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Assayag J, Kim C, Chu H, Webster J. The prognostic value of Eastern Cooperative Oncology Group performance status on overall survival among patients with metastatic prostate cancer: a systematic review and meta-analysis. Front Oncol 2023; 13:1194718. [PMID: 38162494 PMCID: PMC10757350 DOI: 10.3389/fonc.2023.1194718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/15/2023] [Indexed: 01/03/2024] Open
Abstract
Background There is heterogeneity in the literature regarding the strength of association between Eastern Cooperative Oncology Group performance status (ECOG PS) and mortality. We conducted a systematic review and meta-analysis of studies reporting the prognostic value of ECOG PS on overall survival (OS) in metastatic prostate cancer (mPC). Methods PubMed was searched from inception to March 21, 2022. A meta-analysis pooling the effect of ECOG PS categories (≥2 vs. <2, 2 vs. <2, and ≥1 vs. <1) on OS was performed separately for studies including patients with metastatic castration-resistant prostate cancer (mCRPC) and metastatic castration-sensitive prostate cancer (mCSPC) using a random-effects model. Analyses were stratified by prior chemotherapy and study type. Results Overall, 75 studies, comprising 32,298 patients, were included. Most studies (72/75) included patients with mCRPC. Higher ECOG PS was associated with a significant increase in mortality risk, with the highest estimate observed among patients with mCRPC with an ECOG PS of ≥2 versus <2 (hazard ratio [HR]: 2.10, 95% confidence interval [CI]: 1.87-2.37). When stratifying by study type, there was a higher risk estimate of mortality among patients with mCRPC with an ECOG PS of ≥1 versus <1 in real-world data studies (HR: 1.98, 95% CI: 1.72-2.26) compared with clinical trials (HR: 1.32, 95% CI: 1.13-1.54; p < 0.001). There were no significant differences in the HR of OS stratified by previous chemotherapy. Conclusion ECOG PS was a significant predictor of OS regardless of category, previous chemotherapy, and mPC population. Additional studies are needed to better characterize the effect of ECOG PS on OS in mCSPC.
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Affiliation(s)
- Jonathan Assayag
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
| | - Chai Kim
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
| | - Haitao Chu
- Statistical Research and Data Science Center, Global Biometrics and Data Management, Pfizer Inc., New York, NY, United States
| | - Jennifer Webster
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
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García Trevijano Cabetas M, Escario-Gómez M, González-Del Valle L, Sobrino Jiménez C, Bilbao Gomez-Martino C, Romero-Garrido JA, Benedi-González J, Espinosa Arranz E, Díaz Almirón M, Herrero Ambrosio A. Real-world outcomes of abiraterone and enzalutamide in first-line treatment of metastatic castration-resistant prostate cancer: which patients benefit most? Eur J Hosp Pharm 2023; 30:268-272. [PMID: 34620687 PMCID: PMC10447949 DOI: 10.1136/ejhpharm-2021-002798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/28/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Abiraterone and enzalutamide are two oral novel androgen receptor axis-targeted agents approved for the treatment of castration-resistant prostate cancer (mCRPC). Despite the availability of multiple treatments, there is a need to improve the knowledge and management of these drugs in the real-world setting, especially in patient groups under-represented in clinical trials. Our aim was to review the outcome of patients with chemotherapy-naïve mCRPC treated with abiraterone or enzalutamide in routine clinical practice in order to identify factors that are predictive for response. METHODS This observational retrospective study was performed in a Spanish tertiary hospital and included men with chemotherapy-naïve mCPRC who started treatment with abiraterone or enzalutamide between September 2012 and November 2018. The study end date was 30 October 2020. RESULTS Ninety patients with mCRPC were included, 57 with abiraterone and 33 with enzalutamide. Median overall survival (OS) was 26.87 months (95% CI 19.68 to 34.05), with no difference found between the two treatment groups. Nine variables were related to increased OS in the univariate analysis: Eastern Cooperative Oncology Group (ECOG) performance status (0-1 vs 2), pain (need of opioids for cancer pain), visceral disease, ≥3 bone lesions, exclusively lymph node metastases, baseline prostate specific antigen (PSA) (<50 vs ≥50 ng/dL and <20 vs ≥20 ng/dL), haemoglobin (<12 vs ≥12 g/dL) and alkaline phosphatase (≤116 vs >116 IU/L). A PSA response >50% was observed in 65 patients (76.5%). In the multivariate analysis, ECOG performance status, pain, visceral disease and alkaline phosphatase provided independent prognostic information. Median OS by Kaplan-Meier analysis was significantly longer for patients with a PSA response (32.1 vs 17.9 months; HR 0.46, 95% CI 0.27 to 0.78; p=0.003). CONCLUSIONS This study assessed the efficacy of abiraterone and enzalutamide in a real-world setting, including patients under-represented in pivotal studies. Some clinical factors were correlated with improved OS in chemotherapy-naïve men with mCPRC treated with these drugs.
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Affiliation(s)
| | | | | | | | | | | | - Juana Benedi-González
- Pharmacy Department, Universidad Complutense de Madrid, Madrid, Comunidad de Madrid, Spain
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Freedland SJ, Hong A, El-Chaar N, Murty S, Ramaswamy K, Coutinho AD, Nimke D, Morgans AK. Prostate-specific antigen response and clinical progression-free survival in Black and White men with chemotherapy-naïve metastatic castration-resistant prostate cancer treated with enzalutamide in a real-world setting. Prostate Cancer Prostatic Dis 2023; 26:523-530. [PMID: 36517634 PMCID: PMC10449620 DOI: 10.1038/s41391-022-00622-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/08/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND In the United States, Black men have a higher incidence of prostate cancer (PC)-related mortality than men of other races. Several real-world studies in advanced PC suggest, however, that Black men respond better to novel hormonal therapies than White men. Data on treatment responses to enzalutamide by race are limited. We assessed real-world prostate-specific antigen (PSA) response and clinical progression-free survival (cPFS) of Black vs. White men with chemotherapy-naïve PC treated with enzalutamide. METHODS This retrospective cohort study included patients with PC who initiated enzalutamide treatment from 2014 to 2018 in the IntrinsiQ Specialty Solutions™ database, a collection of electronic medical records from community urology practices. Index date was the date of the first prescription for enzalutamide, used as a proxy for metastatic castration-resistant PC (mCRPC). Patients who had undergone chemotherapy and/or abiraterone therapy were excluded. Kaplan-Meier and Cox models adjusted for baseline characteristics were used to estimate PSA response and cPFS by race. RESULTS The study included 214 Black and 1332 White men with chemotherapy-naïve PC presumed to have mCRPC based on the enzalutamide indication during the study period. Black men were younger and had higher baseline median PSA levels than White men. Enzalutamide therapy duration, follow-up time, and number of post-index PSA tests were similar between races. In multivariable analyses, the risk of patients achieving a ≥ 50% PSA decline was similar, whereas a numerically higher trend of ≥90% PSA decline was observed in Black men (HR 1.23; 95% CI 0.93-1.62 [P = 0.14]). In the multivariable analysis, Black men had significantly better cPFS (HR 0.82; 95% CI 0.68-0.98 [P = 0.03]). CONCLUSIONS Black and White men with presumed chemotherapy-naïve mCRPC had similar PSA responses when treated with enzalutamide, but Black men had better cPFS than White men. Further research is warranted to validate these findings.
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Affiliation(s)
- Stephen J Freedland
- Center for Integrated Research in Cancer and Lifestyle, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Durham VA Health Care System, Durham, NC, USA.
| | - Agnes Hong
- Astellas Pharma Inc., Northbrook, IL, USA
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Sigorski D, Wilk M, Gawlik-Urban A, Sałek-Zań A, Kiszka J, Malik M, Czerko K, Kuć K, Szczylik C, Kubiatowski T, Cybulska-Stopa B, Filipczyk-Cisarż E, Bodnar L, Skoneczna I. Real-life data of abiraterone acetate and enzalutamide treatment in post-chemotherapy metastatic castration-resistant prostate cancer in Poland. Front Oncol 2023; 13:1108937. [PMID: 37077831 PMCID: PMC10108911 DOI: 10.3389/fonc.2023.1108937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 02/27/2023] [Indexed: 04/05/2023] Open
Abstract
BackgroundAbiraterone acetate (ABI) and Enzalutamide (ENZA) are second-generation hormone drugs that show breakthrough activity in post-chemotherapy, metastatic castration-resistant prostate cancer (mCRPC). The leading oncological and urological guidelines indicate both drugs with the same strong recommendation. There is a lack of randomized trials which compare the efficacy of ABI and ENZA. The current study aimed to compare the effectiveness of the drugs with an analysis of prognostic factors related to those drugs.Patients and methodsThe study included 420 patients with docetaxel (DXL) pretreated mCRPC from seven Polish cancer centers. Patients were treated according to inclusion and exclusion criteria in the Polish national drug program (1000 mg ABI and 10 mg prednisone, n=76.2%; ENZA, 160 mg; n=23.8%). The study retrospectively analyzed the overall survival (OS), time to treatment failure (TTF), PSA 50% decline rate (PSA 50%) and selected clinic-pathological data.ResultsIn the study group, the median OS was 17 months (95% CI: 15.6-18.3). The median OS (26.1 vs. 15.7 mo.; p<0.001), TTF (14.2 vs. 7.6 mo.; p<0.001) and PSA 50% (87.5 vs. 56%; p<0.001) were higher in ENZA than in ABI treatment. Multivariate analysis shows that ENZA treatment and PSA nadir <17.35 ng/mL during or after DXL treatment were related to longer TTF. ENZA treatment, DXL dose ≥750 mg, PSA nadir <17.35 ng/mL during or after DXL treatment was related to longer OS.ConclusionsENZA treatment may be related to more favorable oncological outcomes than ABI treatment in the studied Polish population of patients. A 50% decline in PSA is an indicator of longer TTF and OS. Due to the non-randomized and retrospective nature of the analysis, the current results require prospective validation.
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Affiliation(s)
- Dawid Sigorski
- Department of Oncology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
- Department of Oncology and Immuno-Oncology, Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration Hospital, Olsztyn, Poland
- *Correspondence: Dawid Sigorski,
| | - Michał Wilk
- Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
| | - Angelika Gawlik-Urban
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
- Faculty of Health Sciences, University of Applied Sciences in Tarnów, Tarnów, Poland
| | - Agata Sałek-Zań
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Joanna Kiszka
- Department of Clinical Oncology, Subcarpathian Cancer Center, Brzozów, Poland
| | - Mateusz Malik
- Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Centre, Wroclaw, Poland
| | - Katarzyna Czerko
- Department of Clinical Oncology and Radiotherapy, St. John Paul II Mazovia Regional Hospital in Siedlce, Siedlce, Poland
| | - Kamil Kuć
- Department of Oncology, St. Pio’s Provincial Hospital, Przemyśl, Poland
| | - Cezary Szczylik
- Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
| | - Tomasz Kubiatowski
- Department of Oncology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
- Department of Oncology and Immuno-Oncology, Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration Hospital, Olsztyn, Poland
| | - Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Emilia Filipczyk-Cisarż
- Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Centre, Wroclaw, Poland
| | - Lubomir Bodnar
- Department of Clinical Oncology and Radiotherapy, St. John Paul II Mazovia Regional Hospital in Siedlce, Siedlce, Poland
- Faculty of Medical and Health Sciences, University of Natural Sciences and Humanities, Siedlce, Poland
| | - Iwona Skoneczna
- Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland
- Department of Oncology, Grochowski Hospital, Warsaw, Poland
- Cancer & Cardio-Oncology Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Hu M, Mao Y, Guan C, Tang Z, Bao Z, Li Y, Liang G. Dynamic changes in PSA levels predict prognostic outcomes in prostate cancer patients undergoing androgen -deprivation therapy: A multicenter retrospective analysis. Front Oncol 2023; 13:1047388. [PMID: 36845723 PMCID: PMC9948006 DOI: 10.3389/fonc.2023.1047388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
Background Androgen-deprivation therapy (ADT) is used for the treatment of prostate cancer. However, the specific risk factors for the development of castration-resistant disease are still unclear. The present study sought to identify predictors of patient prognostic outcomes through analyses of clinical findings in large numbers of prostate cancer patients following ADT treatment. Methods Data pertaining to 163 prostate cancer patients treated at the Second Affiliated Hospital of Bengbu Medical University and Maoming People's Hospital from January 1, 2015, to December 30, 2020, were retrospectively analyzed. Dynamic changes in prostate-specific antigen (PSA) levels were regularly assessed, including both time to nadir (TTN) and nadir PSA (nPSA). Univariate and multivariate analyses were performed with Cox risk proportional regression models, while differences in biochemical progression-free survival (bPFS) were compared among groups with Kaplan-Meier curves and log-rank tests. Results The bPFS values over the median 43.5-month follow-up period differed significantly between patients with nPSA levels < 0.2 ng/mL and ≥ 0.2 ng/mL, being 27.6 months and 13.5 months, respectively (log-rank P < 0.001). A significant difference in median bPFS was also observed when comparing patients with a TTN ≥ 9 months (27.8 months) to those with a TTN < 9 months (13.5 months) (log-rank P < 0.001). Conclusions TTN and nPSA are valuable predictors of prognosis in prostate cancer patients after ADT treatment, with better outcomes evident in patients with nPSA < 0.2 ng/mL and TTN > 9 months.
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Affiliation(s)
- Mingqiu Hu
- Department of Urology, Maoming People’s Hospital, Maoming, China,Department of Urology, the Second Affiliated Hospital of Bengbu Medical College, Bengbu, China,*Correspondence: Mingqiu Hu,
| | - Yifeng Mao
- Department of Urology, the Second Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Chao Guan
- Department of Urology, the Second Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Zhizhong Tang
- Department of Urology, Maoming People’s Hospital, Maoming, China,Department of Center of science, Maoming People’s Hospital, Guangdong, China
| | - Zhihang Bao
- Anhui Province Key Laboratory of Translational Cancer Research, Bengbu Medical University, Anhui, China
| | - Yingbang Li
- Department of Center of science, Maoming People’s Hospital, Guangdong, China
| | - Guowu Liang
- Department of Center of science, Maoming People’s Hospital, Guangdong, China
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Zeng Z, Zhou R, Sun R, Zhang X, Zhang D, Zhu Q, Chen C. Nonlinear hybridization chain reaction-based flow cytometric immunoassay for the detection of prostate specific antigen. Anal Chim Acta 2022; 1220:340048. [DOI: 10.1016/j.aca.2022.340048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 11/01/2022]
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Biomarker-Based Evaluation of Treatment Response and Surveillance of HPV-Associated Squamous Cell Carcinoma. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-021-00386-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Ultrasensitive prostate specific antigen monitoring based on electrochemiluminescent immunesystem with synergistic signal amplification effect of resonance energy transfer coupling with K2S2O8-H2O2 dual coreactants. J Electroanal Chem (Lausanne) 2021. [DOI: 10.1016/j.jelechem.2021.115697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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9
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Karyağar S, Güven O, Karyağar SS, Arici S, Selvi O, Geredeli Ç, Özülker F. Can 68Ga-PSMA PET/CT-derived prostate-specific membrane antigen expression parameters predict prostate-specific antigen response to enzalutamide treatment? Nucl Med Commun 2021; 42:1011-1016. [PMID: 33958536 DOI: 10.1097/mnm.0000000000001431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In patients with metastatic castration-resistant prostate cancer (mCRPCa), enzalutamide is administered when docetaxel treatment fails. The purpose of the study was to evaluate the relationship between prostate-specific antigen (PSA) response and metabolic parameters obtained from 68Ga-PSMA PET/CT before treatment in this patient group. METHODS From February 2018 to May 2020, 34 patients with mCRPCa were enrolled in this study. The association between PSA response (at least 50% decrease compared to the pretreatment value) and quantitative prostate-specific membrane antigen (PSMA) expression parameters such as SUVmax, SUVmean, PSMA-TV (PSMA receptor-expressing tumor volume) and TL-PSMA (total lesion PSMA receptor expression) were evaluated. RESULTS Mean SUVmax, SUVmean, PSMA receptor-expressing tumor volume (PSMA-TV) and total lesion PSMA receptor expression (TL-PSMA) values were 33.66 ± 20.42; 8.82 ± 5.03; 319.85 ± 615.12 cm3; and 2894.76 ± 5195.13, respectively. In the posttreatment 12th week, 22 patients (64.7%) had PSA response, while 12 patients (35.3%) were nonresponders. In patients with PSA response, PSMA-TV values were significantly lower than nonresponders (78.37 ± 80.99 cm3 vs. 451.58 ± 734.61 cm3; P = 0.028). But there was no significant difference between responders and nonresponders in terms of age, ISUP grade, SUVmax, SUVmean, TL-PSMA, pretreatment PSA values, presence of local recurrence or metastases at any site. CONCLUSION PSMA-TV values on 68Ga-PSMA PET/CT imaging before starting enzalutamide treatment following docetaxel failure can predict PSA response in patients with mCRPCa.
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Affiliation(s)
| | | | | | - Serdar Arici
- Department of Medical Oncology, Health Science University Medical Faculty, Prof Dr Cemil Taşçioğlu City Hospital, Istanbul, Turkey
| | - Oğuzhan Selvi
- Department of Medical Oncology, Health Science University Medical Faculty, Prof Dr Cemil Taşçioğlu City Hospital, Istanbul, Turkey
| | - Çağlayan Geredeli
- Department of Medical Oncology, Health Science University Medical Faculty, Prof Dr Cemil Taşçioğlu City Hospital, Istanbul, Turkey
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High Tumor Burden Predicts Poor Response to Enzalutamide in Metastatic Castration-Resistant Prostate Cancer Patients. Cancers (Basel) 2021; 13:cancers13163966. [PMID: 34439119 PMCID: PMC8392339 DOI: 10.3390/cancers13163966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 11/18/2022] Open
Abstract
Simple Summary Several available medications are involved in the treatment of metastatic castration-resistant prostate cancer (mCRPC). In this Taiwanese mCRPC cohort receiving enzalutamide patients with high tumor burden (HTB) were defined as those with either appendicular bony metastasis or visceral metastasis. A high tumor burden reduced the PSA response rate, radiological response rate, and progression-free survival duration. In addition, patients’ comorbidities and laboratory data—such as ALP, LDH, ALT, and hemoglobin—were correlated with the treatment efficacy of enzalutamide. Our study revealed a tumor burden before the use of enzalutamide was associated with treatment outcomes. The physician can use this information to estimate the response rate of enzalutamide and help formulate a personalized treatment plan for mCRPC patients. Abstract To assess the predictive value of tumor burden on the biochemical response, and radiological response in Taiwanese metastatic castration-resistant prostate cancer (mCRPC) patients receiving enzalutamide. The mCRPC patients treated with enzalutamide were recruited from three hospitals. High tumor burden (HTB) was classified as metastases at either appendicular bone or visceral organ. Good prostate-specific antigen (PSA) response was defined as PSA reduction of 80%. In this cohort, there were 104 (54.2%) HTB patients and 88 (45.8%) with low tumor burden (LTB). Compared to LTB patients, fewer HTB patients had good PSA response (odds ratio: 0.43, range: 0.22–0.87, p = 0.019) and fewer radiological response (complete and partial remission) (odds ratio: 0.78, range: 0.36–1.68, p = 0.52) to enzalutamide. The disease control rate which also contained stable disease, was still lower in HTB (76.0%) than LTB group (92.9%, OR: 0.24, range: 0.07–0.77, p = 0.016) in the multivariable model. In addition, HTB patients had significantly shorter progression–free survival duration than did LTB patients (median: 8.3 vs. 21.6 months, log-rank test p = 0.003) in the univariable analysis. The tumor burden before the use of enzalutamide was associated with treatment outcomes. HTB reduced PSA response rate, radiological response rate and progression-free survival duration.
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Gong Q, Zhang X, Liang A, Huang S, Tian G, Yuan M, Ke Q, Cai Y, Yan B, Wang J, Wang J. Proteomic screening of potential N-glycoprotein biomarkers for colorectal cancer by TMT labeling combined with LC-MS/MS. Clin Chim Acta 2021; 521:122-130. [PMID: 34242638 DOI: 10.1016/j.cca.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Colorectal cancer (CRC) is part of the most widespread malignant tumors. At present, colonoscopy is a routine procedure in the diagnosis of CRC, but it is traumatic. Carcinoembryonic antigen, CA199, and CA242 are common serum markers for the diagnosis of CRC; however, they do not demonstrate satisfactory specificity and sensitivity for the diagnosis of CRC. Hence, Now it is necessary to screen many valuable serum biomarkers for CRC, proteomics methods have been used to investigate PTMs such as glycosylation of proteins with prominent roles in the occurrence and development of tumors. METHODS This study screens altering glycosylated proteins of CRC tissues using LC-MS/MS quantitative glycoproteomics, and then these candidate biomarkers for CRC are further validated by serum glycoproteomics. RESULTS The results of glycoproteomics in CRC tissues show that the abundance of 160 and 79 glycerogelatin proteins was obviously upregulated and downregulated compared with their adjacent tissues(P < 0.05). Bioinformatics analysis suggests that these molecules are mainly involved in many biological processes, including skeletal system development, collagen fibril organization, and receptor-mediated endocytosis. Results of serum glycoproteomics show that the changing trends of 2 protein glycosylation were consistent with MS results of CRC tissues, including ICAM1and APMAP. Areas under the ROC curve (AUC) results confirm that ICAM1and APMAP as early immune diagnosis markers of CRC has excellent sensitivity and specificity. CONCLUSION The ICAM1 and APMAP may serve as a potential tumor marker for CRC.
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Affiliation(s)
- Qian Gong
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China
| | - Xiuming Zhang
- Medical Laboratory of Shenzhen Luohu People's Hospital, Shenzhen, PR China
| | - Aifeng Liang
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China
| | - Sinian Huang
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China
| | - Guangang Tian
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China
| | - Mengjiao Yuan
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China
| | - Qing Ke
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China
| | - Yijun Cai
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China
| | - Bin Yan
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China
| | - Jin Wang
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China; Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063210, PR China.
| | - Jinjin Wang
- Department of Clinical Laboratory, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, PR China.
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Finelli A, Beer TM, Chowdhury S, Evans CP, Fizazi K, Higano CS, Kim J, Martin L, Saad F, Saarela O. Comparison of Joint and Landmark Modeling for Predicting Cancer Progression in Men With Castration-Resistant Prostate Cancer: A Secondary Post Hoc Analysis of the PREVAIL Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2112426. [PMID: 34129025 PMCID: PMC8207237 DOI: 10.1001/jamanetworkopen.2021.12426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Dynamic prediction models may help predict radiographic disease progression in advanced prostate cancer. OBJECTIVE To assess whether dynamic prediction models aid prognosis of radiographic progression risk, using ongoing longitudinal prostate-specific antigen (PSA) assessments. DESIGN, SETTING, AND PARTICIPANTS This prognostic study used data from the PREVAIL study to compare dynamic models for predicting disease progression. The PREVAIL study was a phase 3, multinational, double-blind, placebo-controlled randomized clinical trial of enzalutamide for prostate cancer conducted from September 2010 to September 2012. A total of 773 men with metastatic castration-resistant prostate cancer (CRPC) who had never received chemotherapy and had no baseline visceral disease were treated with enzalutamide. For illustration, 4 patients were selected based on PSA kinetics or PSA response in case studies. Data were analyzed from July 2018 to September 2019. MAIN OUTCOMES AND MEASURES Landmark and joint models were applied to dynamically predict radiographic progression-free survival (PFS) using longitudinal PSA profile, baseline PSA, lactate dehydrogenase, and hemoglobin levels. The main outcome was radiographic PFS as predicted using landmark and joint models. Current PSA and PSA change were considered longitudinal biomarkers possibly associated with radiographic PFS. Predictive performance was evaluated using Brier score for overall prediction errors (PEs) and area under the curve (AUC) for model discriminative capability. Case studies were illustrated using dynamic prediction plots. RESULTS A total of 763 men with metastatic CRPC treated with enzalutamide (mean [SD] age, 71.2 [8.5] years; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 28.4 [4.6]) were included in the analysis. Current PSA and PSA change were associated with radiographic PFS in all models. Adding the PSA slope, compared with the landmark models using current PSA alone, improved the prediction of 5-month prospect of radiographic progression, with relative gains of 5.7% in prediction (PE [SE], 0.132 [0.008] vs 0.140 [0.008]) and 7.7% in discrimination (AUC [SE], 0.800 [0.018] vs 0.743 [0.018]) at month 10. In joint models with linear vs nonlinear PSA, prediction of 5-month risk of radiographic progression was improved when PSA trajectories were not assumed to be linear, with 8.0% relative gain in prediction (PE [SE], 0.150 [0.006] vs 0.138 [0.005]) and 19.4% relative gain in discrimination (AUC [SE], 0.653 [0.022] vs 0.780 [0.016]) at month 10. Predictions were affected by amount of marker information accumulated and prespecified assumptions. PSA changes affected progression risk more strongly at later vs earlier follow-up. CONCLUSIONS AND RELEVANCE This prognostic study found that prediction of radiographic PFS was improved when longitudinal PSA information was added to baseline variables. In a population of patients with metastatic CRPC, dynamic predictions using landmark or joint models may help identify patients at risk of progression.
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Affiliation(s)
- Antonio Finelli
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Tomasz M. Beer
- Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Simon Chowdhury
- St Thomas’ Hospitals and Sarah Cannon Research Institute, London, United Kingdom
| | - Christopher P. Evans
- Department of Urologic Surgery, UC Davis Comprehensive Cancer Center, University of California, Davis
| | - Karim Fizazi
- Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Celestia S. Higano
- University of Washington, Seattle
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Janet Kim
- Astellas Pharma Global Development, Northbrook, Illinois
| | - Lisa Martin
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Fred Saad
- Centre Hospitalier de l’Université de Montréal/CRCHUM, Montréal, Canada
| | - Olli Saarela
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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13
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Lozano R, Lorente D, Aragon IM, Romero-Laorden N, Nombela P, Mateo J, Reid AHM, Cendón Y, Bianchini D, Llacer C, Sandhu SK, Sharp A, Rescigno P, Garcés T, Pacheco MI, Flohr P, Massard C, López-Casas PP, Castro E, de Bono JS, Olmos D. Value of Early Circulating Tumor Cells Dynamics to Estimate Docetaxel Benefit in Metastatic Castration-Resistant Prostate Cancer (mCRPC) Patients. Cancers (Basel) 2021; 13:cancers13102334. [PMID: 34066080 PMCID: PMC8151844 DOI: 10.3390/cancers13102334] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary The prognostic role of CTC enumeration in mCRPC patients has been established in several studies, demonstrating a higher prognostic performance than post-treatment changes in PSA levels in patients treated with AR signaling inhibitors, but not taxanes. We carried out a pooled analysis of two prospective studies in mCRPC patients treated with docetaxel. The results of this study showed a greater ability of early changes in circulating tumor cells (CTCs) compared to PSA response endpoints to predict overall survival in metastatic castration-resistant prostate cancer (mCRPC) patients treated with docetaxel. These results encourage the clinical usefulness of CTC enumeration to determine the outcome of mCRPC patients. Abstract Circulating tumor cell (CTC) enumeration and changes following treatment have been demonstrated to be superior to PSA response in determining mCRPC outcome in patients receiving AR signaling inhibitors but not taxanes. We carried out a pooled analysis of two prospective studies in mCRPC patients treated with docetaxel. CTCs were measured at baseline and 3–6 weeks post treatment initiation. Cox regression models were constructed to compare 6-month radiographical progression-free survival (rPFS), CTCs and PSA changes predicting outcome. Among the subjects, 80 and 52 patients had evaluable baseline and post-treatment CTC counts, respectively. A significant association of higher baseline CTC count with worse overall survival (OS), PFS and time to PSA progression (TTPP) was observed. While CTC response at 3–6 weeks (CTC conversion (from ≥5 to <5 CTCs), CTC30 (≥30% decline in CTC) or CTC0 (decline to 0 CTC)) and 6-month rPFS were significantly associated with OS (all p < 0.005), the association was not significant for PSA30 or PSA50 response. CTC and PSA response were discordant in over 50% of cases, with outcome driven by CTC response in these patients. The c-index values for OS were superior for early CTC changes compared to PSA response endpoints, and similar to 6-month rPFS. Early CTC declines were good predictors of improved outcomes in mCRPC patients treated with docetaxel in this small study, offering a superior and/or earlier estimation of docetaxel benefit in comparison to PSA or rPFS that merits further confirmation in larger studies.
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Affiliation(s)
- Rebeca Lozano
- Genitourinary Cancer Traslational Research Group, The Institute of Biomedical Research in Málaga (IBIMA), 29010 Málaga, Spain; (R.L.); (I.M.A.); (C.L.); (T.G.); (M.I.P.); (E.C.)
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
| | - David Lorente
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
- Servicio de Oncología Médica, Hospital Provincial de Castellón, 12004 Castellón de la Plana, Spain
| | - Isabel M. Aragon
- Genitourinary Cancer Traslational Research Group, The Institute of Biomedical Research in Málaga (IBIMA), 29010 Málaga, Spain; (R.L.); (I.M.A.); (C.L.); (T.G.); (M.I.P.); (E.C.)
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
| | - Nuria Romero-Laorden
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
- Hospital Universitario La Princesa, 28006 Madrid, Spain
| | - Paz Nombela
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
| | - Joaquim Mateo
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
- The Royal Marsden NHS Foundation Trust, Sutton, London SM2 5PT, UK
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Alison H. M. Reid
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
- The Royal Marsden NHS Foundation Trust, Sutton, London SM2 5PT, UK
| | - Ylenia Cendón
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
| | - Diletta Bianchini
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
- The Royal Marsden NHS Foundation Trust, Sutton, London SM2 5PT, UK
| | - Casilda Llacer
- Genitourinary Cancer Traslational Research Group, The Institute of Biomedical Research in Málaga (IBIMA), 29010 Málaga, Spain; (R.L.); (I.M.A.); (C.L.); (T.G.); (M.I.P.); (E.C.)
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Shahneen K. Sandhu
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
- The Royal Marsden NHS Foundation Trust, Sutton, London SM2 5PT, UK
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Adam Sharp
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
- The Royal Marsden NHS Foundation Trust, Sutton, London SM2 5PT, UK
| | - Pasquale Rescigno
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
- The Royal Marsden NHS Foundation Trust, Sutton, London SM2 5PT, UK
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy
| | - Teresa Garcés
- Genitourinary Cancer Traslational Research Group, The Institute of Biomedical Research in Málaga (IBIMA), 29010 Málaga, Spain; (R.L.); (I.M.A.); (C.L.); (T.G.); (M.I.P.); (E.C.)
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
| | - Maria I. Pacheco
- Genitourinary Cancer Traslational Research Group, The Institute of Biomedical Research in Málaga (IBIMA), 29010 Málaga, Spain; (R.L.); (I.M.A.); (C.L.); (T.G.); (M.I.P.); (E.C.)
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
| | - Penelope Flohr
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
| | - Christophe Massard
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
- Department of Medical Oncology, Faculté de Medicine Paris-Sud XI, Institut Gustave Roussy, 94805 Villejuif, France
| | - Pedro P. López-Casas
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
| | - Elena Castro
- Genitourinary Cancer Traslational Research Group, The Institute of Biomedical Research in Málaga (IBIMA), 29010 Málaga, Spain; (R.L.); (I.M.A.); (C.L.); (T.G.); (M.I.P.); (E.C.)
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
| | - Johann S. de Bono
- The Institute of Cancer Research, London SW7 3RP, UK; (J.M.); (A.H.M.R.); (D.B.); (S.K.S.); (A.S.); (P.R.); (P.F.); (C.M.); (J.S.d.B.)
- The Royal Marsden NHS Foundation Trust, Sutton, London SM2 5PT, UK
| | - David Olmos
- Genitourinary Cancer Traslational Research Group, The Institute of Biomedical Research in Málaga (IBIMA), 29010 Málaga, Spain; (R.L.); (I.M.A.); (C.L.); (T.G.); (M.I.P.); (E.C.)
- Spanish National Cancer Research Centre (CNIO), Prostate Cancer Clinical Research Unit, 28029 Madrid, Spain; (D.L.); (N.R.-L.); (P.N.); (Y.C.); (P.P.L.-C.)
- Correspondence:
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Loriot Y, Fizazi K. Circulating tumor DNA in patients with metastatic prostate cancer treated with abiraterone acetate. Ann Oncol 2021; 32:694-695. [PMID: 33839261 DOI: 10.1016/j.annonc.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022] Open
Affiliation(s)
- Y Loriot
- Department of Cancer Medicine and INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
| | - K Fizazi
- Department of Cancer Medicine and INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer. Cancers (Basel) 2021; 13:cancers13030526. [PMID: 33573172 PMCID: PMC7866532 DOI: 10.3390/cancers13030526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 01/22/2023] Open
Abstract
Simple Summary Serum prostate-specific antigen (PSA) level is the most valuable biomarker in prostate cancer. This study investigates the predictive value of achieving >30% PSA decline at four weeks of first-line androgen signaling inhibitors (ASIs) using a multi-institutional cohort dataset of 254 mCRPC patients. The achievement of >30% PSA decline at four weeks is an independent predictor for overall survival (OS). Interestingly, in patients who did not achieve >30% PSA decline at four weeks—an achievement of the >30% PSA decline at 12 weeks is eventually observed in 30.9% of those patients. To identify the variables that discriminate the patient survival in 97 patients without achieving >30% PSA decline at four weeks of the first-line treatment, a multivariate analysis is conducted. The duration of androgen deprivation therapy before CRPC < 12 months and Eastern Cooperative Oncology Group Performance Status ≥ 1 are identified as independent predictors for shorter OS for those patients. Abstract The identification of early or primary resistance to androgen signaling inhibitors (ASIs) is of great value for the treatment of metastatic castration-resistant prostate cancer (mCRPC). This study evaluates the predictive value of prostate-specific antigen (PSA) response at dour weeks of first-line ASIs treatment for mCRPC patients. A total of 254 patients treated with ASIs (abiraterone acetate: AA and enzalutamide: Enz) at the first-line treatment are retrospectively analyzed. Patients are stratified according to the achievement of >30% PSA decline at 4 and 12 weeks from the treatment initiation. At four weeks of the treatment, 157 patients (61.8%) achieved >30% PSA decline from the baseline. Thereafter, 177 patients (69.7%) achieved >30% PSA decline at 12 weeks of the treatment. A multivariate analysis exhibits >30% PSA decline at four weeks as an independent predictor for overall survival (OS). We note that 30 of 97 (30.9%) patients who did not achieve >30% PSA decline at four weeks consequently achieved >30% PSA decline at 12 weeks, and had a comparable favorable three years OS rate as the 147 patients achieving >30% PSA decline at both 4 and 12 weeks. To identify the variables that discriminate the patient survival in 97 patients without achieving >30% PSA decline at four weeks, a multivariate analysis is performed. The duration of androgen deprivation therapy before CRPC ≤ 12 months and Eastern Cooperative Oncology Group Performance Status ≥ 1 are identified as independent predictors for shorter OS for those patients. These data offer a concept of early treatment switch after four weeks of first-line ASIs when not observing >30% PSA decline at four weeks—particularly in patients with a modest effect of ADT and poor performance status.
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16
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Prostate-specific Antigen Progression in Enzalutamide-treated Men with Nonmetastatic Castration-resistant Prostate Cancer: Any Rise in Prostate-specific Antigen May Require Closer Monitoring. Eur Urol 2020; 78:847-853. [DOI: 10.1016/j.eururo.2020.08.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 08/16/2020] [Indexed: 11/23/2022]
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17
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España S, Ochoa de Olza M, Sala N, Piulats JM, Ferrandiz U, Etxaniz O, Heras L, Buisan O, Pardo JC, Suarez JF, Barretina P, Comet J, Garcia Del Muro X, Sumoy L, Font A. PSA Kinetics as Prognostic Markers of Overall Survival in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with Abiraterone Acetate. Cancer Manag Res 2020; 12:10251-10260. [PMID: 33116879 PMCID: PMC7584507 DOI: 10.2147/cmar.s270392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/09/2020] [Indexed: 11/23/2022] Open
Abstract
Background Abiraterone acetate (AA) is widely used in the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC). However, a significant percentage of patients will still progress, highlighting the need to identify patients more likely to benefit from AA. Parameters linked to prostate-specific antigen (PSA) kinetics are promising prognostic markers. We have examined clinical and PSA-related factors potentially associated with overall survival (OS) in patients treated with AA. Methods Between 2011 and 2014, 104 patients with mCRPC treated with AA after progression to docetaxel at centers of the Catalan Institute of Oncology were included in this retrospective study. Patients were assessed monthly. Baseline characteristics and variables related to PSA kinetics were included in univariate and multivariate analyses of OS. Results Median OS was 16.4 months (range 12.4-20.6) for all patients. The univariate analysis identified the following baseline characteristics as significantly associated with OS: ECOG PS, location of metastases, time between starting androgen deprivation therapy and starting AA, time between stopping docetaxel treatment and starting AA, neutrophil-lymphocyte ratio (NLR), alkaline phosphatase levels, and PSA levels. Factors related to PSA kinetics associated with longer OS were PSA response >50%, early PSA response (>30% decline at four weeks), PSA decline >50% at week 12, PSA nadir <2.4ng/mL, time to PSA nadir >140 days, the combination of PSA nadir and time to PSA nadir, and low end-of-treatment PSA levels. The multivariate analysis identified ECOG PS (HR 37.46; p<0.001), NLR (HR 3.7; p<0.001), early PSA response (HR 1.22; p=0.002), and time to PSA nadir (HR 0.39; p=0.002) as independent prognostic markers. Conclusion Our results indicate an association between PSA kinetics, especially early PSA response, and outcome to AA after progression to docetaxel. Taken together with other factors, lack of an early PSA response could identify patients who are unlikely to benefit from AA and who could be closely monitored with a view to offering alternative therapies.
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Affiliation(s)
- Sofia España
- Catalan Institute of Oncology, Medical Oncology Department, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - Maria Ochoa de Olza
- Catalan Institute of Oncology, Medical Oncology Department, Bellvitge University Hospital, Hospitalet De Llobregat, Spain
| | - Nuria Sala
- Catalan Institute of Oncology, Medical Oncology Department, University Hospital Josep Trueta, Girona, Spain
| | - Josep Maria Piulats
- Catalan Institute of Oncology, Medical Oncology Department, Bellvitge University Hospital, Hospitalet De Llobregat, Spain
| | - Ulises Ferrandiz
- Catalan Institute of Oncology, Medical Oncology Department, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - Olatz Etxaniz
- Catalan Institute of Oncology, Medical Oncology Department, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - Lucia Heras
- Catalan Institute of Oncology, Medical Oncology Department, Bellvitge University Hospital, Hospitalet De Llobregat, Spain.,Medical Oncology Department, Hospital Sant Joan Despí Moisès Broggi, Barcelona, Spain
| | - Oscar Buisan
- Urology Department, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - Juan Carlos Pardo
- Catalan Institute of Oncology, Medical Oncology Department, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - Jose F Suarez
- Urology Department, Bellvitge University Hospital, Hospitalet de LLobregat, Spain
| | - Pilar Barretina
- Catalan Institute of Oncology, Medical Oncology Department, University Hospital Josep Trueta, Girona, Spain
| | - Josep Comet
- Urology Department, University Hospital Josep Trueta, Girona, Spain
| | - Xavier Garcia Del Muro
- Catalan Institute of Oncology, Medical Oncology Department, Bellvitge University Hospital, Hospitalet De Llobregat, Spain
| | - Lauro Sumoy
- High Content Genomics & Bioinformatics Unit, Germans Trias I Pujol Research Institute (IGTP), Program of Predictive and Personalized Medicine of Cancer (PMPPC), Campus Can Ruti, Badalona, Spain
| | - Albert Font
- Catalan Institute of Oncology, Medical Oncology Department, University Hospital Germans Trias I Pujol, Badalona, Spain
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Tian S, Lei Z, Gong Z, Sun Z, Xu D, Piao M. Clinical implication of prognostic and predictive biomarkers for castration-resistant prostate cancer: a systematic review. Cancer Cell Int 2020; 20:409. [PMID: 32863768 PMCID: PMC7448351 DOI: 10.1186/s12935-020-01508-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
Background Diagnosis of metastatic castrate resistant prostate cancer (mCRPC) with current biomarkers is difficult and often results in unnecessary invasive procedures as well as over-diagnosis and over-treatment. There are a number of prognostic biomarkers for CRPC, but there are no validated predictive biomarkers to guide in clinical decision-making. Specific biomarkers are needed that enable to understand the natural history and complex biology of this heterogeneous malignancy, identify early response to treatment outcomes and to identify the population of men most likely to benefit from the treatment. In this systematic review, we discuss the existing literature for the role of biomarkers in CRPC and how they aid in the prognosis, treatment selection and survival outcomes. Methods We performed a literature search on PubMed and EMBASE databases from January 2015 through February 2020 in accordance to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Articles were assessed to identify relevant observational studies and randomized controlled trials regarding biomarkers which aid in identifying progression to mCRPC as well as predictive biomarkers which help in treatment selection. Results We identified 3640 number of hits of which 58 articles were found to be relevant. Here we addressed biomarkers in the context of prognosis, prediction and patient selection of therapy. These biomarkers were found to be effective as prognostic or predictive factors under variety of conditions. The higher levels for all these biomarkers were associated with shorter median OS and sometimes PFS. Lower amounts of biomarkers in serum or urine were associated with prolonged survival outcomes, longer time to CRPC development or CRPC progression and longer median follow-up irrespective of any therapy. Conclusion We observed that the biomarkers included in our study predicted clinically relevant survival outcomes and treatment exposure. Though the current biomarkers are prognostic when measured prior to initiating treatment, not all are validated as predictive markers in post treatment setting. A greater understanding of biomarkers in CRPC is need of the hour for development of more personalized approach to maximize benefit and minimize harm in men with CRPC.
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Affiliation(s)
- Shengri Tian
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Zhen Lei
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Zuo Gong
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Zhonghai Sun
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Dongyuan Xu
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
| | - Minhu Piao
- Department of Urology, Yanbian University Hospital, Yanji, Jilin China
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Kafka M, Eder IE, Klocker H, Heidegger I. Emerging promising biomarkers for treatment decision in metastatic castration-resistant prostate cancer. Urol Oncol 2020; 38:801-815. [PMID: 32591248 DOI: 10.1016/j.urolonc.2020.05.025] [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: 12/10/2019] [Revised: 05/11/2020] [Accepted: 05/22/2020] [Indexed: 12/11/2022]
Abstract
Prostate cancer is one of the most common causes of death in males. Even if treatment is often of curative intent in early stages of the disease, up to 50% of patients relapse after primary therapy. Moreover, 10% to 15% of patients present in a primary metastatic stage of disease. In the past years the treatment landscape of metastatic castration-resistant prostate cancer expanded due to the development of second-generation antiandrogens (abiraterone acetate, enzalutamide), chemotherapeutic agents and radium-223. With the availability of several therapeutic lines, we are now confronted with the problem of choosing the most suitable therapy in each state of disease. As often observed in clinical routine, prostate specific antigen is not sufficient for early prediction of a therapy response. Furthermore, biomarkers for prediction of the optimal first-line therapy are badly needed in order to avoid primary resistance. Therefore, the present short review article gives an overview of currently available clinical and preclinical biomarkers for treatment response to metastatic castration-resistant prostate cancer therapeutic agents with the aim of providing support for a personalized decision-making process in everyday use.
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Affiliation(s)
- Mona Kafka
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Iris E Eder
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helmut Klocker
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Isabel Heidegger
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria.
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Buttigliero C, Tucci M, Sonetto C, Vignani F, Di Stefano RF, Pisano C, Turco F, Lacidogna G, Guglielmini P, Numico G, Scagliotti GV, Di Maio M. Prognostic role of early PSA drop in castration resistant prostate cancer patients treated with abiraterone acetate or enzalutamide. MINERVA UROL NEFROL 2020; 72:737-745. [PMID: 32284527 DOI: 10.23736/s0393-2249.20.03708-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Previous studies demonstrated a predictive value of prostate-specific antigen (PSA) kinetics for treatment outcome. Our retrospective study evaluates the prognostic role of early PSA drop in metastatic castration resistant prostate cancer (mCRPC) patients receiving abiraterone acetate (AA) or enzalutamide (E). METHODS All mCRPC patients treated with AA or E at the San Luigi Hospital in Orbassano between 2010 and 2018 and at the Ordine Mauriziano Hospital in Turin between 2014 and 2018 were included in this retrospective study. Only patients with an early PSA (measured 28-60 days after the beginning of the treatment) were included in the analysis. Patients were divided in early responders and non-early responders according to early PSA response (drop≥50% from baseline). Univariate and multivariate analyses for progression free survival (PFS) and overall survival (OS) were performed. RESULTS Of 144 patients with early PSA value, 61 (42.4%) patients received E (docetaxel-naïve 42, post-docetaxel 19) and 83 (57.6%) received AA (docetaxel-naïve 44, post-docetaxel 39). Seventy-five (52.1%) patients achieved early PSA drop. In docetaxel-naïve setting (N.=86), median PFS was 14.9 (with early PSA drop) vs. 8.8 months (without early PSA drop, P=0.001). In post-docetaxel setting (N.=58) median PFS was 11.9 vs. 4.5 months (P<0.001). Globally, median PFS was 14.9 vs. 6.3 months in patients with and without early PSA drop, respectively (P<0.001). In docetaxel-naïve setting, patients with early PSA drop had a median OS of 39.5 vs. 18.8 months (P=0.12). In post-docetaxel setting median OS was 29.6 vs. 10.7 months (P=0.01). Comprehensively, median OS was 31.9 vs. 16.3 (P=0.002) in patients with and without early PSA drop, respectively. At multivariate analysis, early PSA drop confirmed an independent association with PFS (HR 0.21; 95% CI: 0.12-0.38, P<0.001) and OS (HR 0.25; 95% CI: 0.12-0.50, P<0.001). CONCLUSIONS mCRPC patients treated with AA or E, in docetaxel-naïve or post-docetaxel setting, with early PSA drop had significantly better OS and PFS.
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Affiliation(s)
- Consuelo Buttigliero
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Marcello Tucci
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy -
| | - Cristina Sonetto
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Francesca Vignani
- Division of Medical Oncology, Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - Rosario F Di Stefano
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Chiara Pisano
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Fabio Turco
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Gaetano Lacidogna
- Division of Medical Oncology, Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - Pamela Guglielmini
- Unit of Oncology, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Gianmauro Numico
- Unit of Oncology, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Giorgio V Scagliotti
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Massimo Di Maio
- Division of Medical Oncology, Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
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21
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Sensors design based on hybrid gold-silica nanostructures. Biosens Bioelectron 2020; 153:112054. [DOI: 10.1016/j.bios.2020.112054] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 01/11/2020] [Accepted: 01/25/2020] [Indexed: 12/14/2022]
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22
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Iacovelli R, Ciccarese C, Schinzari G, Rossi E, Maiorano BA, Astore S, D'Angelo T, Cannella A, Pirozzoli C, Teberino MA, Pierconti F, Martini M, Tortora G. Biomarkers of response to advanced prostate cancer therapy. Expert Rev Mol Diagn 2020; 20:195-205. [PMID: 31986925 DOI: 10.1080/14737159.2020.1707669] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Prostate cancer (PCa) is one of the most common adult malignancies worldwide, and a major leading cause of cancer-related death in men in Western societies. In the last years, the prognosis of advanced PCa patients has been impressively improved thanks to the development of different therapeutic agents, including taxanes (docetaxel and cabazitaxel), second-generation anti-hormonal agents (abiraterone and enzalutamide), and the radiopharmaceutical Radium-223. However, great efforts are still needed to properly select the most appropriate treatment for each single patient.Areas covered: Several prognostic or predictive biomarkers have been studied, none of which has an established validated role in daily clinical practice. This paper analyzed the major biomarkers (including PSA, androgen receptor (AR) splice variants, βIII-tubulin, ALP, circulating tumor cells, and DNA repair genes) with a potential prognostic and/or predictive role in advanced PCa patients.Expert commentary: Surrogate biomarkers - measurable, reproducible, closely associated with tumor behavior and linked to relevant clinical outcomes - are urgently needed to improve PCa patient management.
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Affiliation(s)
- Roberto Iacovelli
- Department of Medical Oncology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy
| | - Chiara Ciccarese
- Department of Medical Oncology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy
| | - Giovanni Schinzari
- Department of Medical Oncology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy
| | - Ernesto Rossi
- Department of Medical Oncology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Brigida Anna Maiorano
- Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy
| | - Serena Astore
- Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy
| | - Tatiana D'Angelo
- Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonella Cannella
- Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy
| | - Celeste Pirozzoli
- Department of Medical Oncology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Maria Anna Teberino
- Department of Medical Oncology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Francesco Pierconti
- Institute of Pathological Anatomy, Catholic University of the Sacred Heart, Rome, Italy
| | - Maurizio Martini
- Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy.,Institute of Pathological Anatomy, Catholic University of the Sacred Heart, Rome, Italy
| | - Giampaolo Tortora
- Department of Medical Oncology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Department of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy
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Abstract
Aim: To evaluate prostate-specific antigen response (PSAr) defined as a ≥50% decrease in PSA concentration from the pretreatment value, as a prognostic factor in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA). Methods: Retrospective evaluation of patients with mCRPC treated with AA. Results: 124 patients were identified. Median overall survival and progression-free survival for patients achieving PSAr versus patients without PSAr were 29.3 versus 9.7 months and 17.0 versus 5.2 months, respectively. Multivariate analysis confirmed that PSAr correlated with better overall survival (hazard ratio: 0.19; 95% CI: 0.10−0.38; p < 0.001) and progression-free survival (hazard ratio: 0.24; 95% CI: 0.14−0.41; p < 0.001). Conclusion: PSAr can be utilized as prognostic and predictive factors in mCRPC patients treated with AA. Therapeutic options for metastatic castration-resistant prostate cancer are expanding. However, biomarkers with predictive and prognostic value to assist in treatment guidance are lacking. The aim of this study was to evaluate prostate-specific antigen response as a prognostic factor in patients treated with abiraterone acetate. It was possible to confirm that prostate-specific antigen response correlated with better overall survival and progression-free survival in this patient cohort, evidencing the possible role of biochemical markers as surrogates for response and prognosis, especially in diseases that are difficult to evaluate radiographically.
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24
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Miyazawa Y, Sekine Y, Shimizu N, Takezawa Y, Nakamura T, Miyao T, Nakayama H, Kurihara S, Syuto T, Nomura M, Koike H, Matsui H, Shibata Y, Suzuki K. An exploratory retrospective multicenter study of prognostic factors in mCRPC patients undergoing enzalutamide treatment: Focus on early PSA decline and kinetics at time of progression. Prostate 2019; 79:1462-1470. [PMID: 31334872 DOI: 10.1002/pros.23865] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 05/22/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Recent studies have shown that an early prostate-specific antigen (PSA) response to androgen receptor-targeting agents in metastatic castration-resistant prostate cancer (mCRPC) is associated with a better prognosis. We analyzed the early PSA response to enzalutamide (ENZ) by measuring the PSA doubling time (PSADT) and PSA velocity (PSAV) while monitoring oncologic outcomes and survival in Japanese patients. METHODS We analyzed a total of 241 patients with mCRPC who were treated with ENZ. The patients' median age was 75 ± 7.9 years (range, 53-93 years). There were 171 (71%) predocetaxel cases, and 70 (29%) post docetaxel cases. PSA-progression-free survival (PFS) and overall survival (OS) were assessed according to Prostate Cancer Working Group 2 criteria. This study was approved by the Institutional Review Board of Gunma University Hospital (No. 1595). RESULTS We observed 77 good response (GR; case in which PSA remained low after treatment) cases (31.9%), 125 acquired resistance (AR; decline in PSA after treatment followed by progression) cases (51.9%), and 39 primary resistance (PR; lack of decline in PSA) cases (16.2%). Predocetaxel, PSA-PFS, and OS were significantly higher compared with post docetaxel (PSA-PFS: 47.0 vs 13.4 weeks, P < .001; OS: not yet reached vs 80.7 weeks, P < .001). Multivariate analysis of prognostic factors, including PSA response at 4 weeks, was performed using Cox regression analysis. ECOG PS (0 vs 1-2), hemoglobin (Hb; ≥ 12.2 vs < 12.2 g/dL), time to CRPC ( ≥ 12 vs < 12 m), docetaxel treatment history (no vs yes), and a PSA reduction of 50% at 4 weeks were significant predictors of OS (all, P < .05). In cases of AR (n = 125), multivariate analysis showed that PSA kinetic factors, such as PSADT and PSAV (ng/mL/m), Hb, time to CRPC, PSADT ( ≥ 2 vs < 2 m), and PSAV ( < 20 vs ≥ 20 ng/mL/m), were all predictive of OS following PSA-progression (P < .05). CONCLUSIONS Our study has demonstrated that PSA dynamics after ENZ administration may be a useful prognostic factor for mCRPC patients.
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Affiliation(s)
| | | | - Nobuaki Shimizu
- Department of Urology, Gunma Prefectural Cancer Center, Japan
| | | | | | - Takeshi Miyao
- Department of Urology, Gunma University Hospital, Japan
| | | | - Sota Kurihara
- Department of Urology, Gunma University Hospital, Japan
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25
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Fang Q, Lin Z, Lu F, Chen Y, Huang X, Gao W. A sensitive electrochemiluminescence immunosensor for the detection of PSA based on CdWS nanocrystals and Ag+@UIO-66-NH2 as a novel coreaction accelerator. Electrochim Acta 2019. [DOI: 10.1016/j.electacta.2019.02.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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26
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Choi SY, Ryu J, You D, Jeong IG, Hong JH, Ahn H, Kim CS. Prognostic factors of oncologic outcomes in metastatic chemotherapy-naïve castration-resistant prostate cancer treated with enzalutamide in actual clinical practice in East Asia. Urol Oncol 2018; 36:401.e11-401.e18. [PMID: 30274641 DOI: 10.1016/j.urolonc.2018.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/05/2018] [Accepted: 06/09/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVES We aimed to evaluate the prognostic factors for chemotherapy-naïve castration-resistant prostate cancer (CRPC) treated with enzalutamide in actual clinical practice using easily accessible clinical variables. METHODS AND MATERIALS We retrospectively reviewed the following data from 113 patients with chemotherapy-naïve CRPC treated with enzalutamide: serum levels of prostate-specific antigen (PSA), testosterone, hemoglobin, total protein, albumin, and alkaline phosphatase (ALP); platelet, neutrophil, and lymphocyte counts; neutrophil-to-lymphocyte ratios (NLRs); and liver profiles. PSA progression-free survival (PFS), radiological PFS, and overall survival were estimated by Cox regression analysis. RESULTS Compared with baseline levels, laboratory values at 2 months showed significantly lower PSA (160.2 ± 351.5 ng/ml vs. 47.4 ± 117.1 ng/ml) and ALP levels (201.86 ± 223.77 IU/l vs. 148.25 ± 146.81 IU/l) and a significantly higher percentage of lymphocytes (28.1% ± 10.6% vs. 31.2% ± 9.7%); those at 1 month showed a significantly lower percentage of neutrophils (61.0% ± 11.0% vs. 57.1% ± 12.5%). In the multivariate analysis, poor prognostic factors for PSA PFS were Gleason score ≥ 9 (hazard ratio [HR] 2.022; P = 0.0250); visceral metastasis (HR 3.143; P = 0.0002); high NLR (HR 1.205; P = 0.0126); and high ALP (HR 1.002; P = 0.0015). For radiological PFS, high NLR (HR 1.249; P = 0.0002) and high ALP (HR 1.002; P = 0.0001) were associated with poor outcomes. The predictors of poor overall survival were visceral metastasis (HR 3.155; P < 0.0001); high NLR (HR 1.341; P < 0.0001); and high ALP (HR 1.001; P = 0.0017). CONCLUSION Enzalutamide is less effective in patients with metastatic chemotherapy-naïve CRPC with Gleason scores ≥ 9, visceral metastasis, high NLR, and high ALP.
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Affiliation(s)
- Se Young Choi
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
| | - Jeman Ryu
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
| | - Dalsan You
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
| | - In Gab Jeong
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
| | - Jun Hyuk Hong
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
| | - Hanjong Ahn
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
| | - Choung-Soo Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
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27
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Martin LJ, Alibhai SMH, Komisarenko M, Timilshina N, Finelli A. Identification of subgroups of metastatic castrate-resistant prostate cancer (mCRPC) patients treated with abiraterone plus prednisone at low- vs. high-risk of radiographic progression: An analysis of COU-AA-302. Can Urol Assoc J 2018; 13:192-200. [PMID: 30407155 DOI: 10.5489/cuaj.5586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Radiographic imaging is used to monitor disease progression for men with metastatic castrate-resistant prostate cancer (mCRPC). The optimal frequency of imaging, a costly and limited resource, is not known. Our objective was to identify predictors of radiographic progression to inform the frequency of imaging for men with mCRPC. METHODS We accessed data for men with chemotherapy-naive mCRPC in the abiraterone acetate plus prednisone (AA-P) group of a randomized trial (COU-AA-302) (n=546). We used Cox proportional hazards modelling to identify predictors of time to progression. We divided patients into groups based on the most important predictors and estimated the probability of radiographic progression-free survival (RPFS) at six and 12 months. RESULTS Baseline disease and change in prostate-specific antigen (PSA) at eight weeks were the strongest determinants of RPFS. The probability of RPFS for men with bone-only disease and a ≥50% fall in PSA was 93% (95% confidence interval [CI] 87-96) at six months and 80% (95% CI 72-86) at 12 months. In contrast, the probability of RPFS for men with bone and soft tissue metastasis and <50% fall in PSA was 55% (95% CI 41-67) at six months and 34% (95% CI 22-47) at 12 months. These findings should be externally validated. CONCLUSIONS Patients with chemotherapy-naive mCRPC treated with first-line AA-P can be divided into groups with significantly different risks of radiographic progression based on a few clinically available variables, suggesting that imaging schedules could be individualized.
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Affiliation(s)
- Lisa J Martin
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Shabbir M H Alibhai
- Toronto General Research Institute, University Health Network, Toronto, ON, Canada
| | - Maria Komisarenko
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Antonio Finelli
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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Linder S, van der Poel HG, Bergman AM, Zwart W, Prekovic S. Enzalutamide therapy for advanced prostate cancer: efficacy, resistance and beyond. Endocr Relat Cancer 2018; 26:R31-R52. [PMID: 30382692 PMCID: PMC6215909 DOI: 10.1530/erc-18-0289] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2018] [Indexed: 12/20/2022]
Abstract
The androgen receptor drives the growth of metastatic castration-resistant prostate cancer. This has led to the development of multiple novel drugs targeting this hormone-regulated transcription factor, such as enzalutamide – a potent androgen receptor antagonist. Despite the plethora of possible treatment options, the absolute survival benefit of each treatment separately is limited to a few months. Therefore, current research efforts are directed to determine the optimal sequence of therapies, discover novel drugs effective in metastatic castration-resistant prostate cancer and define patient subpopulations that ultimately benefit from these treatments. Molecular studies provide evidence on which pathways mediate treatment resistance and may lead to improved treatment for metastatic castration-resistant prostate cancer. This review provides, firstly a concise overview of the clinical development, use and effectiveness of enzalutamide in the treatment of advanced prostate cancer, secondly it describes translational research addressing enzalutamide response vs resistance and lastly highlights novel potential treatment strategies in the enzalutamide-resistant setting.
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Affiliation(s)
- Simon Linder
- Division of OncogenomicsOncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Henk G van der Poel
- Division of UrologyThe Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andries M Bergman
- Division of Medical OncologyThe Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of OncogenomicsThe Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wilbert Zwart
- Division of OncogenomicsOncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Laboratory of Chemical Biology and Institute for Complex Molecular SystemsDepartment of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Stefan Prekovic
- Division of OncogenomicsOncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Correspondence should be addressed to S Prekovic:
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Komura K, Sweeney CJ, Inamoto T, Ibuki N, Azuma H, Kantoff PW. Current treatment strategies for advanced prostate cancer. Int J Urol 2018; 25:220-231. [PMID: 29266472 PMCID: PMC6053280 DOI: 10.1111/iju.13512] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/09/2017] [Indexed: 12/18/2022]
Abstract
During the past decade, treatment strategies for patients with advanced prostate cancer involving stage IV (T4N0M0, N1M0 or M1) hormone-sensitive prostate cancer and recurrent prostate cancer after treatment with curative intent, as well as castration-resistant prostate cancer, have extensively evolved with the introduction and approval of several new agents including sipuleucel-T, radium-223, abiraterone, enzalutamide and cabazitaxel, all of which have shown significant improvement on overall survival. The appropriate use of these agents and the proper sequencing of these agents are still not optimized. The results of several recently reported randomized controlled trials and retrospective studies could assist in developing a treatment strategy for advanced prostate cancer. In addition, prospective studies and molecular characterization of tumors to address these issues are ongoing.
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Affiliation(s)
- Kazumasa Komura
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
| | | | - Teruo Inamoto
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Naokazu Ibuki
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Philip W. Kantoff
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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A novel peptide/Fe3O4@SiO2-Au nanocomposite-based fluorescence biosensor for the highly selective and sensitive detection of prostate-specific antigen. Talanta 2018; 179:531-537. [DOI: 10.1016/j.talanta.2017.11.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/27/2017] [Accepted: 11/17/2017] [Indexed: 12/19/2022]
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31
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Conteduca V, Caffo O, Lolli C, Aieta M, Scarpi E, Bianchi E, Maines F, Schepisi G, Salvi S, Massari F, Carrozza F, Veccia A, Chiuri VE, Campadelli E, Facchini G, De Giorgi U. Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone. Prostate 2017; 77:1012-1019. [PMID: 28429372 DOI: 10.1002/pros.23357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 03/27/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Early changes in PSA have been evaluated in association to treatment outcome. The aim of this study was to assess PSA surge phenomenon in castration-resistant prostate cancer (CRPC) patients treated with abiraterone and to correlate those variations with long-term treatment outcome. PATIENTS AND METHODS We retrospectively evaluated 330 CRPC patients in 11 Italian hospitals, monitoring PSA levels at baseline and every 4 weeks. Other clinical, biochemical and molecular parameters were determined at baseline. We considered PSA surge as PSA increase within the first 8 weeks from starting abiraterone more than 1% from baseline followed by a PSA decline. The log-rank test was applied to compare survival between groups of patients according to PSA surge. The impact of PSA surge on survival was evaluated by Cox regression analyses. RESULTS A total of 330 patients with CRPC, median age 74 years (range, 45-90), received abiraterone (281 chemotherapy-treated and 49 chemotherapy-naïve). PSA surge was observed in 20 (7%) post-chemotherapy and 2 (4%) chemotherapy-naïve patients. For overall patients presenting PSA surge, timing of PSA peak from baseline was 5 ± 1.8 weeks and PSA rise from baseline was 21 ± 18.4%. The overall median follow-up was 23 months (range 1-62). No significant differences in progression-free survival and overall survival were observed between patients with and without PSA surge (P = 0.16 and =0.86, respectively). In addition, uni- and multivariate analyses showed no baseline factors related to PSA surge. CONCLUSION PSA surge occurs in both chemotherapy-treated and chemotherapy-naïve patients treated with abiraterone resulting, however, in no long-term impact on outcome. Physicians and patients should be aware of PSA surge challenge to prevent a premature discontinuation of potentially effective therapy with abiraterone. Further larger and prospective studies are warranted to investigate this not infrequent phenomenon.
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Affiliation(s)
- Vincenza Conteduca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Orazio Caffo
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | - Cristian Lolli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Michele Aieta
- Medical Oncology Department, Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Emanuela Scarpi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | | | - Francesca Maines
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | - Giuseppe Schepisi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Samanta Salvi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | | | | | - Antonello Veccia
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | | | | | - Gaetano Facchini
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale" - Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
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Feng J, Li Y, Li M, Li F, Han J, Dong Y, Chen Z, Wang P, Liu H, Wei Q. A novel sandwich-type electrochemical immunosensor for PSA detection based on PtCu bimetallic hybrid (2D/2D) rGO/g-C3N4. Biosens Bioelectron 2017; 91:441-448. [DOI: 10.1016/j.bios.2016.12.070] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/23/2016] [Accepted: 12/30/2016] [Indexed: 12/01/2022]
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[Management of a progressing prostate cancer: results of a national study]. Prog Urol 2017; 27:381-388. [PMID: 28392429 DOI: 10.1016/j.purol.2017.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 02/15/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The introduction of new treatments in metastatic castration resistant prostate cancer (mCRPC) requires a close follow-up to detect a progression and then to adapt the treatment. In that context, a national survey was proposed to a group of experts and the aim was to identify the modalities of surveillance in different clinical situations. METHODS A questionnaire was sent to 1464 urologists, medical oncologists and radiotherapists, about a clinical case; it was about a patient presenting a prostate cancer, evolving from a biologic progression after radical prostatectomy to a situation of metastasis resistant to the castration. The questionnaire contained ten questions about reasons of changing treatment because of progression, and about modalities of the follow-up. RESULTS A total of 318 questionnaires were analyzed (response rate of 22%). The results showed comparable practices between the different types of specialists, even if a more frequent rhythm of surveillance was reported by medical oncologists and radiotherapists. At progression after radical prostatectomy, a clinical and biological surveillance was generally realized every 3 or 6 months, and imaging exams were done on demand. Then, as the cancer progresses, the surveillance became systematic and more and more close, with imaging done every 3 months or on demand. While the definition of progression was essentially based on PSA testing at the beginning of the castration resistance, it then combines different clinical, biological and radiological criteria. CONCLUSIONS There are few recommendations available about follow-up of patients with a mCRPC. In that survey, the oncologists and urologists reported a more intensive rhythm of surveillance as the prostate cancer progresses. LEVEL OF EVIDENCE 4.
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Armstrong AJ, Saad F, Phung D, Dmuchowski C, Shore ND, Fizazi K, Hirmand M, Forer D, Scher HI, Bono JD. Clinical outcomes and survival surrogacy studies of prostate-specific antigen declines following enzalutamide in men with metastatic castration-resistant prostate cancer previously treated with docetaxel. Cancer 2017; 123:2303-2311. [PMID: 28171710 PMCID: PMC5484320 DOI: 10.1002/cncr.30587] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/15/2016] [Accepted: 12/23/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND In the AFFIRM trial, enzalutamide significantly increased overall survival (OS) for men with metastatic castration‐resistant prostate cancer (mCRPC) after chemotherapy versus placebo and significantly decreased prostate‐specific antigen (PSA) levels. The goal of this post hoc analysis was to associate levels of PSA decline from baseline after enzalutamide with clinical outcomes in the postchemotherapy mCRPC setting. METHODS Men in the AFFIRM trial (n = 1199) were grouped by maximal PSA decline in the first 90 days of treatment. Kaplan‐Meier estimates evaluated the association of defined PSA changes from baseline with OS, progression‐free survival (PFS), radiographic PFS (rPFS), and pain response. Each PSA decline category was assessed for OS surrogacy using Prentice criteria, proportion of treatment effect explained (PTE), and proportion of variation explained. RESULTS Men treated with enzalutamide had improved OS (hazard ratio, 0.63; P < .001) and higher rates of PSA decline (odds ratio, >19.0; P < .001) versus placebo. PSA declines of any, ≥30%, ≥50%, and ≥90% with enzalutamide were strongly associated with greater OS, PSA PFS, rPFS (P < .001), and pain response (P < .026) versus PSA increase/no decline. Any, ≥30%, and ≥50% declines in PSA resulted in the PTE range of 1.07‐1.29, where treatment was no longer significant after adjustment for decline measures (P > .20). CONCLUSIONS PSA declines of any, ≥30%, and ≥50% following enzalutamide were associated with greater clinical and pain response and improvements in PFS and OS. Surrogacy of PSA decline for OS was not fully established, possibly due to lack of PSA declines with placebo, and discordant results between PSA and imaging responses over time, and because some declines were not durable due to rapid resistance development. However, a lack of PSA decline by 90 days following enzalutamide treatment was a poor prognosis indicator in this setting. Conclusions from sensitivity analyses of maximal PSA decline from baseline over the entire treatment period are consistent with PSA declines restricted to the first 90 days. Cancer 2017;123:2303–2311. © 2017 American Cancer Society. A post hoc analysis of the randomized, double‐blind AFFIRM trial revealed that postenzalutamide prostate‐specific antigen declines of any, ≥30%, and ≥50% are associated with greater clinical and pain response. The decline criteria explain a large proportion of treatment effect on survival improvements but do not fulfill the criteria for surrogacy.
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Affiliation(s)
| | - Fred Saad
- Centre Hospitalier de l'Université de Montréal and CRCHUM, Montreal, Quebec, Canada
| | - De Phung
- Astellas Pharma, Inc., Leiden, Netherlands
| | | | - Neal D Shore
- Carolina Urologic Research Center, Myrtle Beach, South Carolina
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Sud, Paris, France
| | | | | | - Howard I Scher
- Sidney Kimmel Center for Prostate and Urologic Cancers and Memorial Sloan-Kettering Cancer Center, New York, New York
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Amin S, Bathe OF. Response biomarkers: re-envisioning the approach to tailoring drug therapy for cancer. BMC Cancer 2016; 16:850. [PMID: 27814715 PMCID: PMC5097425 DOI: 10.1186/s12885-016-2886-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/25/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The rapidly expanding arsenal of chemotherapeutic agents approved in the past 5 years represents significant progress in the field. However, this poses a challenge for oncologists to choose which drug or combination of drugs is best for any individual. Because only a fraction of patients respond to any drug, efforts have been made to devise strategies to personalize care. The majority of efforts have involved development of predictive biomarkers. While there are notable successes, there are no predictive biomarkers for most drugs. Moreover, predictive biomarkers enrich the cohort of individuals likely to benefit; they do not guarantee benefit. MAIN TEXT There is a need to devise alternate strategies to tailor cancer care. One alternative approach is to enhance the current adaptive approach, which involves administration of a drug and cessation of treatment once progression is documented. This currently involves radiographic tests for the most part, which are expensive, inconvenient and imperfect in their ability to categorize patients who are and are not benefiting from treatment. A biomarker approach to categorizing response may have advantages. CONCLUSION Herein, we discuss the state of the art on treatment response assessment. While the most mature technologies for response assessment involve radiographic tests such as CT and PET, reports are emerging on biomarkers used to monitor therapeutic efficacy. Potentially, response biomarkers represent a less expensive and more convenient means of monitoring therapy, although an ideal response biomarker has not yet been described. A framework for future response biomarker discovery is described.
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Affiliation(s)
- Shahil Amin
- Cumming School of Medicine, Faculty of Graduate Studies, University of Calgary, Calgary, Canada.,University of Calgary, Arnie Charbonneau Cancer Research Institute, Health Research Innovation Centre, 2AA-07, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Oliver F Bathe
- Department of Surgery, University of Calgary, Calgary, Canada. .,Department of Oncology, University of Calgary, Calgary, Canada. .,University of Calgary, Arnie Charbonneau Cancer Research Institute, Health Research Innovation Centre, 2AA-07, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada. .,Tom Baker Cancer Center, 1131 29th Street NW, Calgary, AB, T2N 4 N2, Canada.
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Baciarello G, Sternberg CN. Treatment of metastatic castration-resistant prostate cancer (mCRPC) with enzalutamide. Crit Rev Oncol Hematol 2016; 106:14-24. [PMID: 27637350 DOI: 10.1016/j.critrevonc.2016.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/23/2016] [Accepted: 07/12/2016] [Indexed: 01/15/2023] Open
Abstract
Prostate cancer is initially responsive to androgen deprivation therapy, but most patients eventually develop castration-resistant disease. Enzalutamide is an androgen receptor (AR) inhibitor that targets several steps in the AR signaling pathway and has shown significant efficacy in the treatment of metastatic castration-resistant prostate cancer in patients with or without prior chemotherapy. To provide optimal treatment, it is important to understand the implications of enzalutamide use in the context of other therapies, as recent findings have suggested cross-resistance occurs between and within drug classes. Mutations and splice variants of AR also impact the course of prostate cancer. Future strategies involving enzalutamide should account for previous exposure to taxanes or antiandrogen therapies and the presence of AR variants that could affect efficacy.
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Affiliation(s)
- Giulia Baciarello
- Department of Medical Oncology, San Camillo and Forlanini Hospitals, Padiglione Flajani, Circonvallazione Gianicolense 87, Rome, 00152, Italy.
| | - Cora N Sternberg
- Department of Medical Oncology, San Camillo and Forlanini Hospitals, Padiglione Flajani, Circonvallazione Gianicolense 87, Rome, 00152, Italy.
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