HJ. How to read biparametric MRI in men with a clinical suspicious of prostate cancer: Pictorial review for beginners with public access to imaging, clinical and histopathological database. Acta Radiol Open 2021; 10:20584601211060707. [PMID: 34868663 PMCID: PMC8638086 DOI: 10.1177/20584601211060707] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
Prostate Magnetic Resonance Imaging (MRI) is increasingly being used in men with a clinical suspicion of prostate cancer (PCa). Performing prostate MRI without the use of an intravenous contrast (IV) agent in men with a clinical suspicion of PCa can lead to reduced MRI scan time. Enabling a large array of different medical providers (from mid-level to specialized radiologists) to evaluate and potentially report prostate MRI in men with a clinical suspicion of PCa with a high accuracy could be one way to enable wide adoption of prostate MRI in men with a clinical suspicion of PCa. The aim of this pictorial review is to provide an insight into acquisition, quality control and reporting of prostate MRI performed without IV contrast agent in men with a clinical suspicion of PCa, aimed specifically at radiologists starting reporting prostate MRI, urologists, urology/radiology residents and mid-level medical providers without experience in reporting prostate MRI. Free public access (http://petiv.utu.fi/improd/and http://petiv.utu.fi/multiimprod/) to complete datasets of 161 and 338 men is provided. The imaging datasets are accompanied by clinical, laboratory and histopathological findings. Several topics are simplified in order to provide a solid base for the development of skills needed for an unsupervised review and potential reporting of prostate MRI in men with a clinical suspicion of PCa. The current review represents the first step towards enabling a large array of different medical providers to review and report accurately prostate MRI performed without IV contrast agent in men with a clinical suspicion of PCa.
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Affiliation(s)
- Ivan Jambor
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Department of Radiology, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| | - Alberto Martini
- Department of Oncology/Unit of
Urology, Urological Research Institute, IRCCS
Ospedale San Raffaele, Milan, Italy
| | - Ugo G Falagario
- Department of Urology and Organ
Transplantation, University of Foggia, Foggia, Italy
| | - Otto Ettala
- Department of Urology, University of Turku and Turku
University Hospital, Turku, Finland
| | - Pekka Taimen
- Institute of Biomedicine, University of Turku and Department of
Pathology, Turku University Hospital, Turku, Finland
| | - Juha Knaapila
- Department of Urology, University of Turku and Turku
University Hospital, Turku, Finland
| | - Kari T Syvänen
- Department of Urology, University of Turku and Turku
University Hospital, Turku, Finland
| | - Aida Steiner
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Medical Imaging Centre of Southwest
Finland, Turku University
Hospital, Turku, Finland
| | - Janne Verho
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Medical Imaging Centre of Southwest
Finland, Turku University
Hospital, Turku, Finland
| | - Ileana M Perez
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Harri Merisaari
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Paula Vainio
- Institute of Biomedicine, University of Turku and Department of
Pathology, Turku University Hospital, Turku, Finland
| | - Tarja Lamminen
- Department of Urology and Organ
Transplantation, University of Foggia, Foggia, Italy
| | - Jani Saunavaara
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Department of Medical Physics, Turku University
Hospital, Turku, Finland
| | - Giuseppe Carrieri
- Department of Urology and Organ
Transplantation, University of Foggia, Foggia, Italy
| | - Peter J Boström
- Department of Urology, University of Turku and Turku
University Hospital, Turku, Finland
| | - Hannu J Aronen
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Department of Oncology/Unit of
Urology, Urological Research Institute, IRCCS
Ospedale San Raffaele, Milan, Italy
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Micoogullari U, Cakici MC, Kisa E, Canda AE, Kilic FU, Ardicoglu A, Altinova S, Atmaca AF, Akbulut Z, Balbay MD. A risk grouping algorithm for predicting factors of persistently elevated prostate-specific antigen in patients following robot-assisted radical prostatectomy. Int J Clin Pract 2021; 75:e14495. [PMID: 34155724 DOI: 10.1111/ijcp.14495] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/11/2021] [Accepted: 06/10/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE After radical prostatectomy, prostate-specific antigen(PSA) value measuring ≥0.1 ng/mL is defined as persistent PSA(pPSA) and in many studies, it was found to be associated with aggressive disease and poor prognosis. Our aim in this study is to point out the pathological and clinical factors affecting pPSA among the patients who underwent robot-assisted radical prostatectomy(RARP) in an experienced academic centre and to make a useful risk grouping algorithm that can predict pPSA value based on operative data. METHODS We examined records of 1273 patients who underwent RARP retrospectively. Preoperative, operative and postoperative data were collected. Based on the PSA values (ng/mL) measured after 4-to-8 weeks of RARP, patients were divided into two groups as pPSA group (Group1)(n = 97) with PSA values ≥0.1 ng/mL and undetectable PSA group (Group2)(n = 778) with PSA values <0.1 ng/mL. Later on, Group1 was further divided into Group1a (PSA:0.1-0.2 ng/mL) and Group 1b (PSA≥0.2 ng/mL) to evaluate biochemical recurrence(BCR). RESULTS Multivariate logistic regression analyses of the collected data revealed that preoperative PSA≥20 ng/mL, operation time, a postoperative international society of urological pathology (ISUP) grade of ≥4, pT 3-4 and pN were independently associated with pPSA. Based on these results, a risk grouping algorithm predicting pPSA was developed. By looking at the risk grouping algorithm pPSA was found in 98.9% of the cases with a preoperative PSA value of ≥20 ng/mL, an operation time of 150 min, a postoperative ISUP grade of 4-5, a positive lymphovascular invasion (LVI) status, pT3-T4, and pN+; while pPSA was found in 25.5% of the cases with a preoperative PSA value of <20 ng/mL, an operation time of 100 min, a postoperative ISUP grade of <4-5, a negative LVI status, pT<3-4 and pN-. The estimated BCR-free survival time was 16.3 months in Group 1a and 57.0 months in Group2 (P < .001). Adjuvant treatment ratio was 64.9% in Group1 and 7.1% in Group2 (P < .001). CONCLUSION For the patients who underwent RARP, factors associated with aggressive disease can predict the PSA persistence. To plan our treatment modalities accurately, an applicable risk grouping algorithm in daily practice would be useful.
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Affiliation(s)
- Uygar Micoogullari
- Department of Urology, Tepecik Education and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Mehmet Caglar Cakici
- Department of Urology, School of Medicine, Istanbul Medeniyet University, İstanbul, Turkey
| | - Erdem Kisa
- Department of Urology, Tepecik Education and Research Hospital, University of Health Sciences, İzmir, Turkey
| | | | - Furkan Umut Kilic
- Department of Urology, School of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Arslan Ardicoglu
- Department of Urology, School of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | | | - Ali Fuat Atmaca
- Deparment of Urology, Memorial Hospital Ankara, Ankara, Turkey
| | - Ziya Akbulut
- Department of Urology, Liv Hospital, Ankara, Turkey
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Chinnappan S, Chandra P, Kumar JS, Chandran G, Nath S. SUVmax/ADC Ratio as a Molecular Imaging Biomarker for Diagnosis of Biopsy-Naïve Primary Prostate Cancer. Indian J Nucl Med 2021; 36:377-384. [PMID: 35125755 PMCID: PMC8771060 DOI: 10.4103/ijnm.ijnm_62_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 05/12/2021] [Revised: 07/09/2021] [Accepted: 08/06/2021] [Indexed: 01/13/2023] Open
Abstract
Background: Gallium-68-prostate-specific membrane antigen (68Ga-PSMA) positron emission tomography/computed tomography (PET/CT) has recently been shown to be very high accuracy in biopsy-naïve prostate cancer (PCa) detection and can potentially improve the low specificity noted with diffusion-weighted magnetic resonance imaging (DW-MRI), especially in instances of prostate inflammation. We aimed to compare the diagnostic accuracy of DW-MRI and PSMA PET/CT using apparent diffusion coefficient (ADC) and maximum standardized uptake (SUVmax) values in the diagnosis of PCa. Patients and Methods: A retrospective study comparing and analyzing the diagnostic accuracy of prebiopsy DW-MRI and 68Ga-PSMA PET/CTs done in patients with suspected PCa (raised prostate specific antigen [PSA] and/or positive digital rectal examination) from January 2019 to December 2020. The standard of reference was transrectal ultrasound-guided biopsies. Results: Sixty-seven patients were included in the study, mean age: 70 years (range 49–84), mean PSA: 23.2 ng/ml (range 2.97–45.6). Biopsy was positive for PCa in 56% (n = 38) and negative in 43% (n = 29). Of the benign results, benign hyperplasia was noted in 75% (n = 22) and prostatitis in 25% (n = 7). Of the PCa, 55% (n = 21) of were high International Society of Urological Pathology (ISUP) grade (4–5) and 45% (n = 17) low/intermediate ISUP grade (1–3). Overall the sensitivity/specificity/Accuracy for prediction of PCa of MRI using prostate imaging and reporting data system version 2 criteria and PSMA PET/CT using PCa molecular imaging standardized evaluation criteria was 92.1%/65.5%/80.5% and 76.3%/96.5%/85.1% respectively. Mean apparent diffusion co-efficient (mean ADC) value of benign lesions and PCa was 1.135 × 10-3 mm2/s and 0.723 × 10-3 mm2/s, respectively (P = 0.00001). Mean SUVmax and ADC of benign and PCa lesions was 4.01 and 16.4 (P = 0.000246). Mean SUVmax/ADC ratio of benign and malignant lesions was 3.8 × 103 versus 25.21 × 103 (P < 0.000026). Inverse correlation was noted between ADC and SUVmax values (R = −0.609), inverse correlation noted between ADC and Gleason's score (R = −0.198), and positive correlation of SUVmax and SUVmax/ADC with Gleason's score (R = 0.438 and R = 0.448). Receiver operating characteristic curve analysis revealed a SUVmax cutoff 6.03 (sensitivity/specificity - 76%/90%, area under the curve (AUC) - 0.935, Youden index (YI) - 0.66), ADC cutoff of 0.817 × 10−3 mm2/s (sensitivity/specificity – 79%/86%, AUC – 0.890, YI - 0.65), and SUVmax/ADC ratio cutoff of 7.43 × 103 (sensitivity/specificity – 87%/98%, AUC - 0.966, YI - 0.85) for PCa diagnosis. Conclusion: For diagnosis of biopsy-naïve PCas, the combination of diffusion-weighted MRI and PSMA PET/CT (i.e., SUVmax/ADC ratio) shows better diagnostic accuracy than either used alone and the combination of PET and MRI is especially useful when distinguishing cancer from prostatitis.
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Affiliation(s)
- Sheela Chinnappan
- Department of Radiodiagnosis, Sri Ramchandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Piyush Chandra
- Department of Nuclear Medicine, MIOT International Hospital, Chennai, Tamil Nadu, India
| | - John Santa Kumar
- Department of Nuclear Medicine, MIOT International Hospital, Chennai, Tamil Nadu, India
| | - Ganesan Chandran
- Department of Nuclear Medicine, MIOT International Hospital, Chennai, Tamil Nadu, India
| | - Satish Nath
- Department of Nuclear Medicine, MIOT International Hospital, Chennai, Tamil Nadu, India
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Xu B, Li G, Kong C, Chen M, Hu B, Jiang Q, Li N, Zhou L. A multicenter retrospective study on evaluation of predicative factors for positive biopsy of prostate cancer in real-world setting. Curr Med Res Opin 2021; 37:1617-1625. [PMID: 34192993 DOI: 10.1080/03007995.2021.1949270] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE This study aimed to evaluate the predictors for positive biopsy in prostate cancer (PCa) patients and develop a risk-stratification score model for positive biopsy rate in patients with prostate specific antigen (PSA) in the gray zone. METHODS In this retrospective, multicenter, real-world study, Chinese patients receiving prostate biopsy for the first time were included. The study evaluated the positive biopsy rate, predictors for positive biopsy and a risk prediction model for PSA 4-10 ng/mL PCa was developed. The univariate and multivariate logistic regression analyses were used to identify the risk factors. RESULTS A total of 2426 patients were included in the study. The biopsy positive rate was 47.57%, 25.77%, and 60.57% among overall patients, total PSA (t-PSA) 4-10 ng/mL patients, and PSA > 10 ng/mL patients respectively. Elderly age 60-74, ≥75, multi parametric magnetic resonance imaging (MP-MRI), pre-operative PSA > 10 and PSA density (PSAD) significantly increased the positive rate in overall population, and elderly age, MP-MRI, positive digital rectal examination and f-PSA were significant predictors for positive biopsy in PSA 4-10 ng/mL population. A risk prediction model for positive biopsy rate in patients with PSA in the gray zone was developed. Area under curve (AUC) was associated with low accuracy for all the variables used such as tPSA (0.53), PSAD (0.57), frequency of puncture (0.53) and MP-MRI (0.64) in prediction of biopsy positive rate. CONCLUSION Our study evaluated the significant predicative factors for positive biopsy and the PCa risk prediction model developed might help Clinicians to avoid unnecessary biopsy in patients with PSA in gray zone.
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Affiliation(s)
- Ben Xu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Gonghui Li
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chuize Kong
- Department of Urology, First hospital of China Medical University, Shenyang, China
| | - Ming Chen
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Bin Hu
- Department of Urology, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, Shenyang, China
| | - Qing Jiang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ningchen Li
- Department of Urology, Peking University Shougang Hospital, Peking University Health Science Center, Beijing, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
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Lonergan PE, Cowan JE, Washington SL, Greenberg SA, Nguyen HG, Carroll PR. Natural history of an immediately detectable PSA following radical prostatectomy in a contemporary cohort. Prostate 2021; 81:1009-1017. [PMID: 34288004 DOI: 10.1002/pros.24198] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/04/2021] [Accepted: 07/07/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND A detectable prostate-specific antigen (PSA) following radical prostatectomy (RP) is an unfavorable prognostic factor. However, not all men with a detectable PSA experience recurrence. We describe the natural history and outcomes in men with a detectable PSA following RP in a contemporary cohort. METHODS A retrospective analysis of men who underwent RP for non-metastatic prostate cancer at the University of California, San Francisco from 2000 to 2020 was performed. A detectable PSA was defined as PSA ≥ 0.03 ng/ml within 6 months of RP. Cox regression models tested the effect of detectable PSA on the development of metastasis, prostate cancer-specific mortality, and overall survival. RESULTS We identified 2941 men who had RP with 408 (13.9%) with a detectable PSA within the first 6 months. The median follow-up was 4.42 years (interquartile range [IQR], 2.58-8.00). In total, 296 (72.5%) men with a detectable PSA had salvage treatment at a median of 6 months (IQR, 4-11). One hundred sixteen of these men had PSA failure after salvage treatment at a median of 2.0 years (IQR, 0.7-3.8). On multivariable Cox regression, the risk of development of metastasis (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.01-1.09; p = .01), prostate cancer-specific mortality (HR, 1.13; 95% CI, 1.05-1.21; p = .0005), and overall mortality (HR, 1.07; 95% CI, 1.03-1.12; p = .002) was associated with PSA velocity after salvage treatment in men with a detectable PSA. CONCLUSIONS Men with a detectable PSA after RP may have excellent long-term outcomes. PSA velocity after salvage treatment may be an important predictor for the development of metastasis, prostate cancer-specific mortality, and overall mortality.
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Affiliation(s)
- Peter E Lonergan
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA
| | - Janet E Cowan
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA
| | - Samuel L Washington
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Scott A Greenberg
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA
| | - Hao G Nguyen
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA
| | - Peter R Carroll
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA
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Siroosbakht S, Rezakhaniha S, Namdari F, Rezakhaniha B. Is there relationship between serum uric acid levels and lower urinary tract symptoms, prostate volume, and PSA in men without cancer? A prospective population-based study. Andrologia 2021; 53:e14200. [PMID: 34339053 DOI: 10.1111/and.14200] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/26/2022] Open
Abstract
There are conflicting results about uric acid (UA) effect on the prostate. We investigated the relationship between UA and PSA, free PSA, prostate volume and international prostate symptoms score (IPSS) in benign prostate hyperplasia (BPH). This study was conducted in BPH men without cancer who were referred for annual health workup (N = 910) from 2017 to 2020. The mean ages were 67.28 ± 9.2 years. UA was positively related to IPSS and PSA (r = 0.210, p = .023 and r = 0.156, p = .041 respectively) and also negatively related to free/total PSA ratio (r = -0.332, p = .01) but not related to prostate volume (r = 0.036, p = .696). After adjustment for age, BMI and prostate volume, there were significant relationships between hyperuricaemia and PSA, free/total PSA ratio, and IPSS (95% CI: 0.254-1.645, OR = 0.647, p = .039; 95% CI: 0.076-0.899, OR = 0.270, p = .033 and 95% CI: 1.011-3.386, OR = 1.851, p = .038 respectively). These results should be considered during the general assessment of the patients with BPH. The findings raise the possible hypothesis of relationship between serum UA with IPSS and PSA which should be investigated by future studies.
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Affiliation(s)
| | - Sadra Rezakhaniha
- Department of Nutrition, Islamic Azad University, Science and Research branch, Tehran, Iran
| | - Farshad Namdari
- Department of Urology, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran
| | - Bijan Rezakhaniha
- Department of Urology, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran
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Guo ZF, Yang F, Lu XW, Wu JW, He C, Han CH. Significance of the prostate central gland and total gland volume ratio in the diagnosis of prostate cancer patients in the prostate specific antigen grey zone. J Int Med Res 2021; 49:3000605211019879. [PMID: 34308690 PMCID: PMC8320581 DOI: 10.1177/03000605211019879] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective To explore the significance of the prostate central gland to total gland volume ratio (PVc/PV) in the diagnosis of prostate cancer (PCa) in patients with prostate specific antigen (PSA) levels in the grey zone (4–10 ng/ml). Methods This retrospective study enrolled patients that had undergone prostate biopsy. The volume of the prostate and the central prostate gland were measured. The differences in PSA, the ratio of free to total PSA (f/tPSA), PSA density (PSAD) and PVc/PV between the PCa and non-PCa groups were compared. Receiver operating characteristic curve analysis for PCa and clinically significant PCa (csPCa) diagnosis were calculated according to PSA (reference), f/tPSA, PSAD and PVc/PV. Results This study enrolled 136 patients. There was no significant difference in PSA and f/tPSA between the PCa and non-PCa groups, while there were significant differences in PSAD and PVc/PV. The area under the curve values of PVc/PV for PCa or csPCa diagnosis were 0.876 and 0.933, respectively; and for PSAD, they were 0.705 and 0.790, respectively. These were significantly different compared with the PSA curve, whereas f/tPSA showed no significant difference from the PSA curve. Conclusion PVc/PV could be a predictor of PCa when PSA is between 4–10 ng/ml.
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Affiliation(s)
- Zhui-Feng Guo
- Medical College of Soochow University, Suzhou, Jiangsu Province, China.,Department of Urology, Minhang Branch, Zhongshan Hospital, Fudan University/Minhang Hospital, Fudan University, Shanghai, China
| | - Fan Yang
- Department of Urology, Minhang Branch, Zhongshan Hospital, Fudan University/Minhang Hospital, Fudan University, Shanghai, China
| | - Xu-Wei Lu
- Department of Urology, Minhang Branch, Zhongshan Hospital, Fudan University/Minhang Hospital, Fudan University, Shanghai, China
| | - Jia-Wen Wu
- Department of Urology, Minhang Branch, Zhongshan Hospital, Fudan University/Minhang Hospital, Fudan University, Shanghai, China
| | - Chang He
- Department of Urology, Minhang Branch, Zhongshan Hospital, Fudan University/Minhang Hospital, Fudan University, Shanghai, China
| | - Cong-Hui Han
- Medical College of Soochow University, Suzhou, Jiangsu Province, China.,Department of Urology, 159434Xuzhou Central Hospital, 159434Xuzhou Central Hospital, Xuzhou, Jiangsu Province, China
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Kałuża A, Szczykutowicz J, Ferens-Sieczkowska M. Glycosylation: Rising Potential for Prostate Cancer Evaluation. Cancers (Basel) 2021; 13:3726. [PMID: 34359624 DOI: 10.3390/cancers13153726] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Aberrant protein glycosylation is a well-known hallmark of cancer and is associated with differential expression of enzymes such as glycosyltransferases and glycosidases. The altered expression of the enzymes triggers cancer cells to produce glycoproteins with specific cancer-related aberrations in glycan structures. Increasing number of data indicate that glycosylation patterns of PSA and other prostate-originated proteins exert a potential to distinguish between benign prostate disease and cancer as well as among different stages of prostate cancer development and aggressiveness. This review summarizes the alterations in glycan sialylation, fucosylation, truncated O-glycans, and LacdiNAc groups outlining their potential applications in non-invasive diagnostic procedures of prostate diseases. Further research is desired to develop more general algorithms exploiting glycobiology data for the improvement of prostate diseases evaluation. Abstract Prostate cancer is the second most commonly diagnosed cancer among men. Alterations in protein glycosylation are confirmed to be a reliable hallmark of cancer. Prostate-specific antigen is the biomarker that is used most frequently for prostate cancer detection, although its lack of sensitivity and specificity results in many unnecessary biopsies. A wide range of glycosylation alterations in prostate cancer cells, including increased sialylation and fucosylation, can modify protein function and play a crucial role in many important biological processes in cancer, including cell signalling, adhesion, migration, and cellular metabolism. In this review, we summarize studies evaluating the prostate cancer associated glycosylation related alterations in sialylation, mainly α2,3-sialylation, core fucosylation, branched N-glycans, LacdiNAc group and presence of truncated O-glycans (sTn, sT antigen). Finally, we discuss the great potential to make use of glycans as diagnostic and prognostic biomarkers for prostate cancer.
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Mngomezulu K, Mzobe GF, Mtshali A, Osman F, Liebenberg LJP, Garrett N, Singh R, Rompalo A, Mindel A, Karim SSA, Karim QA, Baxter C, Ngcapu S. Recent Semen Exposure Impacts the Cytokine Response and Bacterial Vaginosis in Women. Front Immunol 2021; 12:695201. [PMID: 34177961 PMCID: PMC8221111 DOI: 10.3389/fimmu.2021.695201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background The presence of semen in the vagina from unprotected sex may influence the immune and microbial environment of the female genital tract. Inflammatory cytokine concentrations and BV-associated bacteria in female genital secretions may influence HIV risk, although the effect of recent sexual intercourse on incident BV and the cytokine milieu of cervicovaginal secretions has rarely been measured in previous studies. Here, we investigated the extent to which partner semen impacts the cytokine response and incident BV. Methods At baseline, we assessed the recency of semen exposure in menstrual cup supernatants by quantifying prostate specific antigen (PSA) levels using ELISA in 248 HIV-uninfected women at high risk for HIV infection. Luminex was used to measure 48 cytokines in menstrual cup supernatants and vaginal swabs to diagnose BV by Nugent score. Point-of-care screening for Chlamydia trachomatis and Neisseria gonorrhoeae was conducted using GeneXpert while OSOM was used for Trichomonas vaginalis detection. Multivariable models, adjusted for age, sexually transmitted infections, BV, current contraception use and condom use, were used to assess the impact of semen exposure on biomarkers of inflammation and BV. Results Presence of PSA, indicating recent semen exposure within 48 hours prior to sampling, was observed in menstrual cup supernatants of 17% (43/248) of women. Of these women, 70% (30/43) had self-reported condom use at their last sex act and 84% (36/43) had BV (Nugent score >7). PSA presence was significantly associated with prevalent BV (Relative Risk (RR), 2.609; 95% Confidence Interval (CI), 1.104 - 6.165; p = 0.029). Furthermore, women with detectable PSA had high median concentrations of macrophage inflammatory protein- beta (MIP-1α, p=0.047) and low median concentration of the stem cell growth factor beta (SCGF-β, p=0.038) compared to those without PSA. Conclusion A degree of discordance between self-reports of consistent condom use and PSA positivity was observed. There was also evidence of a relationship between recent semen exposure, BV prevalence and altered cytokine concentrations. These findings suggest that PSA, as a semen biomarker, should be taken into consideration when investigating biological markers in the female genital tract and self-reported condom use in studies on reproductive and sexual health.
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Affiliation(s)
- Khanyisile Mngomezulu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Gugulethu F. Mzobe
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Andile Mtshali
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Farzana Osman
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Lenine J. P. Liebenberg
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Medical Microbiology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Ravesh Singh
- Department of Medical Microbiology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Microbiology, National Health Laboratory Services, KwaZulu-Natal Academic Complex, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Anne Rompalo
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, United States
| | - Adrian Mindel
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Salim S. Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Epidemiology, Columbia University, New York, NY, United States
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Epidemiology, Columbia University, New York, NY, United States
| | - Cheryl Baxter
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Sinaye Ngcapu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Medical Microbiology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Brawley OW, Paller CJ. The Realities of Prostate Cancer Screening, Treatment, and Race. J Natl Cancer Inst 2021; 113:1272-1273. [PMID: 33964161 DOI: 10.1093/jnci/djab073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/06/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Otis W Brawley
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore Medicine.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Medicine
| | - Channing J Paller
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore Medicine
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Greenberg SA, Washington SL 3rd, Lonergan PE, Cowan JE, Baskin AS, Nguyen HG, Odisho AY, Simko JP, Carroll PR. Residual Benign Prostate Glandular Tissue after Radical Prostatectomy is Not Associated with the Development of Detectable Postoperative Serum Prostate Specific Antigen. J Urol 2021; 206:706-14. [PMID: 33905262 DOI: 10.1097/JU.0000000000001793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine if benign glandular tissue at the surgical margin (BGM) is associated with detectable prostate specific antigen (PSA) and/or biochemical recurrence (BCR) after radical prostatectomy (RP). MATERIALS AND METHODS Participants underwent RP for localized prostate cancer between 2004 and 2018. Regression analysis was used to identify demographic, clinical and surgical factors associated with the likelihood of BGM presence on surgical pathology. Oncologic outcomes included detectable PSA (>0.03 ng/ml), BCR (≥0.2 ng/ml) and progression to BCR or salvage treatment after detectable PSA. Life tables and Cox proportional hazards regression models were used to determine the association of BGM and risk of oncologic outcomes. RESULTS A total of 1,082 men underwent RP for localized prostate cancer with BGM reported on surgical pathology and an undetectable postoperative PSA. BGM was present on 249 (23%) specimens. Younger age, bilateral nerve sparing surgery and robotic approach were associated with presence of BGM while malignancy at the surgical margin (MSM) was not. At 7 years after RP, 29% experienced detectable PSA and 11% had BCR. In the subgroup of men who reached detectable PSA, 79% had progression within 7 years. On multivariate Cox proportional hazards regression, BGM status was not independently associated with detectable PSA, BCR and/or progression from detectable PSA to BCR or salvage treatment. CONCLUSIONS The presence of BGM at RP was not associated with increased risk of MSM, detectable PSA, BCR or progression after detectable PSA.
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Kim DS, Moon SK, Lim JW, Jeon SH, Lee SH. The Value of Low Prostate Imaging-Reporting and Data System (PI-RADS) Scores in Preventing Unnecessary Prostate Biopsies. ACTA ACUST UNITED AC 2021; 57:medicina57050413. [PMID: 33923251 PMCID: PMC8145899 DOI: 10.3390/medicina57050413] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/01/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022]
Abstract
Background and Objectives: Magnetic resonance imaging (MRI) and the Prostate Imaging-Reporting and Data System (PI-RADS) have become essential tools for prostate cancer evaluation. We evaluated the ability of PI-RADS scores in identifying significant prostate cancer, which would help avoid unnecessary prostate biopsies. Materials and Methods: Patients with prostate-specific antigen (PSA) levels ≤ 20 ng/mL, who underwent prostate MRI for evaluation from January 2018 to November 2019, were analyzed. Among them, 105 patients who received transrectal ultrasonography (TRUS)-guided biopsy were included. PSA, PI-RADS scores (low 1–2, high 3–5), biopsy results, and Gleason scores (GS) were evaluated. Biopsies with GS higher than 3 + 4 were considered as significant cancers and biopsies with no cancer or Gleason 3 + 3 were considered insignificant or no cancers. Results: Among the 105 patients, 45 patients had low PI-RADS and 60 had high PI-RADS scores. There were no patients with significant prostate cancer in the low PI-RADS groups. For the high PI-RADS group, 28 (46.7%) patients had significant cancer and 32 (53.3%) had insignificant or no cancer. The sensitivity and specificity of high PI-RADS to detect significant cancer was 100% and 58.4%, respectively. Positive predictive value was 46.7% and negative predictive value was 100%. Conclusions: Low PI-RADS scores on MRI did not show significant prostate cancer and surveillance should be considered in selected cases to prevent unnecessary invasive procedures and overdiagnosis.
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Affiliation(s)
- Dong-Soo Kim
- Department of Urology, Kyung Hee University School of Medicine, Seoul 02453, Korea; (D.-S.K.); (S.-H.J.)
| | - Sung-Kyoung Moon
- Department of Radiology, Kyung Hee University School of Medicine, Seoul 02453, Korea; (S.-K.M.); (J.-W.L.)
| | - Joo-Won Lim
- Department of Radiology, Kyung Hee University School of Medicine, Seoul 02453, Korea; (S.-K.M.); (J.-W.L.)
| | - Seung-Hyun Jeon
- Department of Urology, Kyung Hee University School of Medicine, Seoul 02453, Korea; (D.-S.K.); (S.-H.J.)
| | - Sang-Hyub Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul 02453, Korea; (D.-S.K.); (S.-H.J.)
- Correspondence: ; Tel.: +82-2-958-8521
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Allemailem KS, Almatroudi A, Alrumaihi F, Makki Almansour N, Aldakheel FM, Rather RA, Afroze D, Rah B. Single nucleotide polymorphisms (SNPs) in prostate cancer: its implications in diagnostics and therapeutics. Am J Transl Res 2021; 13:3868-3889. [PMID: 34017579 PMCID: PMC8129253] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Prostate cancer is one of the most frequently diagnosed malignancies in developed countries and approximately 248,530 new cases of prostate cancer are likely to be diagnosed in the United States in 2021. During the late 1990s and 2000s, the prostate cancer-related death rate has decreased by 4% per year on average because of advancements in prostate-specific antigen (PSA) testing. However, the non-specificity of PSA to distinguish between benign and malignant forms of cancer is a major concern in the management of prostate cancer. Despite other risk factors in the pathogenesis of prostate cancer, recent advancement in molecular genetics suggests that genetic heredity plays a crucial role in prostate carcinogenesis. Approximately, 60% of heritability and more than 100 well-recognized single-nucleotide-polymorphisms (SNPs) have been found to be associated with prostate cancer and constitute a major risk factor in the development of prostate cancer. Recent findings revealed that a low to moderate effect on the progression of prostate cancer of individual SNPs was observed compared to a strong progressive effect when SNPs were in combination. Here, in this review, we made an attempt to critically analyze the role of SNPs and associated genes in the development of prostate cancer and their implications in diagnostics and therapeutics. A better understanding of the role of SNPs in prostate cancer susceptibility may improve risk prediction, enhance fine-mapping, and furnish new insights into the underlying pathophysiology of prostate cancer.
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Affiliation(s)
- Khaled S Allemailem
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim UniversityBuraydah, Saudi Arabia
| | - Ahmad Almatroudi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim UniversityBuraydah, Saudi Arabia
| | - Faris Alrumaihi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim UniversityBuraydah, Saudi Arabia
| | - Nahlah Makki Almansour
- Department of Biology, College of Science, University of Hafr Al BatinHafr Al Batin, Saudi Arabia
| | - Fahad M Aldakheel
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud UniversityRiyadh, Saudi Arabia
- Prince Sattam Chair for Epidemiology and Public Health Research, College of Medicine, King Saud UniversityRiyadh, Saudi Arabia
| | - Rafiq Ahmad Rather
- Advanced Centre for Human Genetics, Sher-i-Kashmir Institute of Medical ScienceSrinagar, Jammu and Kashmir, India
| | - Dil Afroze
- Advanced Centre for Human Genetics, Sher-i-Kashmir Institute of Medical ScienceSrinagar, Jammu and Kashmir, India
| | - Bilal Rah
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim UniversityBuraydah, Saudi Arabia
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Dadgar H, Seyedi Vafaee M, Norouzbeigi N, Jafari E, Gholamrezanezhad A, Assadi M. Dual-phase 68Ga-PSMA-11 PET/CT may increase the rate of detected lesions in prostate cancer patients. Urologia 2021; 88:355-361. [PMID: 33627056 DOI: 10.1177/0391560321993544] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study was conducted to compare the early static (3-6 min post-injection (p.i.)) and standard whole body (1 h, p.i.) 68Ga-PSMA-11 PET/CT imaging for detection of lesions in prostate cancer (PC) patients. MATERIALS AND METHODS In this study, PC patients suspected of recurrence underwent 68Ga-PSMA-11 PET/CT. Early static images were acquired from the pelvis and the lower abdomen 3-5 minutes after radiotracer injection and, a routine whole body scan was performed from the skull to the mid-thigh 1 h after injection. Quantitative analysis (SUVmax) was evaluated in suspicious lesions. RESULTS Of 19 evaluated PC patients with a median age of 72 ± 1.66 years (range: 55-85 years) and prostate-specific antigen (PSA) of 1.72 ± 6.11 ng/ml (range: 0.1-100 ng/ml) (median ± SE), 16 showed positive in the whole body PET/CT. All of the patients with positive whole body scans due to pelvic involvement had positive early scan results. Totally, 22 lesions were detected in both early and delay scans in the pelvic which 16 were related to prostate involvement, 4 were related to lymph node involvement, and 2 were related to bone involvement. Moreover, in addition to the mentioned 22 lesions, early PET imaging successfully detected local recurrence in a patient who was negative on WB PET/ CT; this lesion was masked in the delay scan due to bladder activity. The median SUVmax values of the early and delay scans were 3.69 ± 1.07 (median ± SE) (range: 1.2-14.5) and 5.85 ± 1.69 (range: 3.1-23.4), respectively. (p = 0.005). CONCLUSION Early static 68Ga-PSMA-11 PET/CT imaging might discriminate metastases from urinary bladder activity. Therefore, early static imaging in combination with whole body 60-min p.i. imaging can improve the detection of local involvement pelvic disease.
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Affiliation(s)
- Habibollah Dadgar
- RAZAVI Cancer Research Center, RAZAVI Hospital, Imam Reza International University, Mashhad, Iran
| | - Manouchehr Seyedi Vafaee
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.,Translational Neuroscience, BRIDGE, University of Southern Denmark, Odense, Denmark
| | - Nasim Norouzbeigi
- RAZAVI Cancer Research Center, RAZAVI Hospital, Imam Reza International University, Mashhad, Iran
| | - Esmail Jafari
- Department of Molecular Imaging and Radionuclide Therapy, Bushehr Medical University Hospital, The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Majid Assadi
- Department of Molecular Imaging and Radionuclide Therapy, Bushehr Medical University Hospital, The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
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Cheung S, Jain P, So J, Shahidi S, Chung S, Koritzinsky M. p38 MAPK Inhibition Mitigates Hypoxia-Induced AR Signaling in Castration-Resistant Prostate Cancer. Cancers (Basel) 2021; 13:831. [PMID: 33671134 DOI: 10.3390/cancers13040831] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Progression of prostate cancer to a castration-resistant state is associated with poor patient outcomes, and new therapeutic targeting approaches are needed. Poorly oxygenated (hypoxic) cancer cells are resistant to many treatment modalities, and it is therefore important that novel therapies also target these cells. Here we show that targeting the p38 MAPK protein kinase can inhibit growth and survival of both well-oxygenated and hypoxic castration resistant prostate cancer cells and prolong survival of tumor bearing mice. p38 MAPK targeting inhibited phosphorylation of the chaperone protein Hsp27 and activity of the androgen receptor. This demonstrates that prostate cancer cells can remain dependent on the p38 MAPK/Hsp27 signaling axis upon progression to castration-resistance, and that hypoxia does not offer protection against targeting this pathway. Abstract Background: Aberrant androgen receptor (AR) signaling is a major driver of castration-resistant prostate cancer (CRPC). Tumor hypoxia increases AR signaling and is associated with treatment resistance in prostate cancer. Heat shock protein 27 (Hsp27) is a molecular chaperone that is activated in response to heat shock and hypoxia. Hsp27 has previously been reported to facilitate AR nuclear translocation in a p38 mitogen-activated protein kinase (MAPK) dependent manner in castration-sensitive prostate cancer cell lines. Here, we evaluated the potential for inhibiting p38 MAPK/Hsp27 mediated AR signaling under normoxia and hypoxia in experimental models of CRPC. Methods: We inhibited p38 MAPK with SB203580 in prostate cancer cell lines and measured Hsp27 phosphorylation, AR activity, cell proliferation, and clonogenicity under normoxia and hypoxia. AR activity was measured using an androgen response element driven reporter assay and qPCR to measure expression of AR target genes. Xenograft-bearing mice were treated with SB203580 to measure tumor growth and serum prostate specific antigen (PSA). Results: Our results indicate that p38 MAPK and Hsp27 are activated under normoxia and hypoxia in response to androgens in CRPC cells. p38 MAPK inhibition diminished Hsp27 activation and the hypoxia-mediated increase in AR activity. Additionally, inhibition of p38 MAPK activity decreased proliferation and survival of CRPC cells in vitro and prolonged the survival of tumor-bearing mice. Conclusions: These results suggest that p38 MAPK inhibition may represent a therapeutic strategy to disrupt AR signaling in the heterogeneous CRPC tumor microenvironment.
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