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Li W, Mao Y, Hua B, Gu X, Lu C, Xu B, Pan W. Sasanquasaponin inhibited epithelial to mesenchymal transition in prostate cancer by regulating the PI3K/Akt/mTOR and Smad pathways. PHARMACEUTICAL BIOLOGY 2022; 60:1865-1875. [PMID: 36205544 PMCID: PMC9553173 DOI: 10.1080/13880209.2022.2123931] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 05/19/2023]
Abstract
CONTEXT Sasanquasaponin (SQS) is a commonly used traditional Chinese medicine proved to have a wide range of pharmacological functions. OBJECTIVE The objective of this study is to explore the effect and underlying mechanism of SQS in the treatment of prostate cancer (PC). MATERIALS AND METHODS PC cell lines (22Rv1 and PC-3) were treated with SQS (0, 0.5, 1, 2, and 4 μM) for 12 or 24 h. The viability of cells was evaluated, while the mRNA and protein levels of epithelial to mesenchymal transition (EMT)-related genes in PC cell lines were measured (Groups: Control, TGF-β1, TNF-α, TGF-β1 + TNF-α, and TGF-β1 + TNF-α + SQS). The migration and invasion abilities of PC cell lines were evaluated (Groups: Control, SQS). Finally, the antitumour effect of SQS (25, 50,100, and 200 mg/kg) in BALB/c nude mice (6 weeks, 18-20 g) was evaluated (Groups: Control, Vehicle, 25, 50,100, and 200 mg/kg SQS). The study duration was 1 month. RESULTS SQS inhibited the viability and the number of colonies of 22Rv1 or PC-3 cells. The IC50 of SQS of 12 and 24 h in these two cells was 3.25, 1.82, 4.76, and 4.70 μM, respectively. SQS inhibited the adhesion, migration, and invasion of PC cells. It also inhibited the expression of EMT-related markers of PC cells. The PI3K/Akt/mTOR and Smad2/3 signalling pathways were activated in the process of EMT, and SQS could significantly reduce the activation of the PI3K/Akt/mTOR and Smad2/3 pathways. Finally, SQS inhibited the growth of xenograft tumours in vivo. CONCLUSIONS SQS inhibited EMT in PC by regulating the PI3K/Akt/mTOR and Smad pathways.
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Affiliation(s)
- Wenfeng Li
- Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanshen Mao
- Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bao Hua
- Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Gu
- Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Lu
- Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Xu
- Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- CONTACT Xu Bin
| | - Weixin Pan
- Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Urology, Hainan Western Central Hospital, Danzhou, China
- Weixin Pan Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Manufacturing Bureau Road, Huangpu District, Shanghai200011, China
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Ye J, Gao M, Guo X, Zhang H, Jiang F. Breviscapine suppresses the growth and metastasis of prostate cancer through regulating PAQR4-mediated PI3K/Akt pathway. Biomed Pharmacother 2020; 127:110223. [PMID: 32413672 DOI: 10.1016/j.biopha.2020.110223] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Prostate cancer, one of the most frequently diagnosed tumors of men, leads to poor quality of life. Previous studies have shown that breviscapine (BRE) exerts therapeutic activity in malignant tumors. However, the role and mechanism of BRE exhibit an anti-tumor effect on prostate cancer are largely unknown. METHODS The mRNA and protein levels in prostate cancer tissues and cell lines were measured using RT-qPCR, western blot, and immunohistochemical staining, respectively. Cell proliferation, invasion, and migration in both PC3 and DU145 cells were evaluated using CCK-8 and Transwell assay. The effect of BRE on cell proliferation and metastasis by regulating the PAQR4-mediated PI3K/Akt pathway in vitro and in vivo was determined. RESULTS PAQR4 was significantly overexpressed in prostate cancer tissues and cell lines, which was positively correlated with poor prognosis. Knockdown of PAQR4 inhibited the proliferation, invasion, migration, and epithelial-mesenchymal transition (EMT) of both PC3 and DU145 cells. Mechanistically, BRE treatment significantly suppressed the malignant biological behavior of both prostate cancer cells by downregulating PAQR4 and blocking the PI3K/Akt pathway. In vivo experiments, BRE administration remarkably inhibited tumor growth and metastasis in a xenograft model of prostate cancer. CONCLUSION Our findings revealed that BRE exerts anti-tumor and anti-metastasis roles in prostate cancer by inhibiting PAQR4-mediated PI3K/Akt pathway, which provides a new therapeutic agent for prostate cancer clinical treatment.
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Affiliation(s)
- Jiwei Ye
- Department of Urology, Nanyang Second People's Hospital of Henan Province, Nanyang, 473000, Henan, China.
| | - Mingquan Gao
- Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, Sichuan, China.
| | - Xinwu Guo
- Department of Urology, Nanyang Second People's Hospital of Henan Province, Nanyang, 473000, Henan, China.
| | - Henan Zhang
- Institute of Edible Fungi, Shanghai Academy of Agricultural Sciences, National Engineering Research Center of Edible Fungi, Key Laboratory of Edible Fungi Resources and Utilization (South), Ministry of Agriculture, Shanghai, 201403, China.
| | - Fuchun Jiang
- Department of Pharmaceutical Botany, School of Pharmacy, The Second Military Medical University, Shanghai, 200433, China.
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Valero J, Peleteiro P, Henríquez I, Conde A, Piquer T, Lozano A, Soler CC, Muñoz J, Illescas A, Jove J, Flores MM, Baquedano J, Diezhandino P, de Celis RP, Pardo EH, Samper P, Villoslada I, Eguiguren M, Millan V. Age, Gleason Score, and PSA are important prognostic factors for survival in metastatic castration-resistant prostate cancer. Results of The Uroncor Group (Uro-Oncological Tumors) of the Spanish Society of Radiation Oncology (SEOR). Clin Transl Oncol 2020; 22:1378-1389. [PMID: 31989474 DOI: 10.1007/s12094-019-02274-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The treatment of metastatic castration-resistant prostate cancer (mCRPC) has changed significantly in recent years. Inhibitors of androgen receptors have shown especially significant benefits in overall (OS) and progression-free survival (PFS), with a good toxicity profile. Treatment selection depends on the patient's individual clinical, radiological, and biological characteristics. OBJECTIVE To describe treatment outcomes (efficacy, toxicity) in a cohort of patients with mCRPC in Spain. MATERIALS AND METHODS Multicenter, retrospective study of patients with mCRPC included in a database of the Urological Tumour Working Group (URONCOR) of the Spanish Society of Radiation Oncology (SEOR). Metastatic CRPC was defined according to the prostate cancer working group 3 (PCWG3) criteria. The Kaplan-Meier technique was used to evaluate OS and the Common Terminology Criteria for Adverse Events (CTCAE, v.4.0) were used to assess toxicity. Univariate and multivariate Cox regression analyses were performed to identify the factors significantly associated with OS. RESULTS A total of 314 patients from 17 hospitals in Spain diagnosed with mCRPC between June 2010 and September 2017 were included in this study. Mean age at diagnosis was 68 years (range 45-89). At a median follow-up of 35 months, OS at 1, 3, and 5 years were 92%, 38%, and 28%, respectively. Grades 1-2 and grade 3 toxicity rates were, respectively, 68% and 19%. No grade 4 toxicities were observed. On the multivariate analysis, the following factors were significantly associated with OS: age (hazard ratio [HR] 0.42, p = 0.010), PSA value at diagnosis of mCRPC (HR 0.55, p = 0.008), and Gleason score (HR 0.61, p = 0.009). CONCLUSIONS Age, Gleason score, and PSA at diagnosis of mCRPC are independently associated with overall survival in patients with mCRPC. The efficacy and toxicity outcomes in this patient cohort treated in radiation oncology departments in Spain are consistent with previous reports.
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Affiliation(s)
- J Valero
- Hospital Universitario HM Sanchinarro, Madrid, Spain.
| | - P Peleteiro
- Hospital Clinico Universitario de Santiago de Compostela, Santiago, Spain
| | - I Henríquez
- Hospital Universitario Sant Joan de Reus, Tarragona, Spain
| | - A Conde
- Hospital La Fe de Valencia, Valencia, Spain
| | - T Piquer
- Hospital de Castellon, Castellón, Spain
| | - A Lozano
- Hospital Virgen de la Arrixaca de Murcia, El Palmar, Spain
| | - C C Soler
- Hospital Torrecardenas Almeria, Almería, Spain
| | - J Muñoz
- Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain
| | - A Illescas
- Hospital Virgen de la Macarena de Sevilla, Sevilla, Spain
| | - J Jove
- Instituto Catalan de Oncologia Badalona, Barcelona, Spain
| | - M M Flores
- Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - J Baquedano
- Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - P Diezhandino
- Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - R P de Celis
- Hospital Txagorritxu de Vitoria, Vitoria-Gasteiz, Spain
| | - E H Pardo
- Hospital Txagorritxu de Vitoria, Vitoria-Gasteiz, Spain
| | - P Samper
- Hospital Universitario Rey Juan Carlos de Mostoles, Madrid, Spain
| | | | - M Eguiguren
- Hospital Universitario Donostia, Donostia-San Sebastian, Spain
| | - V Millan
- Hospital Clinico Universitario de Zaragoza, Zaragoza, Spain
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Beardo P, Osman I, San José B, Llarena R, Congregado B, Campá J, Medina-López RA, Extramiana J. Safety and outcomes of new generation hormone-therapy in elderly chemotherapy-naive metastatic castration-resistant prostate cancer patients in the real world. Arch Gerontol Geriatr 2019; 82:179-185. [PMID: 30818172 DOI: 10.1016/j.archger.2019.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/14/2018] [Accepted: 02/16/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Abiraterone acetate and enzalutamide are standard treatments for chemotherapy-naive metastatic castration-resistant prostate cancer (CN-mCRPC). The purpose of this study was to evaluate the effectiveness and safety of these medications in elderly (≥ 75 years old) compared with young CN-mCRPC patients in a real-world clinical setting. Secondarily, we explored the survival prognostic value of different anatomo-clinical factors in elderly group. METHODS In this retrospective observational multicentre study, we included 134 consecutive CN-mCRPC patients, 64 young and 70 elderly men, who had received AA or Enz. RESULTS We did not find significant differences in treatment duration [16.6 months, (95% CI 9-24.2 months) vs. 16.8 months (95% CI: 6.3-27.2 months); p = 0.926] and overall survival [median not reached vs. 23.3 months (95% CI 10.2-36.3 months); p = 0.131] between the young and elderly groups. In elderly group, the only predictors of overall survival with AA or Enz were good ECOG performance status and high G8 score. Adverse events of grade ≥3 was similar in elderly group (12.9%) and in the young group (15.6%). Treatment was discontinued due to AEs in 6.3% of young group and 18.6% of elderly group. CONCLUSIONS Effectiveness and safety of treatment of CN-mRCPC with Abiraterone acetate and enzalutamide were similar in older and younger patients, although treatment discontinuation due to AEs was more frequent in the older age group. In addition to ECOG PS, assessment using specific geriatric scales as G8 screening tool could help to identify patients aged ≥75 who would most benefit from treatment with new-generation hormone therapy.
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Affiliation(s)
- Pastora Beardo
- Department of Urology, Araba University Hospital, c/ José Atxotegi s/n, PC 01009, Vitoria-Gasteiz, Araba, Spain.
| | - Ignacio Osman
- Department of Urology, UGC Urology and Nephrology, Instituto of Biomedicina of Sevilla, IBIS/Virgen del Rocío, University Hospital/CSIC/ Sevilla University, AV Manuel Siurot s/n, PC 41013, Sevilla, Spain.
| | - Begoña San José
- Department of Pharmacy, Cruces University Hospital, Plaza de Cruces s/n, PC 48903, Bilbao, Vizcaya, Spain.
| | - Roberto Llarena
- Department of Urology, Cruces University Hospital, Plaza de Cruces s/n, PC 48903, Bilbao, Vizcaya, Spain.
| | - Belén Congregado
- Department of Urology, UGC Urology and Nephrology, Instituto of Biomedicina of Sevilla, IBIS/Virgen del Rocío, University Hospital/CSIC/ Sevilla University, AV Manuel Siurot s/n, PC 41013, Sevilla, Spain.
| | - Josep Campá
- Department of Urology, Araba University Hospital, c/ José Atxotegi s/n, Spain.
| | - Rafael A Medina-López
- Department of Urology, UGC Urology and Nephrology, Instituto of Biomedicina of Sevilla, IBIS/Virgen del Rocío, University Hospital/CSIC/ Sevilla University, AV Manuel Siurot s/n, PC 41013, Sevilla, Spain.
| | - Javier Extramiana
- Department of Urology, Araba University Hospital, c/ José Atxotegi s/n, PC 01009, Vitoria-Gasteiz, Araba, Spain.
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Kosaka T, Hongo H, Watanabe K, Mizuno R, Kikuchi E, Oya M. No significant impact of patient age and prior treatment profile with docetaxel on the efficacy of cabazitaxel in patient with castration-resistant prostate cancer. Cancer Chemother Pharmacol 2018; 82:1061-1066. [PMID: 30283980 PMCID: PMC6267665 DOI: 10.1007/s00280-018-3698-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 09/10/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND The correlation of the oncological outcomes of docetaxel and cabazitaxel in Japanese metastatic castration-resistant prostate cancer (mCRPC) patients has not been unclear. MATERIALS AND METHODS This study included a total of 47 consecutive Japanese mCRPC patients treated with cabazitaxel and assessed the prognostic significance of cabazitaxel, focusing on patient age and the correlation of efficacy between docetaxel and cabazitaxel. RESULTS Prostate-specific antigen (PSA) decline was observed in 27 patients (57.4%), including 19 (40.0%) achieving the response defined by PSA decline ≥ 30%. The median overall survival (OS) periods after the introduction of cabazitaxel was 16.1 months. Twenty (42.6%) were judged to have responded to cabazitaxel with a PSA decrease ≥ 30% from the baseline. A 30% PSA response to cabazitaxel was achieved in 4 (50.0%) patients with ≧ 75 years (n = 8) and 16 (41.0%) patients with less than 75 years (n = 39). There was no significant correlation between the PSA response and patients' age (p = 0.707). A 30% PSA response to cabazitaxel was achieved in 13 (46.4%) and 7 (36.8%) patients with and without that to docetaxel, respectively. A 30% PSA response to cabazitaxel was achieved in 5 (16.6%) and 7 (41.2%) patients who had treated with less than 10 cycles docetaxel or 10 ≦ cycles, respectively. Univariate and multivariate analyses revealed that there were no significant correlation of patient age (p = 0.537), the response to prior docetaxel therapy (p = 0.339) or cycles of docetaxel therapy (p = 0.379) with shorter OS. CONCLUSION These results indicate that the introduction of cabazitaxel for Japanese mCRPC patients could result in oncological outcomes without any association with patient's age and the profiles of previous docetaxel therapy.
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Affiliation(s)
- Takeo Kosaka
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Hiroshi Hongo
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keitaro Watanabe
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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de Bono JS, Smith MR, Saad F, Rathkopf DE, Mulders PFA, Small EJ, Shore ND, Fizazi K, De Porre P, Kheoh T, Li J, Todd MB, Ryan CJ, Flaig TW. Subsequent Chemotherapy and Treatment Patterns After Abiraterone Acetate in Patients with Metastatic Castration-resistant Prostate Cancer: Post Hoc Analysis of COU-AA-302. Eur Urol 2016; 71:656-664. [PMID: 27402060 PMCID: PMC5609503 DOI: 10.1016/j.eururo.2016.06.033] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/21/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND Treatment patterns for metastatic castration-resistant prostate cancer (mCRPC) have changed substantially in the last few years. In trial COU-AA-302 (chemotherapy-naïve men with mCRPC), abiraterone acetate plus prednisone (AA) significantly improved radiographic progression-free survival and overall survival (OS) when compared to placebo plus prednisone (P). OBJECTIVE This post hoc analysis investigated clinical responses to docetaxel as first subsequent therapy (FST) among patients who progressed following protocol-specified treatment with AA, and characterized subsequent treatment patterns among older (≥75 yr) and younger (<75 yr) patient subgroups. DESIGN, SETTING, AND PARTICIPANTS Data were collected at the final OS analysis (96% of expected death events). Subsequent therapy data were prospectively collected, while response and discontinuation data were collected retrospectively following discontinuation of the study drug. INTERVENTION At the discretion of the investigator, 67% (365/546) of patients from the AA arm received subsequent treatment with one or more agents approved for mCRPC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Efficacy analysis was performed for patients for whom baseline and at least one post-baseline prostate-specific antigen (PSA) values were available. RESULTS AND LIMITATIONS Baseline and at least one post-baseline PSA values were available for 100 AA patients who received docetaxel as FST. While acknowledging the limitations of post hoc analyses, 40% (40/100) of these patients had an unconfirmed ≥50% PSA decline with first subsequent docetaxel therapy, and 27% (27/100) had a confirmed ≥50% PSA decline. The median docetaxel treatment duration among these 100 patients was 4.2 mo. Docetaxel was the most common FST among older and younger patients from each treatment arm. However, 43% (79/185) of older patients who progressed on AA received no subsequent therapy for mCRPC, compared with 17% (60/361) of younger patients. CONCLUSIONS Patients with mCRPC who progress with AA treatment may still derive benefit from subsequent docetaxel therapy. These data support further assessment of treatment patterns following AA treatment for mCRPC, particularly among older patients. TRIAL REGISTRATION ClinicalTrials.gov NCT00887198. PATIENT SUMMARY Treatment patterns for advanced prostate cancer have changed substantially in the last few years. This additional analysis provides evidence of clinical benefit for subsequent chemotherapy in men with advanced prostate cancer whose disease progressed after treatment with abiraterone acetate. Older patients were less likely to be treated with subsequent therapy.
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Affiliation(s)
- Johann S de Bono
- The Institute of Cancer Research and The Royal Marsden Hospital, Sutton, UK.
| | - Matthew R Smith
- Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
| | - Fred Saad
- Centre Hospitalier University of Montréal, Montréal, Québec, Canada
| | - Dana E Rathkopf
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | | | - Eric J Small
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Neal D Shore
- Carolina Urologic Research Center, Atlantic Urology Clinics, Myrtle Beach, SC, USA
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | | | - Thian Kheoh
- Janssen Research & Development, San Diego, CA, USA
| | - Jinhui Li
- Johnson & Johnson Medical China, Shanghai, China
| | | | - Charles J Ryan
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
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Prostate Cancer in the Elderly. Prostate Cancer 2016. [DOI: 10.1016/b978-0-12-800077-9.00007-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Flaig TW, Potluri RC, Ng Y, Todd MB, Mehra M. Treatment evolution for metastatic castration-resistant prostate cancer with recent introduction of novel agents: retrospective analysis of real-world data. Cancer Med 2015; 5:182-91. [PMID: 26710718 PMCID: PMC4735776 DOI: 10.1002/cam4.576] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/25/2015] [Accepted: 09/30/2015] [Indexed: 12/31/2022] Open
Abstract
Despite increasing drug treatment options for metastatic castration‐resistant prostate cancer (mCRPC) patients, real‐world treatment data are lacking. We conducted retrospective analyses of commercial claims and electronic medical record (EMR) databases to understand how treatment patterns for mCRPC have changed in a US‐based real‐world population. Truven Health Analytics MarketScan® (2000–2013) and EMR (2004–2013) databases were used to identify patients with an index prostate cancer diagnosis (ICD‐9 codes 185X or 233.4X) and prescription claims for an mCRPC drug (mitoxantrone, estramustine, docetaxel, sipuleucel‐T, cabazitaxel, abiraterone acetate, enzalutamide, or radium‐223). Regimen analyses for first line of therapy (LOT1), second line of therapy, and beyond were performed among cohorts based on year of first mCRPC drug usage. mCRPC drug usage and treatment duration were compared across cohorts and age groups within each cohort. The commercial claims cohort yielded 3437 evaluable patients. Most men (91%) commencing mCRPC treatment had docetaxel as LOT1 in 2010; this number had declined to 15% in 2013. In 2013, 67% and 9% of patients used abiraterone acetate and enzalutamide, respectively, as LOT1. Among both commercial claims and EMR cohorts, treatment pattern changes were most pronounced in men aged >80 years, and median treatment duration for some mCRPC drugs was shorter than expected based on available clinical trial information. These results demonstrate a shift in mCRPC treatments during the past 5 years, with greater use of newer noncytotoxic treatments than docetaxel. These real‐world data aid in understanding the changing role of chemotherapy in the management of mCRPC.
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Affiliation(s)
- Thomas W Flaig
- University of Colorado Cancer Center, Medical Oncology, Aurora, Colorado
| | | | - Yvette Ng
- Janssen Global Services, Global Medical Affairs, Raritan, New Jersey
| | - Mary B Todd
- Janssen Global Services, Global Medical Affairs, Raritan, New Jersey
| | - Maneesha Mehra
- Janssen Global Services, Global Market Access Analytics, Raritan, New Jersey
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Liu JB, Dai CM, Su XY, Cao L, Qin R, Kong QB. Gene microarray assessment of multiple genes and signal pathways involved in androgen-dependent prostate cancer becoming androgen independent. Asian Pac J Cancer Prev 2015; 15:9791-5. [PMID: 25520106 DOI: 10.7314/apjcp.2014.15.22.9791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
To study the gene expression change and possible signal pathway during androgen-dependent prostate cancer (ADPC) becoming androgen-independent prostate cancer (AIPC), an LNCaP cell model of AIPC was established using flutamide in combination with androgen-free environment inducement, and differential expression genes were screened by microarray. Then the biological process, molecular function and KEGG pathway of differential expression genes are analyzed by Molecule Annotation System (MAS). By comparison of 12,207 expression genes, 347 expression genes were acquired, of which 156 were up-ragulated and 191 down-regulated. After analyzing the biological process and molecule function of differential expression genes, these genes are found to play crucial roles in cell proliferation, differntiation, cell cycle control, protein metabolism and modification and other biological process, serve as signal molecules, enzymes, peptide hormones, cytokines, cytoskeletal proteins and adhesion molecules. The analysis of KEGG show that the relevant genes of AIPC transformation participate in glutathione metabolism, cell cycle, P53 signal pathway, cytochrome P450 metabolism, Hedgehog signal pathway, MAPK signal pathway, adipocytokines signal pathway, PPAR signal pathway, TGF-β signal pathway and JAK-STAT signal pathway. In conclusion, during the process of ADPC becoming AIPC, it is not only one specific gene or pathway, but multiple genes and pathways that change. The findings above lay the foundation for study of AIPC mechanism and development of AIPC targeting drugs.
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Affiliation(s)
- Jun-Bao Liu
- China-Japan Union Hospital of Jilin University, Changchun, Jilin, China E-mail :
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Smith MR, Rathkopf DE, Mulders PFA, Carles J, Van Poppel H, Li J, Kheoh T, Griffin TW, Molina A, Ryan CJ. Efficacy and Safety of Abiraterone Acetate in Elderly (75 Years or Older) Chemotherapy Naïve Patients with Metastatic Castration Resistant Prostate Cancer. J Urol 2015; 194:1277-84. [PMID: 26151676 DOI: 10.1016/j.juro.2015.07.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE Metastatic castration resistant prostate cancer primarily affects elderly men. In this post hoc analysis we investigated the safety and efficacy of abiraterone acetate in elderly (age 75 years or greater) and younger (less than 75 years) patient subgroups at the prespecified interim analysis (55% of total overall survival events) for the COU-AA-302 (Abiraterone Acetate in Asymptomatic or Mildly Symptomatic Patients with Metastatic Castration-Resistant Prostate Cancer) trial. MATERIALS AND METHODS Patients were stratified and randomized 1:1 to abiraterone acetate 1,000 mg plus prednisone/prednisolone 5 mg twice daily (abiraterone-prednisone) vs placebo plus prednisone/prednisolone 5 mg twice daily (prednisone alone). Co-primary end points were radiographic progression-free and overall survival. Median time to event and HR were estimated using the Kaplan-Meier method and a Cox model, respectively. RESULTS A total of 350 elderly patients treated with abiraterone-prednisone had significant improvements in overall and radiographic progression-free survival vs those with prednisone alone (HR 0.71, 95% CI 0.53-0.96 vs HR 0.63, 95% CI 0.48-0.83), similar to 738 younger patients (HR 0.81, 95% CI 0.63-1.03 vs HR 0.49, 95% CI 0.40-0.59). All secondary end points favored the abiraterone-prednisone arm for both age subgroups. Specific adverse events with abiraterone-prednisone were similar between the age subgroups. Elderly patients in both treatment arms had higher rates of fluid retention and cardiac disorders than younger patients, although rates of dose reduction or treatment interruptions due to adverse events were low in both age subgroups. CONCLUSIONS Abiraterone acetate demonstrated clinical benefit and was well tolerated in elderly and younger men with chemotherapy naïve, metastatic castration resistant prostate cancer. Thus, findings support it as a treatment option for elderly patients who may not tolerate other therapies with greater toxicity.
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Affiliation(s)
- Matthew R Smith
- Department of Genitourinary Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts.
| | - Dana E Rathkopf
- Department of Oncology and Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Peter F A Mulders
- Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Joan Carles
- Department of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Hendrik Van Poppel
- Department of Urology, University Hospitals of KU Leuven, Leuven, Belgium
| | - Jinhui Li
- Department of Biostatistics Oncology, Janssen Research & Development, Raritan, New Jersey
| | - Thian Kheoh
- Department of Biostatistics and Programming, Janssen Research & Development, San Diego, California
| | - Thomas W Griffin
- Department of WC Clinical Oncology, Janssen Research & Development, Los Angeles, California
| | - Arturo Molina
- Department of Oncology, Janssen Research & Development, Los Angeles, California
| | - Charles J Ryan
- Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
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11
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Joly F, Delva R, Mourey L, Sevin E, Bompas E, Vedrine L, Ravaud A, Eymard JC, Tubiana-Mathieu N, Linassier C, Houede N, Guillot A, Ringensen F, Cojocarasu O, Valenza B, Leconte A, Lheureux S, Clarisse B, Oudard S. Clinical benefits of non-taxane chemotherapies in unselected patients with symptomatic metastatic castration-resistant prostate cancer after docetaxel: the GETUG-P02 study. BJU Int 2014; 115:65-73. [DOI: 10.1111/bju.12552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Florence Joly
- Medical Oncology-Clinical Research Department; Centre François Baclesse - CHU Côte de Nacre; Caen France
- Universite Basse Normandie; Caen France
| | - Remy Delva
- Medical Oncology; Institut de Cancérologie de l'Ouest Centre Paul Papin; Angers France
| | - Loïc Mourey
- Medical Oncology; Institut Claudius Régaud; Toulouse France
| | - Emmanuel Sevin
- Medical Oncology-Clinical Research Department; Centre François Baclesse - CHU Côte de Nacre; Caen France
| | | | | | - Alain Ravaud
- Medical Oncology; Hôpital Saint-André; Bordeaux France
| | | | | | | | - Nadine Houede
- Medical Oncology; Institut Bergonié; Bordeaux France
| | - Aline Guillot
- Institut de Cancérologie de la Loire; Saint-Etienne France
| | | | | | - Bruno Valenza
- Oncology-Hematology; Centre Hospitalier; Frejus France
| | | | - Stéphanie Lheureux
- Medical Oncology-Clinical Research Department; Centre François Baclesse - CHU Côte de Nacre; Caen France
| | | | - Stéphane Oudard
- Medical Oncology Department; Georges Pompidou Hospital; Paris France
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12
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Nelius T, Martinez-Marin D, Hirsch J, Miller B, Rinard K, Lopez J, de Riese W, Filleur S. Pigment epithelium-derived factor expression prolongs survival and enhances the cytotoxicity of low-dose chemotherapy in castration-refractory prostate cancer. Cell Death Dis 2014; 5:e1210. [PMID: 24810046 PMCID: PMC4047872 DOI: 10.1038/cddis.2014.180] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 02/02/2014] [Accepted: 02/03/2014] [Indexed: 01/24/2023]
Abstract
There is currently no cure for advanced castration-refractory prostate cancer (CRPC) despite the recent approval of several new therapeutic agents. We report here the anti-tumor effect of the angio-inhibitory pigment epithelium-derived factor (PEDF) in the metastatic LNCaP-derivative CRPC CL1 model and explore PEDF anti-neoplasic efficacy in combination with low-dose chemotherapy. Androgen-sensitive LNCaP and CRPC PC3 cell lines were examined as comparison. Using a retroviral expression system, we showed that PEDF limited the proliferation of all prostatic cell lines tested; an effect attributed to interleukin 8 (IL8)-CXCR1/IL8RA inhibition. PEDF also reduced the number and size of 3D tumor spheroids in vitro, but only induced cell differentiation in CRPC spheroids. Similarly, PEDF inhibited the migration of CRPC cells suggesting both anti-proliferative and anti-migratory functions. In vivo, PEDF decreased by 85% and 65% the growth of subcutaneous (s.c.) PC3 and CL1 tumors, respectively. In the CL1 orthotopic model, tumor intake with lethal metastases was found in all animals; nevertheless, PEDF prolonged the median survival of tumor-bearing mice (95% confidence interval: 53±0.001 to 57±1 days). Accordingly, PEDF delayed the emergence of skeletal-related event in intra-tibial xenografts. Next, we evaluated low-dose docetaxel (DTX; 5, 1, 0.5 mg/kg) or cyclophosphamide (CTX; 10–20 mg/kg) on established s.c. PC3 tumors that conditionally express PEDF anti-tumoral epitope/NT3. Although NT3–DTX-5 mg/kg combination was inefficient, NT3–DTX-1 mg/kg and -0.5 mg/kg inhibited by 95% and 87.8%, respectively, tumor growth compared with control and induced tumor stasis. Both NT3–CTX combinations were advantageous. Inversely, PEDF–DTX-5 mg/kg and PEDF–CTX-10 mg/kg delayed the most CL1 tumor growth (15, 11 and 5 days for PEDF–DTX-5 mg/kg, PEDF–CTX-10 mg/kg and single treatments, respectively) with elevated apoptosis and serum thrombospondin-1 as possible mechanism and marker, respectively. As well, both PEDF–CTX-10 mg/kg and PEDF–DTX-5 mg/kg prolonged significantly the survival of tumor-bearing mice compared with single treatments. Metastases were reduced in PEDF–DTX-5 mg/kg compared with other treatments, suggesting that PEDF–DTX delayed metastases formation. Our results advocate that PEDF/low-dose chemotherapy may represent a new therapeutic alternative for CRPC.
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Affiliation(s)
- T Nelius
- Department of Urology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA
| | - D Martinez-Marin
- Department of Urology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA
| | - J Hirsch
- Department of Urology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA
| | - B Miller
- Department of Pathology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA
| | - K Rinard
- Department of Urology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA
| | - J Lopez
- Department of Urology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA
| | - W de Riese
- Department of Urology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA
| | - S Filleur
- 1] Department of Urology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA [2] Department of Immunology and Molecular Microbiology, Texas Tech University-Health Sciences Center, 3601 4th Street, Lubbock, TX, USA
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13
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Deshmukh RR, Schmitt SM, Hwang C, Dou QP. Chemotherapeutic inhibitors in the treatment of prostate cancer. Expert Opin Pharmacother 2013; 15:11-22. [PMID: 24156780 DOI: 10.1517/14656566.2014.852184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Prostate cancer being the second leading cause of death in men in Western countries remains a major challenge in healthcare. Several novel agents targeting signaling pathways in prostate cancer have recently been approved by the US Food and Drug Administration (FDA) but there is still an unmet need for new treatment strategies for castration-resistant prostate cancer (CRPC). AREAS COVERED This review provides a broad overview of prostate cancer therapeutics and highlights key players in the biology of prostate cancer as well as first- and second-line treatments for CRPC. Keywords 'chemotherapeutic agents', 'prostate cancer', 'Phase III clinical trials' and 'US FDA approval' were used for search in PubMed and clinicalTrials.gov databases and the obtained literature was reviewed and summarized. EXPERT OPINION Owing to the advances in screening and diagnostic techniques, the majority of prostate cancer cases are diagnosed at an early stage resulting in an almost 100% 5-year survival rate. Recently FDA-approved novel agents (e.g., abiraterone acetate and enzalutamide) have provided new hope in the fight against prostate cancer. However, CRPC remains an incurable disease. Identification of mechanisms of resistance, new biomarkers, appropriate clinical trial end points and novel treatments holds the key for the future of prostate cancer therapy.
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Affiliation(s)
- Rahul R Deshmukh
- Wayne state University, Karmanos Cancer Institute, School of Medicine, Department of Pathology , 540.1 HWCRC, 4100 John R Road, Detroit, MI 48201 , USA
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14
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Sridhar SS, Freedland SJ, Gleave ME, Higano C, Mulders P, Parker C, Sartor O, Saad F. Castration-resistant prostate cancer: from new pathophysiology to new treatment. Eur Urol 2013; 65:289-99. [PMID: 23957948 DOI: 10.1016/j.eururo.2013.08.008] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 08/01/2013] [Indexed: 12/31/2022]
Abstract
CONTEXT Until recently, the only approved agent for metastatic castration-resistant prostate cancer (mCRPC) was docetaxel chemotherapy. But over the last 5 years, significant advances in the field have led to the approval of five new agents, each with different mechanisms of action and demonstrating improved overall survival in separate randomized phase 3 trials. Many of these novel agents are now also being evaluated in earlier stages of the disease, which may ultimately lead to even better outcomes. OBJECTIVE To summarize the current literature on the management of mCRPC with a particular focus on novel chemotherapy approaches, hormonal approaches, immunotherapy, and radiopharmaceuticals showing survival benefits in phase 3 clinical trials. Emerging therapies in late stages of development are also discussed briefly. EVIDENCE ACQUISITION A comprehensive search of PubMed, identified studies pertaining to novel therapies evaluated in mCRPC since the initial approval of docetaxel in 2004. Abstracts from major international meetings were hand searched to identify studies of novel agents in late stage development in mCRPC. The Clinical Trials.gov database was used to find ongoing clinical trials in the area of mCRPC. A detailed search of each new agent was also performed to ensure that additional trials of these agents in other stages of the disease were included where relevant. EVIDENCE SYNTHESIS The main agents discussed are the androgen synthesis inhibitor abiraterone acetate, the androgen receptor inhibitor enzalutamide, the novel taxane chemotherapy cabazitaxel, the immunotherapy sipuleucel-T, and the radiopharmaceutical radium 223. Other emerging agents and a brief discussion of negative phase 3 results are also included. CONCLUSIONS It is a very exciting time in the field of mCRPC, where therapeutic advances have improved outcomes in this disease, although once metastatic overall median survival remains a dismal 2-3 years. The key now will be to understand how best to use these new agents, understand the mechanisms of resistance to them, continue to develop novel treatment strategies, and ultimately test these agents earlier in the disease when cure may be possible.
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Affiliation(s)
| | - Stephen J Freedland
- Durham VA Medical Center and Duke University Medical Center, Durham, NC, USA
| | | | | | - Peter Mulders
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | | | - Fred Saad
- University of Montreal Hospital Center, Montreal, PQ, Canada
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