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Dahiya V, Hans S, Kumari R, Bagchi G. Prostate cancer biomarkers: from early diagnosis to precision treatment. Clin Transl Oncol 2024:10.1007/s12094-024-03508-2. [PMID: 38744755 DOI: 10.1007/s12094-024-03508-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
Prostate cancer (PCa) is the second most prevalent cancer in men. In 2020, approximately 1,414,259 new cases were reported that accounted for 3,75,324 deaths (Sung et al. in CA 71:209-249, 2021). PCa is often asymptomatic at early stages; hence, routine screening and monitoring based on reliable biomarkers is crucial for early detection and assessment of cancer progression. Early diagnosis of disease is key step in reducing PCa-induced mortality. Biomarkers such as PSA have played vital role in reducing recent PCa deaths. Recent research has identified many other biomarkers and also refined PSA-based tests for non-invasive diagnosis of PCa in patients. Despite progress in screening methods, an important issue that influences treatment is heterogeneity of the cancer in different individuals, necessitating personalized treatment. Currently, focus is to identify biomarkers that can accurately diagnose PCa at early stage, indicate the stage of the disease, metastatic nature and chances of survival based on individual patient profile (Fig. 1). Fig. 1 Graphical abstract.
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Affiliation(s)
- Versha Dahiya
- Amity Institute of Biotechnology, Amity University Haryana, Gurgaon, India, 122413
| | - Sanjana Hans
- Amity Institute of Biotechnology, Amity University Haryana, Gurgaon, India, 122413
| | - Ruchi Kumari
- Amity Institute of Biotechnology, Amity University Haryana, Gurgaon, India, 122413
| | - Gargi Bagchi
- Amity Institute of Biotechnology, Amity University Haryana, Gurgaon, India, 122413.
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2
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Lymphatic Dissemination in Prostate Cancer: Features of the Transcriptomic Profile and Prognostic Models. Int J Mol Sci 2023; 24:ijms24032418. [PMID: 36768739 PMCID: PMC9916851 DOI: 10.3390/ijms24032418] [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: 10/31/2022] [Revised: 12/19/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
Radical prostatectomy is the gold standard treatment for prostate cancer (PCa); however, it does not always completely cure PCa, and patients often experience a recurrence of the disease. In addition, the clinical and pathological parameters used to assess the prognosis and choose further tactics for treating a patient are insufficiently informative and need to be supplemented with new markers. In this study, we performed RNA-Seq of PCa tissue samples, aimed at identifying potential prognostic markers at the level of gene expression and miRNAs associated with one of the key signs of cancer aggressiveness-lymphatic dissemination. The relative expression of candidate markers was validated by quantitative PCR, including an independent sample of patients based on archival material. Statistically significant results, derived from an independent set of samples, were confirmed for miR-148a-3p and miR-615-3p, as well as for the CST2, OCLN, and PCAT4 genes. Considering the obtained validation data, we also analyzed the predictive value of models based on various combinations of identified markers using algorithms based on machine learning. The highest predictive potential was shown for the "CST2 + OCLN + pT" model (AUC = 0.863) based on the CatBoost Classifier algorithm.
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3
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Kobelyatskaya AA, Kudryavtsev AA, Kudryavtseva AV, Snezhkina AV, Fedorova MS, Kalinin DV, Pavlov VS, Guvatova ZG, Naberezhnev PA, Nyushko KM, Alekseev BY, Krasnov GS, Bulavkina EV, Pudova EA. ALDH3A2, ODF2, QSOX2, and MicroRNA-503-5p Expression to Forecast Recurrence in TMPRSS2-ERG-Positive Prostate Cancer. Int J Mol Sci 2022; 23:ijms231911695. [PMID: 36232996 PMCID: PMC9569942 DOI: 10.3390/ijms231911695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/23/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
Abstract
Following radical surgery, patients may suffer a relapse. It is important to identify such patients so that therapy tactics can be modified appropriately. Existing stratification schemes do not display the probability of recurrence with enough precision since locally advanced prostate cancer (PCa) is classified as high-risk but is not ranked in greater detail. Between 40 and 50% of PCa cases belong to the TMPRSS2-ERG subtype that is a sufficiently homogeneous group for high-precision prognostic marker search to be possible. This study includes two independent cohorts and is based on high throughput sequencing and qPCR data. As a result, we have been able to suggest a perspective-trained model involving a deep neural network based on both qPCR data for mRNA and miRNA and clinicopathological criteria that can be used for recurrence risk forecasts in patients with TMPRSS2-ERG-positive, locally advanced PCa (the model uses ALDH3A2 + ODF2 + QSOX2 + hsa-miR-503-5p + ISUP + pT, with an AUC = 0.944). In addition to the prognostic model’s use of identified differentially expressed genes and miRNAs, miRNA–target pairs were found that correlate with the prognosis and can be presented as an interactome network.
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Affiliation(s)
- Anastasiya A. Kobelyatskaya
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
- Correspondence:
| | | | - Anna V. Kudryavtseva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Anastasiya V. Snezhkina
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Maria S. Fedorova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Dmitry V. Kalinin
- Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, 117997 Moscow, Russia
| | - Vladislav S. Pavlov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Zulfiya G. Guvatova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Pavel A. Naberezhnev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Kirill M. Nyushko
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, 125284 Moscow, Russia
| | - Boris Y. Alekseev
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, 125284 Moscow, Russia
| | - George S. Krasnov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Elizaveta V. Bulavkina
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Elena A. Pudova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
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4
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Marra G, Laguna MP, Walz J, Pavlovich CP, Bianco F, Gregg J, Lebastchi AH, Lepor H, Macek P, Rais-Bahrami S, Robertson C, Rukstalis D, Salomon G, Ukimura O, Abreu AL, Barbe Y, Cathelineau X, Gandaglia G, George AK, Gomez Rivas J, Gupta RT, Lawrentschuk N, Kasivisvanathan V, Lomas D, Malavaud B, Margolis D, Matsuoka Y, Mehralivand S, Moschini M, Oderda M, Orabi H, Rastinehad AR, Remzi M, Schulman A, Shin T, Shiraishi T, Sidana A, Shoji S, Stabile A, Valerio M, Tammisetti VS, Phin Tan W, VAN DEN Bos W, Villers A, Willemse PP, DE LA Rosette J, Polascik T, Sanchez-Salas R. Molecular biomarkers in the context of focal therapy for prostate cancer: recommendations of a Delphi Consensus from the Focal Therapy Society. Minerva Urol Nephrol 2022; 74:581-589. [PMID: 33439577 DOI: 10.23736/s2724-6051.20.04160-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Focal therapy (FT) for prostate cancer (PCa) is promising. However, long-term oncological results are awaited and there is no consensus on follow-up strategies. Molecular biomarkers (MB) may be useful in selecting, treating and following up men undergoing FT, though there is limited evidence in this field to guide practice. We aimed to conduct a consensus meeting, endorsed by the Focal Therapy Society, amongst a large group of experts, to understand the potential utility of MB in FT for localized PCa. METHODS A 38-item questionnaire was built following a literature search. The authors then performed three rounds of a Delphi Consensus using DelphiManager, using the GRADE grid scoring system, followed by a face-to-face expert meeting. Three areas of interest were identified and covered concerning MB for FT, 1) the current/present role; 2) the potential/future role; 3) the recommended features for future studies. Consensus was defined using a 70% agreement threshold. RESULTS Of 95 invited experts, 42 (44.2%) completed the three Delphi rounds. Twenty-four items reached a consensus and they were then approved at the meeting involving (N.=15) experts. Fourteen items reached a consensus on uncertainty, or they did not reach a consensus. They were re-discussed, resulting in a consensus (N.=3), a consensus on a partial agreement (N.=1), and a consensus on uncertainty (N.=10). A final list of statements were derived from the approved and discussed items, with the addition of three generated statements, to provide guidance regarding MB in the context of FT for localized PCa. Research efforts in this field should be considered a priority. CONCLUSIONS The present study detailed an initial consensus on the use of MB in FT for PCa. This is until evidence becomes available on the subject.
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Affiliation(s)
- Giancarlo Marra
- Department of Urology, Institut Mutualiste Montsouris, Paris, France.,D epartment of Urology, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Maria P Laguna
- Department of Urology, Medipol Mega University Hospital, Istanbul, Turkey
| | - Jochen Walz
- Department of Urology, Paoli-Calmettes Institute, Marseille, France
| | | | - Fernando Bianco
- Urological Research Network, Nova University, Miami, FL, USA
| | - Justin Gregg
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amir H Lebastchi
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Herbert Lepor
- Department of Urology, NYU Langone Medical Center, New York, NY, USA
| | - Petr Macek
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | | | | | - Daniel Rukstalis
- Department of Urology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Georg Salomon
- Martini Clinic, Prostate Cancer Center, Hamburg, Germany
| | - Osamu Ukimura
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Andre L Abreu
- Department of Urology, Keck School of Medicine, University of South California, Los Angeles, CA, USA
| | - Yann Barbe
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | | | | | - Arvin K George
- Division of Urologic Oncology, Department of Urology, Michigan Medicine, Ann Arbor, MI, USA
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain
| | - Rajan T Gupta
- Department of Radiology, Duke University, Durham, NC, USA
| | | | | | - Derek Lomas
- Department of Urology, San Raffaele Hospital, Milan, Italy
| | - Bernard Malavaud
- Department of Urology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Daniel Margolis
- Department of Radiology, Weill Cornell Imaging, Cornell University, New York, NY, USA
| | - Yoh Matsuoka
- Urology at Tokyo Medical and Dental University, Tokyo, Japan
| | - Sherif Mehralivand
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marco Moschini
- Department of Urology, San Raffaele Hospital, Milan, Italy.,Department of Urology, Lucerne Kanton Hospital, Lucerne, Switzerland
| | - Marco Oderda
- D epartment of Urology, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Hazem Orabi
- Department of Urology, Duke University, Durham, NC, USA.,Department of Urology, University of Assiut, Assiut, Egypt
| | | | - Mesut Remzi
- Department of Urology, Döbling Hospital, Vienna, Austria
| | - Ariel Schulman
- Department of Urology, Maimonides Medical Center, Brooklyn, NY, USA
| | | | - Takumi Shiraishi
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Abhinav Sidana
- Division of Urology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sunao Shoji
- Department of Urology, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan
| | | | - Massimo Valerio
- Department of Urology, Vaudois University Center Hospital, Lausanne, Switzerland
| | - Varaha S Tammisetti
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wei Phin Tan
- Department of Urology, Duke University, Durham, NC, USA
| | | | | | | | - Jean DE LA Rosette
- Department of Urology, Medipol Mega University Hospital, Istanbul, Turkey
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5
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Garcia-Marques F, Liu S, Totten SM, Bermudez A, Tanimoto C, Hsu EC, Nolley R, Hembree A, Stoyanova T, Brooks JD, Pitteri SJ. Protein signatures to distinguish aggressive from indolent prostate cancer. Prostate 2022; 82:605-616. [PMID: 35098564 PMCID: PMC8916040 DOI: 10.1002/pros.24307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Distinguishing men with aggressive from indolent prostate cancer is critical to decisions in the management of clinically localized prostate cancer. Molecular signatures of aggressive disease could help men overcome this major clinical challenge by reducing unnecessary treatment and allowing more appropriate treatment of aggressive disease. METHODS We performed a mass spectrometry-based proteomic analysis of normal and malignant prostate tissues from 22 men who underwent surgery for prostate cancer. Prostate cancer samples included Grade Groups (3-5), with 8 patients experiencing recurrence and 14 without evidence of recurrence with a mean of 6.8 years of follow-up. To better understand the biological pathways underlying prostate cancer aggressiveness, we performed a systems biology analysis and gene enrichment analysis. Proteins that distinguished recurrent from nonrecurrent cancer were chosen for validation by immunohistochemical analysis on tissue microarrays containing samples from a larger cohort of patients with recurrent and nonrecurrent prostate cancer. RESULTS In all, 24,037 unique peptides (false discovery rate < 1%) corresponding to 3,313 distinct proteins were identified with absolute abundance ranges spanning seven orders of magnitude. Of these proteins, 115 showed significantly (p < 0.01) different levels in tissues from recurrent versus nonrecurrent cancers. Analysis of all differentially expressed proteins in recurrent and nonrecurrent cases identified several protein networks, most prominently one in which approximately 24% of the proteins in the network were regulated by the YY1 transcription factor (adjusted p < 0.001). Strong immunohistochemical staining levels of three differentially expressed proteins, POSTN, CALR, and CTSD, on a tissue microarray validated their association with shorter patient survival. CONCLUSIONS The protein signatures identified could improve understanding of the molecular drivers of aggressive prostate cancer and be used as candidate prognostic biomarkers.
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Affiliation(s)
- Fernando Garcia-Marques
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
| | - Shiqin Liu
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
| | - Sarah M. Totten
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
| | - Abel Bermudez
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
| | - Cheylene Tanimoto
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
| | - En-Chi Hsu
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
| | - Rosalie Nolley
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA 94305
| | - Amy Hembree
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
| | - Tanya Stoyanova
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
| | - James D. Brooks
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA 94305
| | - Sharon J. Pitteri
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA 94304
- Corresponding Author: Sharon Pitteri, 3155 Porter Drive, Palo Alto, CA 94304,
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6
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Pan B, Yu J, Liu X. Upregulation of miR-886 indicates poor prognosis and promotes tumour progression of prostate cancer. Andrologia 2021; 54:e14296. [PMID: 34787343 DOI: 10.1111/and.14296] [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: 09/21/2021] [Revised: 10/08/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022] Open
Abstract
Prostate cancer is a heterogeneous disease with high incidence and mortality. The functional role of miR-886 has been reported in various cancers and its dysregulation in prostate cancer was also found. Whether miR-886 was involved in the development of prostate cancer remains unclear, which was explored. miR-886 was evaluated in prostate cancer by RT-qPCR, and its clinical value was also assessed. Additionally, the role of miR-886 in prostate cancer cells was assessed by MTT and transwell assay. miR-886 was upregulated and was associated with the Gleason score and TNM stage of prostate cancer patients. miR-886 could predict the poor survival of patients. Moreover, miR-886 was a tumour promoter, of which the upregulation significantly promoted major cellular processes of prostate cancer. miR-886 mediated the disease development and predicted the clinical outcomes of patients. The knockdown of miR-886 inhibits cellular processes of prostate cancer, which provides a novel therapeutic target.
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Affiliation(s)
- Bin Pan
- Department of Urology Surgery, Affiliated Hospital of Weifang Medical University, Shandong, China
| | - Jie Yu
- Clinical Skills Training Center, Affiliated Hospital of Weifang Medical University, Shandong, China
| | - Xiaoli Liu
- Hospital Office, Affiliated Hospital of Weifang Medical University, Shandong, China
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Connell SP, Mills R, Pandha H, Morgan R, Cooper CS, Clark J, Brewer DS. Integration of Urinary EN2 Protein & Cell-Free RNA Data in the Development of a Multivariable Risk Model for the Detection of Prostate Cancer Prior to Biopsy. Cancers (Basel) 2021; 13:cancers13092102. [PMID: 33925381 PMCID: PMC8123800 DOI: 10.3390/cancers13092102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/21/2022] Open
Abstract
Simple Summary Prostate cancer is a disease responsible for a large proportion of all male cancer deaths but there is a high chance that a patient will die with the disease rather than from. Therefore, there is a desperate need for improvements in diagnosing and predicting outcomes for prostate cancer patients to minimise overdiagnosis and overtreatment whilst appropriately treating men with aggressive disease, especially if this can be done without taking an invasive biopsy. In this work we develop a test that predicts whether a patient has prostate cancer and how aggressive the disease is from a urine sample. This model combines the measurement of a protein-marker called EN2 and the levels of 10 genes measured in urine and proves that integration of information from multiple, non-invasive biomarker sources has the potential to greatly improve how patients with a clinical suspicion of prostate cancer are risk-assessed prior to an invasive biopsy. Abstract The objective is to develop a multivariable risk model for the non-invasive detection of prostate cancer prior to biopsy by integrating information from clinically available parameters, Engrailed-2 (EN2) whole-urine protein levels and data from urinary cell-free RNA. Post-digital-rectal examination urine samples collected as part of the Movember Global Action Plan 1 study which has been analysed for both cell-free-RNA and EN2 protein levels were chosen to be integrated with clinical parameters (n = 207). A previously described robust feature selection framework incorporating bootstrap resampling and permutation was applied to the data to generate an optimal feature set for use in Random Forest models for prediction. The fully integrated model was named ExoGrail, and the out-of-bag predictions were used to evaluate the diagnostic potential of the risk model. ExoGrail risk (range 0–1) was able to determine the outcome of an initial trans-rectal ultrasound guided (TRUS) biopsy more accurately than clinical standards of care, predicting the presence of any cancer with an area under the receiver operator curve (AUC) = 0.89 (95% confidence interval(CI): 0.85–0.94), and discriminating more aggressive Gleason ≥ 3 + 4 disease returning an AUC = 0.84 (95% CI: 0.78–0.89). The likelihood of more aggressive disease being detected significantly increased as ExoGrail risk score increased (Odds Ratio (OR) = 2.21 per 0.1 ExoGrail increase, 95% CI: 1.91–2.59). Decision curve analysis of the net benefit of ExoGrail showed the potential to reduce the numbers of unnecessary biopsies by 35% when compared to current standards of care. Integration of information from multiple, non-invasive biomarker sources has the potential to greatly improve how patients with a clinical suspicion of prostate cancer are risk-assessed prior to an invasive biopsy.
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Affiliation(s)
- Shea P. Connell
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (S.P.C.); (C.S.C.); (J.C.)
| | - Robert Mills
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk NR4 7UY, UK;
| | - Hardev Pandha
- Faculty of Health and Medical Sciences, The University of Surrey, Guildford GU2 7XH, UK;
| | - Richard Morgan
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK;
| | - Colin S. Cooper
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (S.P.C.); (C.S.C.); (J.C.)
| | - Jeremy Clark
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (S.P.C.); (C.S.C.); (J.C.)
| | - Daniel S. Brewer
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (S.P.C.); (C.S.C.); (J.C.)
- The Earlham Institute, Norwich Research Park, Norwich, Norfolk NR4 7UZ, UK
- Correspondence: ; Tel.: +44-(0)-1603-593761
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Jairath NK, Dal Pra A, Vince R, Dess RT, Jackson WC, Tosoian JJ, McBride SM, Zhao SG, Berlin A, Mahal BA, Kishan AU, Den RB, Freedland SJ, Salami SS, Kaffenberger SD, Pollack A, Tran P, Mehra R, Morgan TM, Weiner AB, Mohamad O, Carroll PR, Cooperberg MR, Karnes RJ, Nguyen PL, Michalski JM, Tward JD, Feng FY, Schaeffer EM, Spratt DE. A Systematic Review of the Evidence for the Decipher Genomic Classifier in Prostate Cancer. Eur Urol 2021; 79:374-383. [DOI: 10.1016/j.eururo.2020.11.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022]
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9
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Tonry C, Finn S, Armstrong J, Pennington SR. Clinical proteomics for prostate cancer: understanding prostate cancer pathology and protein biomarkers for improved disease management. Clin Proteomics 2020; 17:41. [PMID: 33292167 PMCID: PMC7678104 DOI: 10.1186/s12014-020-09305-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
Following the introduction of routine Prostate Specific Antigen (PSA) screening in the early 1990′s, Prostate Cancer (PCa) is often detected at an early stage. There are also a growing number of treatment options available and so the associated mortality rate is generally low. However, PCa is an extremely complex and heterogenous disease and many patients suffer disease recurrence following initial therapy. Disease recurrence commonly results in metastasis and metastatic PCa has an average survival rate of just 3–5 years. A significant problem in the clinical management of PCa is being able to differentiate between patients who will respond to standard therapies and those who may benefit from more aggressive intervention at an earlier stage. It is also acknowledged that for many men the disease is not life threatenting. Hence, there is a growing desire to identify patients who can be spared the significant side effects associated with PCa treatment until such time (if ever) their disease progresses to the point where treatment is required. To these important clinical needs, current biomarkers and clinical methods for patient stratification and personlised treatment are insufficient. This review provides a comprehensive overview of the complexities of PCa pathology and disease management. In this context it is possible to review current biomarkers and proteomic technologies that will support development of biomarker-driven decision tools to meet current important clinical needs. With such an in-depth understanding of disease pathology, the development of novel clinical biomarkers can proceed in an efficient and effective manner, such that they have a better chance of improving patient outcomes.
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Affiliation(s)
- Claire Tonry
- UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Stephen Finn
- Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin 8, Ireland
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Pudova EA, Krasnov GS, Nyushko KM, Kobelyatskaya AA, Savvateeva MV, Poloznikov AA, Dolotkazin DR, Klimina KM, Guvatova ZG, Simanovsky SA, Gladysh NS, Tokarev AT, Melnikova NV, Dmitriev AA, Alekseev BY, Kaprin AD, Kiseleva MV, Snezhkina AV, Kudryavtseva AV. miRNAs expression signature potentially associated with lymphatic dissemination in locally advanced prostate cancer. BMC Med Genomics 2020; 13:129. [PMID: 32948204 PMCID: PMC7500008 DOI: 10.1186/s12920-020-00788-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 08/31/2020] [Indexed: 02/08/2023] Open
Abstract
Background Prostate cancer is one of the most common and socially significant cancers among men. The aim of our study was to reveal changes in miRNA expression profiles associated with lymphatic dissemination in prostate cancer and to identify the most prominent miRNAs as potential prognostic markers for future studies. Methods High-throughput miRNA sequencing was performed for 44 prostate cancer specimens taken from Russian patients, with and without lymphatic dissemination (N1 – 20 samples; N0 – 24 samples). Results We found at least 18 microRNAs with differential expression between N0 and N1 sample groups: miR-182-5p, miR-183-5p, miR-96-5p, miR-25-3p, miR-93-5p, miR-7-5p, miR-615-3p, miR-10b, miR-1248 (N1-miRs; elevated expression in N1 cohort; p < 0.05); miR-1271-5p, miR-184, miR-222-3p, miR-221-5p, miR-221-3p, miR-455-3p, miR-143-5p, miR-181c-3p and miR-455-5p (N0-miRs; elevated expression in N0; p < 0.05). The expression levels of N1-miRs were highly correlated between each other (the same is applied for N0-miRs) and the expression levels of N0-miRs and N1-miRs were anti-correlated. The tumor samples can be divided into two groups depending on the expression ratio between N0-miRs and N1-miRs. Conclusions We found the miRNA expression signature associated with lymphatic dissemination, in particular on the Russian patient cohort. Many of these miRNAs are well-known players in either oncogenic transformation or tumor suppression. Further experimental studies with extended sampling are required to validate these results.
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Affiliation(s)
- Elena A Pudova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia.
| | - George S Krasnov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Kirill M Nyushko
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - Maria V Savvateeva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Andrey A Poloznikov
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daniyar R Dolotkazin
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Kseniya M Klimina
- Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Zulfiya G Guvatova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Sergey A Simanovsky
- A. N. Severtsov Institute of Ecology and Evolution, Russian Academy of Sciences, Moscow, Russia
| | | | | | - Nataliya V Melnikova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Alexey A Dmitriev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Boris Y Alekseev
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrey D Kaprin
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Marina V Kiseleva
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - Anna V Kudryavtseva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
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11
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Hamdy FC, Donovan JL, Lane JA, Mason M, Metcalfe C, Holding P, Wade J, Noble S, Garfield K, Young G, Davis M, Peters TJ, Turner EL, Martin RM, Oxley J, Robinson M, Staffurth J, Walsh E, Blazeby J, Bryant R, Bollina P, Catto J, Doble A, Doherty A, Gillatt D, Gnanapragasam V, Hughes O, Kockelbergh R, Kynaston H, Paul A, Paez E, Powell P, Prescott S, Rosario D, Rowe E, Neal D. Active monitoring, radical prostatectomy and radical radiotherapy in PSA-detected clinically localised prostate cancer: the ProtecT three-arm RCT. Health Technol Assess 2020; 24:1-176. [PMID: 32773013 PMCID: PMC7443739 DOI: 10.3310/hta24370] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Prostate cancer is the most common cancer among men in the UK. Prostate-specific antigen testing followed by biopsy leads to overdetection, overtreatment as well as undertreatment of the disease. Evidence of treatment effectiveness has lacked because of the paucity of randomised controlled trials comparing conventional treatments. OBJECTIVES To evaluate the effectiveness of conventional treatments for localised prostate cancer (active monitoring, radical prostatectomy and radical radiotherapy) in men aged 50-69 years. DESIGN A prospective, multicentre prostate-specific antigen testing programme followed by a randomised trial of treatment, with a comprehensive cohort follow-up. SETTING Prostate-specific antigen testing in primary care and treatment in nine urology departments in the UK. PARTICIPANTS Between 2001 and 2009, 228,966 men aged 50-69 years received an invitation to attend an appointment for information about the Prostate testing for cancer and Treatment (ProtecT) study and a prostate-specific antigen test; 82,429 men were tested, 2664 were diagnosed with localised prostate cancer, 1643 agreed to randomisation to active monitoring (n = 545), radical prostatectomy (n = 553) or radical radiotherapy (n = 545) and 997 chose a treatment. INTERVENTIONS The interventions were active monitoring, radical prostatectomy and radical radiotherapy. TRIAL PRIMARY OUTCOME MEASURE Definite or probable disease-specific mortality at the 10-year median follow-up in randomised participants. SECONDARY OUTCOME MEASURES Overall mortality, metastases, disease progression, treatment complications, resource utilisation and patient-reported outcomes. RESULTS There were no statistically significant differences between the groups for 17 prostate cancer-specific (p = 0.48) and 169 all-cause (p = 0.87) deaths. Eight men died of prostate cancer in the active monitoring group (1.5 per 1000 person-years, 95% confidence interval 0.7 to 3.0); five died of prostate cancer in the radical prostatectomy group (0.9 per 1000 person-years, 95% confidence interval 0.4 to 2.2 per 1000 person years) and four died of prostate cancer in the radical radiotherapy group (0.7 per 1000 person-years, 95% confidence interval 0.3 to 2.0 per 1000 person years). More men developed metastases in the active monitoring group than in the radical prostatectomy and radical radiotherapy groups: active monitoring, n = 33 (6.3 per 1000 person-years, 95% confidence interval 4.5 to 8.8); radical prostatectomy, n = 13 (2.4 per 1000 person-years, 95% confidence interval 1.4 to 4.2 per 1000 person years); and radical radiotherapy, n = 16 (3.0 per 1000 person-years, 95% confidence interval 1.9 to 4.9 per 1000 person-years; p = 0.004). There were higher rates of disease progression in the active monitoring group than in the radical prostatectomy and radical radiotherapy groups: active monitoring (n = 112; 22.9 per 1000 person-years, 95% confidence interval 19.0 to 27.5 per 1000 person years); radical prostatectomy (n = 46; 8.9 per 1000 person-years, 95% confidence interval 6.7 to 11.9 per 1000 person-years); and radical radiotherapy (n = 46; 9.0 per 1000 person-years, 95% confidence interval 6.7 to 12.0 per 1000 person years; p < 0.001). Radical prostatectomy had the greatest impact on sexual function/urinary continence and remained worse than radical radiotherapy and active monitoring. Radical radiotherapy's impact on sexual function was greatest at 6 months, but recovered somewhat in the majority of participants. Sexual and urinary function gradually declined in the active monitoring group. Bowel function was worse with radical radiotherapy at 6 months, but it recovered with the exception of bloody stools. Urinary voiding and nocturia worsened in the radical radiotherapy group at 6 months but recovered. Condition-specific quality-of-life effects mirrored functional changes. No differences in anxiety/depression or generic or cancer-related quality of life were found. At the National Institute for Health and Care Excellence threshold of £20,000 per quality-adjusted life-year, the probabilities that each arm was the most cost-effective option were 58% (radical radiotherapy), 32% (active monitoring) and 10% (radical prostatectomy). LIMITATIONS A single prostate-specific antigen test and transrectal ultrasound biopsies were used. There were very few non-white men in the trial. The majority of men had low- and intermediate-risk disease. Longer follow-up is needed. CONCLUSIONS At a median follow-up point of 10 years, prostate cancer-specific mortality was low, irrespective of the assigned treatment. Radical prostatectomy and radical radiotherapy reduced disease progression and metastases, but with side effects. Further work is needed to follow up participants at a median of 15 years. TRIAL REGISTRATION Current Controlled Trials ISRCTN20141297. FUNDING This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 37. See the National Institute for Health Research Journals Library website for further project information.
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Affiliation(s)
- Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | | | - J Athene Lane
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Malcolm Mason
- School of Medicine, University of Cardiff, Cardiff, UK
| | - Chris Metcalfe
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Peter Holding
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Julia Wade
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Sian Noble
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Grace Young
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael Davis
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Tim J Peters
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Emma L Turner
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Jon Oxley
- Department of Cellular Pathology, North Bristol NHS Trust, Bristol, UK
| | - Mary Robinson
- Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - John Staffurth
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - Eleanor Walsh
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Jane Blazeby
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard Bryant
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Prasad Bollina
- Department of Urology and Surgery, Western General Hospital, University of Edinburgh, Edinburgh, UK
| | - James Catto
- Academic Urology Unit, University of Sheffield, Sheffield, UK
| | - Andrew Doble
- Department of Urology, Addenbrooke's Hospital, Cambridge, UK
| | - Alan Doherty
- Department of Urology, Queen Elizabeth Hospital, Birmingham, UK
| | - David Gillatt
- Department of Urology, Southmead Hospital and Bristol Urological Institute, Bristol, UK
| | | | - Owen Hughes
- Department of Urology, Cardiff and Vale University Health Board, Cardiff, UK
| | - Roger Kockelbergh
- Department of Urology, University Hospitals of Leicester, Leicester, UK
| | - Howard Kynaston
- Department of Urology, Cardiff and Vale University Health Board, Cardiff, UK
| | - Alan Paul
- Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Edgar Paez
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK
| | - Philip Powell
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK
| | - Stephen Prescott
- Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Derek Rosario
- Academic Urology Unit, University of Sheffield, Sheffield, UK
| | - Edward Rowe
- Department of Urology, Southmead Hospital and Bristol Urological Institute, Bristol, UK
| | - David Neal
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Academic Urology Group, University of Cambridge, Cambridge, UK
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12
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Demircan Tan B, Turan T, Yucel B, Altundag Kara S, Salman Yilmaz S, Yildirim A. Aberrant SOCS3 Promoter Methylation as a Noninvasive Diagnostic Biomarker for Locally Advanced Prostate Cancer. Medeni Med J 2020; 35:99-105. [PMID: 32733758 PMCID: PMC7384502 DOI: 10.5222/mmj.2020.58708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/12/2020] [Indexed: 11/05/2022] Open
Abstract
Objective The aim of this study was to investigate the promoter methylation status of Rasassociated domain family 1A (RASSF1A), O-6-methylguanine-DNA methyltransferase (MGMT), Phosphatase with tensin homology (PTEN) and Suppressor of cytokine signaling 3 (SOCS3) tumor suppressor genes and evaluate the clinical utility of these genes as noninvasive, blood-based epigenetic biomarkers for the diagnosis of Prostate Cancer (PCa). Method A total of 41 consecutive patients and 10 healthy control groups were enrolled in the study. Pyrosequencing was performed to analyze the methylation levels of the promoter regions of the four tumor suppressor genes in patients compared to healthy controls. Results The promoter methylation levels of RASSF1A, MGMT, PTEN and SOCS3 did not differ between the patient and control groups. However, SOCS3 promoter methylation level was significantly higher for patients having locally advanced PCa compared to those having localizedPCa (p<0.05). Conclusion Our results indicated that SOCS3 could be a useful, noninvasive blood-based epigenetic biomarker for the diagnosis of locally advanced PCa.
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Affiliation(s)
- Berna Demircan Tan
- Istanbul Medeniyet University, Faculty of Medicine Department of Medical Biology, Istanbul, Turkey
| | - Turgay Turan
- Istanbul Medeniyet University, Faculty of Medicine, Department of Urology, Istanbul, Turkey
| | - Burcu Yucel
- Istanbul Medeniyet University, Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey
| | - Sedef Altundag Kara
- Istanbul Okan University, Faculty of Medicine, Department of Histology, Istanbul, Turkey
| | - Seda Salman Yilmaz
- Istanbul University Cerrahpasa, Faculty of Medicine, Department of Medical Genetics, Istanbul, Turkey
| | - Asif Yildirim
- Istanbul Medeniyet University, Faculty of Medicine, Department of Urology, Istanbul, Turkey
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13
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Jairath NK, Farha MW, Srinivasan S, Jairath R, Green MD, Dess RT, Jackson WC, Weiner AB, Schaeffer EM, Zhao SG, Feng FY, El Naqa I, Spratt DE. Tumor Immune Microenvironment Clusters in Localized Prostate Adenocarcinoma: Prognostic Impact of Macrophage Enriched/Plasma Cell Non-Enriched Subtypes. J Clin Med 2020; 9:jcm9061973. [PMID: 32599760 PMCID: PMC7356642 DOI: 10.3390/jcm9061973] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Prostate cancer (PCa) is characterized by significant heterogeneity in its molecular, genomic, and immunologic characteristics. Methods: Whole transcriptome RNAseq data from The Cancer Genome Atlas of prostate adenocarcinomas (n = 492) was utilized. The immune microenvironment was characterized using the CIBERSORTX tool to identify immune cell type composition. Unsupervised hierarchical clustering was performed based on immune cell type content. Analyses of progression-free survival (PFS), distant metastases, and overall survival (OS) were performed using Kaplan–Meier estimates and Cox regression multivariable analyses. Results: Four immune clusters were identified, largely defined by plasma cell, CD4+ Memory Resting T Cells (CD4 MR), and M0 and M2 macrophage content (CD4 MRHighPlasma CellHighM0LowM2Mid, CD4 MRLowPlasma CellHighM0LowM2Low, CD4 MRHighPlasma CellLowM0HighM2Low, and CD4 MRHighPlasma CellLowM0LowM2High). The two macrophage-enriched/plasma cell non-enriched clusters (3 and 4) demonstrated worse PFS (HR 2.24, 95% CI 1.46–3.45, p = 0.0002) than the clusters 1 and 2. No metastatic events occurred in the plasma cell enriched, non-macrophage-enriched clusters. Comparing clusters 3 vs. 4, in patients treated by surgery alone, cluster 3 had zero progression events (p < 0.0001). However, cluster 3 patients had worse outcomes after post-operative radiotherapy (p = 0.018). Conclusion: Distinct tumor immune clusters with a macrophage-enriched, plasma cell non-enriched phenotype and reduced plasma cell enrichment independently characterize an aggressive phenotype in localized prostate cancer that may differentially respond to treatment.
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Affiliation(s)
- Neil K. Jairath
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
| | - Mark W. Farha
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
| | - Sudharsan Srinivasan
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
| | - Ruple Jairath
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
| | - Michael D. Green
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
- Veterans Affair Ann Arbor Healthcare System, University of Michigan, Ann Arbor, MI 48104, USA
| | - Robert T. Dess
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
| | - William C. Jackson
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
| | - Adam B. Weiner
- Department of Urology, Northwestern University, Chicago, IL 60611, USA; (A.B.W.); (E.M.S.)
| | - Edward M. Schaeffer
- Department of Urology, Northwestern University, Chicago, IL 60611, USA; (A.B.W.); (E.M.S.)
| | - Shuang G. Zhao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
| | - Felix Y. Feng
- Department of Radiation Oncology, UCSF, San Francisco, CA 94143, USA;
| | - Issam El Naqa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
| | - Daniel E. Spratt
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48104, USA; (N.K.J.); (M.W.F.); (S.S.); (R.J.); (M.D.G.); (R.T.D.); (W.C.J.); (S.G.Z.); (I.E.N.)
- Correspondence: ; Tel.: +734-647-1372; Fax: +734-936-1900
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14
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Lo Gullo R, Daimiel I, Morris EA, Pinker K. Combining molecular and imaging metrics in cancer: radiogenomics. Insights Imaging 2020; 11:1. [PMID: 31901171 PMCID: PMC6942081 DOI: 10.1186/s13244-019-0795-6] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023] Open
Abstract
Background Radiogenomics is the extension of radiomics through the combination of genetic and radiomic data. Because genetic testing remains expensive, invasive, and time-consuming, and thus unavailable for all patients, radiogenomics may play an important role in providing accurate imaging surrogates which are correlated with genetic expression, thereby serving as a substitute for genetic testing. Main body In this article, we define the meaning of radiogenomics and the difference between radiomics and radiogenomics. We provide an up-to-date review of the radiomics and radiogenomics literature in oncology, focusing on breast, brain, gynecological, liver, kidney, prostate and lung malignancies. We also discuss the current challenges to radiogenomics analysis. Conclusion Radiomics and radiogenomics are promising to increase precision in diagnosis, assessment of prognosis, and prediction of treatment response, providing valuable information for patient care throughout the course of the disease, given that this information is easily obtainable with imaging. Larger prospective studies and standardization will be needed to define relevant imaging biomarkers before they can be implemented into the clinical workflow.
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Affiliation(s)
- Roberto Lo Gullo
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, New York, NY, 10065, USA.
| | - Isaac Daimiel
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, New York, NY, 10065, USA
| | - Elizabeth A Morris
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, New York, NY, 10065, USA
| | - Katja Pinker
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, New York, NY, 10065, USA.,Department of Biomedical Imaging and Image-guided Therapy, Molecular and Gender Imaging Service, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
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15
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Yan W, Jamal M, Tan SH, Song Y, Young D, Chen Y, Katta S, Ying K, Ravindranath L, Woodle T, Kohaar I, Cullen J, Kagan J, Srivastava S, Dobi A, McLeod DG, Rosner IL, Sesterhenn IA, Srinivasan A, Srivastava S, Petrovics G. Molecular profiling of radical prostatectomy tissue from patients with no sign of progression identifies ERG as the strongest independent predictor of recurrence. Oncotarget 2019; 10:6466-6483. [PMID: 31741711 PMCID: PMC6849651 DOI: 10.18632/oncotarget.27294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/19/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND As a major cause of morbidity and mortality among men, prostate cancer is a heterogenous disease, with a vast heterogeneity in the biology of the disease and in clinical outcome. While it often runs an indolent course, local progression or metastasis may eventually develop, even among patients considered "low risk" at diagnosis. Therefore, biomarkers that can discriminate aggressive from indolent disease at an early stage would greatly benefit patients. We hypothesized that tissue specimens from early stage prostate cancers may harbor predictive signatures for disease progression. METHODS We used a cohort of radical prostatectomy patients with longitudinal follow-up, who had tumors with low grade and stage that revealed no signs of future disease progression at surgery. During the follow-up period, some patients either remained indolent (non-BCR) or progressed to biochemical recurrence (BCR). Total RNA was extracted from tumor, and adjacent normal epithelium of formalin-fixed-paraffin-embedded (FFPE) specimens. Differential gene expression in tumors, and in tumor versus normal tissues between BCR and non-BCR patients were analyzed by NanoString using a customized CodeSet of 151 probes. RESULTS After controlling for false discovery rates, we identified a panel of eight genes (ERG, GGT1, HDAC1, KLK2, MYO6, PLA2G7, BICD1 and CACNAID) that distinguished BCR from non-BCR patients. We found a clear association of ERG expression with non-BCR, which was further corroborated by quantitative RT-PCR and immunohistochemistry assays. CONCLUSIONS Our results identified ERG as the strongest predictor for BCR and showed that potential prognostic prostate cancer biomarkers can be identified from FFPE tumor specimens.
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Affiliation(s)
- Wusheng Yan
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- These authors contributed equally to this work
| | - Muhammad Jamal
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- These authors contributed equally to this work
| | - Shyh-Han Tan
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- These authors contributed equally to this work
| | - Yingjie Song
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Denise Young
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Yongmei Chen
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Shilpa Katta
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Kai Ying
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Lakshmi Ravindranath
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Tarah Woodle
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Indu Kohaar
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Jennifer Cullen
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Jacob Kagan
- Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Sudhir Srivastava
- Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Albert Dobi
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - David G. McLeod
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Inger L. Rosner
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | - Alagarsamy Srinivasan
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Shiv Srivastava
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Gyorgy Petrovics
- Henry Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, USA
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
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Wibmer AG, Robertson NL, Hricak H, Zheng J, Capanu M, Stone S, Ehdaie B, Brawer MK, Vargas HA. Extracapsular extension on MRI indicates a more aggressive cell cycle progression genotype of prostate cancer. Abdom Radiol (NY) 2019; 44:2864-2873. [PMID: 31030245 DOI: 10.1007/s00261-019-02023-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To explore associations between magnetic resonance imaging (MRI) features of prostate cancer and expression levels of cell cycle genes, as assessed by the Prolaris® test. MATERIALS AND METHODS Retrospective analysis of 118 PCa patients with genetic testing of biopsy specimen and prostate MRI from 08/2013 to 11/2015. Associations between the cell cycle risk (CCR) score and MRI features [i.e., PI-RADSv2 score, extracapsular extension (ECE), quantitative metrics] were analyzed with Fisher's exact test, nonparametric tests, and Spearman's correlation coefficient. In 41 patients (34.7%), test results were compared to unfavorable features on prostatectomy specimen (i.e., Gleason group ≥ 3, ECE, lymph node metastases). RESULTS Fifty-four (45.8%), 60 (50.8%), and 4 (3.4%) patients had low-, intermediate-, and high-risk cancers according to American Urological Association scoring system. Patients with ECE on MRI had significantly higher mean CCR scores (reader 1: 3.9 vs. 3.2, p = 0.015; reader 2: 3.6 vs. 3.2, p = 0.045). PI-RADSv2 scores and quantitative MRI features were not associated with CCR scores. In the prostatectomy subset, ECE on MRI (p = < 0.001-0.001) and CCR scores (p = 0.049) were significantly associated with unfavorable histopathologic features. CONCLUSION The phenotypic trait of ECE on MRI indicates a more aggressive genotype of prostate cancer.
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Affiliation(s)
- Andreas G Wibmer
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
| | - Nicola L Robertson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Hedvig Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Junting Zheng
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marinela Capanu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Behfar Ehdaie
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Hebert Alberto Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
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A TMEFF2-regulated cell cycle derived gene signature is prognostic of recurrence risk in prostate cancer. BMC Cancer 2019; 19:423. [PMID: 31060542 PMCID: PMC6503380 DOI: 10.1186/s12885-019-5592-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 04/09/2019] [Indexed: 01/27/2023] Open
Abstract
Background The clinical behavior of prostate cancer (PCa) is variable, and while the majority of cases remain indolent, 10% of patients progress to deadly forms of the disease. Current clinical predictors used at the time of diagnosis have limitations to accurately establish progression risk. Here we describe the development of a tumor suppressor regulated, cell-cycle gene expression based prognostic signature for PCa, and validate its independent contribution to risk stratification in several radical prostatectomy (RP) patient cohorts. Methods We used RNA interference experiments in PCa cell lines to identify a gene expression based gene signature associated with Tmeff2, an androgen regulated, tumor suppressor gene whose expression shows remarkable heterogeneity in PCa. Gene expression was confirmed by qRT-PCR. Correlation of the signature with disease outcome (time to recurrence) was retrospectively evaluated in four geographically different cohorts of patients that underwent RP (834 samples), using multivariate logistical regression analysis. Multivariate analyses were adjusted for standard clinicopathological variables. Performance of the signature was compared to previously described gene expression based signatures using the SigCheck software. Results Low levels of TMEFF2 mRNA significantly (p < 0.0001) correlated with reduced disease-free survival (DFS) in patients from the Memorial Sloan Kettering Cancer Center (MSKCC) dataset. We identified a panel of 11 TMEFF2 regulated cell cycle related genes (TMCC11), with strong prognostic value. TMCC11 expression was significantly associated with time to recurrence after prostatectomy in four geographically different patient cohorts (2.9 ≤ HR ≥ 4.1; p ≤ 0.002), served as an independent indicator of poor prognosis in the four RP cohorts (1.96 ≤ HR ≥ 4.28; p ≤ 0.032) and improved the prognostic value of standard clinicopathological markers. The prognostic ability of TMCC11 panel exceeded previously published oncogenic gene signatures (p = 0.00017). Conclusions This study provides evidence that the TMCC11 gene signature is a robust independent prognostic marker for PCa, reveals the value of using highly heterogeneously expressed genes, like Tmeff2, as guides to discover prognostic indicators, and suggests the possibility that low Tmeff2 expression marks a distinct subclass of PCa. Electronic supplementary material The online version of this article (10.1186/s12885-019-5592-6) contains supplementary material, which is available to authorized users.
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Vermassen T, De Bruyne S, Himpe J, Lumen N, Callewaert N, Rottey S, Delanghe J. N-Linked Glycosylation and Near-Infrared Spectroscopy in the Diagnosis of Prostate Cancer. Int J Mol Sci 2019; 20:ijms20071592. [PMID: 30934974 PMCID: PMC6479798 DOI: 10.3390/ijms20071592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/21/2019] [Accepted: 03/23/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Performing a prostate biopsy is the most robust and reliable way to diagnose prostate cancer (PCa), and to determine the disease grading. As little to no biochemical markers for prostate tissue exist, we explored the possibilities of tissue N-glycosylation and near-infrared spectroscopy (NIR) in PCa diagnosis. Methods: Tissue specimens from 100 patients (benign prostate hyperplasia (BPH), n = 50; and PCa, n = 50) were obtained. The fresh-frozen tissue was dispersed and a tissue N-glycosylation profile was determined. Consequently, the formalin-fixed paraffin-embedded slides were analyzed using NIR spectroscopy. A comparison was made between the benign and malignant tissue, and between the various Gleason scores. Results: A difference was observed for the tissue of N-glycosylation between the benign and malignant tissue. These differences were located in the fycosylation ratios and the total amount of bi- and tetra-antennary structures (all p < 0.0001). These differences were also present between various Gleason scores. In addition, the NIR spectra revealed changes between the benign and malignant tissue in several regions. Moreover, spectral ranges of 1055–1065 nm and 1450–1460 nm were significantly different between the Gleason scores (p = 0.0042 and p = 0.0195). Conclusions: We have demonstrated biochemical changes in the N-glycan profile of prostate tissue, which allows for the distinction between malignant and benign tissue, as well as between various Gleason scores. These changes can be correlated to the changes observed in the NIR spectra. This could possibly further improve the histological assessment of PCa diagnosis, although further method validation is needed.
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Affiliation(s)
- Tijl Vermassen
- Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium.
| | - Sander De Bruyne
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium.
| | - Jonas Himpe
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium.
| | - Nicolaas Lumen
- Department of Urology, Ghent University Hospital, 9000 Ghent, Belgium.
| | - Nico Callewaert
- Unit for Medical Biotechnology, Inflammation Research Center, VIB⁻Ghent University, 9052 Zwijnaarde, Belgium.
| | - Sylvie Rottey
- Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium.
| | - Joris Delanghe
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium.
- Department of Clinical Chemistry, Ghent University Hospital, 9000 Ghent, Belgium.
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19
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Correlation between MRI phenotypes and a genomic classifier of prostate cancer: preliminary findings. Eur Radiol 2019; 29:4861-4870. [PMID: 30847589 DOI: 10.1007/s00330-019-06114-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/07/2019] [Accepted: 02/15/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES We sought to evaluate the correlation between MRI phenotypes of prostate cancer as defined by PI-RADS v2 and the Decipher Genomic Classifier (used to estimate the risk of early metastases). METHODS This single-center, retrospective study included 72 nonconsecutive men with prostate cancer who underwent MRI before radical prostatectomy performed between April 2014 and August 2017 and whose MRI registered lesions were microdissected from radical prostatectomy specimens and then profiled using Decipher (89 lesions; 23 MRI invisible [PI-RADS v2 scores ≤ 2] and 66 MRI visible [PI-RADS v2 scores ≥ 3]). Linear regression analysis was used to assess clinicopathologic and MRI predictors of Decipher results; correlation coefficients (r) were used to quantify these associations. AUC was used to determine whether PI-RADS v2 could accurately distinguish between low-risk (Decipher score < 0.45) and intermediate-/high-risk (Decipher score ≥ 0.45) lesions. RESULTS MRI-visible lesions had higher Decipher scores than MRI-invisible lesions (mean difference 0.22; 95% CI 0.13, 0.32; p < 0.0001); most MRI-invisible lesions (82.6%) were low risk. PI-RADS v2 had moderate correlation with Decipher (r = 0.54) and had higher accuracy (AUC 0.863) than prostate cancer grade groups (AUC 0.780) in peripheral zone lesions (95% CI for difference 0.01, 0.15; p = 0.018). CONCLUSIONS MRI phenotypes of prostate cancer are positively correlated with Decipher risk groups. Although PI-RADS v2 can accurately distinguish between lesions classified by Decipher as low or intermediate/high risk, some lesions classified as intermediate/high risk by Decipher are invisible on MRI. KEY POINTS • MRI phenotypes of prostate cancer as defined by PI-RADS v2 positively correlated with a genomic classifier that estimates the risk of early metastases. • Most but not all MRI-invisible lesions had a low risk for early metastases according to the genomic classifier. • MRI could be used in conjunction with genomic assays to identify lesions that may carry biological potential for early metastases.
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Moschini M, Sharma V, Soligo M, Psutka S, Rangel L, Boorjian SA, Frank I, Gettman MT, Thompson RH, Tollefson MK, Karnes RJ. Heterogeneity of risk within Gleason 4 + 4, 4 + 5 and 5 + 4 prostate cancer. Scand J Urol 2019; 52:340-348. [DOI: 10.1080/21681805.2018.1534886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Vidit Sharma
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Matteo Soligo
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Sarah Psutka
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Laureano Rangel
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Igor Frank
- Department of Urology, Mayo Clinic, Rochester, MN, USA
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Abstract
Since its development between 1966 and 1977, the Gleason grading system has remained one of the most important prognostic indicators in prostatic acinar adenocarcinoma. The grading system was first majorly revised in 2005 and again in 2014. With the publication of the 8th edition of the American Joint Committee on Cancer TNM staging manual in 2018, the classification of prostate cancer and its reporting have further evolved and are now included as part of staging criteria. This article reflects the aspects that are most influential on daily practice. A brief summary of 3 ancillary commercially available genomic tests is also provided.
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Affiliation(s)
- Beth L Braunhut
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 North West 12th Avenue, Miami, FL, 33136 USA
| | - Sanoj Punnen
- Department of Urology, University of Miami Miller School of Medicine, 1150 North West 14th Street, Miami, FL 33136, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 North West 12th Ave, Miami, FL 33136, USA
| | - Oleksandr N Kryvenko
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 North West 12th Avenue, Miami, FL, 33136 USA; Department of Urology, University of Miami Miller School of Medicine, 1150 North West 14th Street, Miami, FL 33136, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 North West 12th Ave, Miami, FL 33136, USA.
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22
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Diffusion weighted MRI as an early predictor of tumor response to hypofractionated stereotactic boost for prostate cancer. Sci Rep 2018; 8:10407. [PMID: 29991748 PMCID: PMC6039515 DOI: 10.1038/s41598-018-28817-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 06/27/2018] [Indexed: 11/17/2022] Open
Abstract
We evaluated the feasibility of using the kinetic of diffusion-weighted MRI (DWI) and the normalized apparent coefficient diffusion (ADC) map value as an early biomarker in patients treated by external beam radiotherapy (EBRT). Twelve patients were included within the frame of a multicenter phase II trial and treated for intermediate risk prostate cancer (PCa). Multiparametric MRI was performed before treatment (M0) and every 6 months until M24. Association between nADC and PSA or PSA kinetic was evaluated using the test of nullity of the Spearman correlation coefficient. The median rates of PSA at the time of diagnosis, two years and four years after EBRT were 9.29 ng/ml (range from 5.26 to 17.67), 0.68 ng/ml (0.07–2.7), 0.47 ng/ml (0.09–1.39), respectively. Median nADC increased from 1.14 × 10−3 mm2/s to 1.59 × 10−3 mm2/s between M0 and M24. Only one patient presented a decrease of nADC (1.35 × 10−3 mm2/s and 1.11 × 10−3 mm2/s at M0 and M12 respectively). The increase in nADC at M6 was correlated with PSA decrease at M18, M24 and M30 (p < 0.05). The increase in nADc at M12 was correlated with PSA decrease at M36 (p = 0.019). Early nADC variation were correlated with late PSA decrease for patients with PCa treated by EBRT.
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23
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Zhao S, Leonardson A, Geybels MS, McDaniel AS, Yu M, Kolb S, Zong H, Carter K, Siddiqui J, Cheng A, Wright JL, Pritchard CC, Lance R, Troyer D, Fan J, Ostrander EA, Dai JY, Tomlins SA, Feng Z, Stanford JL. A five-CpG DNA methylation score to predict metastatic-lethal outcomes in men treated with radical prostatectomy for localized prostate cancer. Prostate 2018; 78:1084-1091. [PMID: 29956356 PMCID: PMC6120526 DOI: 10.1002/pros.23667] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 06/11/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prognostic biomarkers for localized prostate cancer (PCa) could improve personalized medicine. Our group previously identified a panel of differentially methylated CpGs in primary tumor tissue that predict disease aggressiveness, and here we further validate these biomarkers. METHODS Pyrosequencing was used to assess CpG methylation of eight biomarkers previously identified using the HumanMethylation450 array; CpGs with strongly correlated (r >0.70) results were considered technically validated. Logistic regression incorporating the validated CpGs and Gleason sum was used to define and lock a final model to stratify men with metastatic-lethal versus non-recurrent PCa in a training dataset. Coefficients from the final model were then used to construct a DNA methylation score, which was evaluated by logistic regression and Receiver Operating Characteristic (ROC) curve analyses in an independent testing dataset. RESULTS Five CpGs were technically validated and all were retained (P < 0.05) in the final model. The 5-CpG and Gleason sum coefficients were used to calculate a methylation score, which was higher in men with metastatic-lethal progression (P = 6.8 × 10-6 ) in the testing dataset. For each unit increase in the score there was a four-fold increase in risk of metastatic-lethal events (odds ratio, OR = 4.0, 95%CI = 1.8-14.3). At 95% specificity, sensitivity was 74% for the score compared to 53% for Gleason sum alone. The score demonstrated better prediction performance (AUC = 0.91; pAUC = 0.037) compared to Gleason sum alone (AUC = 0.87; pAUC = 0.025). CONCLUSIONS The DNA methylation score improved upon Gleason sum for predicting metastatic-lethal progression and holds promise for risk stratification of men with aggressive tumors. This prognostic score warrants further evaluation as a tool for improving patient outcomes.
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Affiliation(s)
- Shanshan Zhao
- National Institute of Environmental Health SciencesBiostatistics and Computational Biology BranchResearch Triangle ParkDurhamNorth Carolina
| | - Amy Leonardson
- Division of Public Health SciencesFred Hutchison Cancer Research CenterSeattleWashington
| | - Milan S. Geybels
- Division of Public Health SciencesFred Hutchison Cancer Research CenterSeattleWashington
- Department of EpidemiologyGROW School for Oncology and Developmental BiologyMaastricht UniversityMaastrichtThe Netherlands
| | - Andrew S. McDaniel
- Departments of Pathology and UrologyUniversity of MichiganAnn ArborMichigan
| | - Ming Yu
- Division of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWashington
| | - Suzanne Kolb
- Division of Public Health SciencesFred Hutchison Cancer Research CenterSeattleWashington
| | - Hong Zong
- Division of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWashington
| | - Kelly Carter
- Division of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWashington
| | - Javed Siddiqui
- Departments of Pathology and UrologyUniversity of MichiganAnn ArborMichigan
| | - Anqi Cheng
- Division of Public Health SciencesFred Hutchison Cancer Research CenterSeattleWashington
| | - Jonathan L. Wright
- Division of Public Health SciencesFred Hutchison Cancer Research CenterSeattleWashington
- Department of UrologyUniversity of Washington School of MedicineSeattleWashington
| | - Colin C. Pritchard
- Department of Laboratory MedicineUniversity of Washington School of MedicineSeattleWashington
| | - Raymond Lance
- Department of UrologyEastern Virginia Medical SchoolNorfolkVirginia
| | - Dean Troyer
- Departments of Pathology, Microbiology, and Molecular Cell BiologyEastern Virginia Medical SchoolNorfolkVirginia
| | - Jian‐Bing Fan
- Department of OncologyIllumina, Inc.San DiegoCalifornia
| | - Elaine A. Ostrander
- Cancer Genetics and Comparative Genomics BranchNational Human Genome Research InstituteNIHBethesdaMaryland
| | - James Y. Dai
- Division of Public Health SciencesFred Hutchison Cancer Research CenterSeattleWashington
| | - Scott A. Tomlins
- Departments of Pathology and UrologyUniversity of MichiganAnn ArborMichigan
| | - Ziding Feng
- Division of Public Health SciencesFred Hutchison Cancer Research CenterSeattleWashington
- Department of BiostatisticsMD Anderson Cancer CenterHoustonTexas
| | - Janet L. Stanford
- Division of Public Health SciencesFred Hutchison Cancer Research CenterSeattleWashington
- Department of EpidemiologyUniversity of Washington School of Public HealthSeattleWashington
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Emerging proteomics biomarkers and prostate cancer burden in Africa. Oncotarget 2018; 8:37991-38007. [PMID: 28388542 PMCID: PMC5514967 DOI: 10.18632/oncotarget.16568] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/27/2017] [Indexed: 12/25/2022] Open
Abstract
Various biomarkers have emerged via high throughput omics-based approaches for use in diagnosis, treatment, and monitoring of prostate cancer. Many of these have yet to be demonstrated as having value in routine clinical practice. Moreover, there is a dearth of information on validation of these emerging prostate biomarkers within African cohorts, despite the huge burden and aggressiveness of prostate cancer in men of African descent. This review focusses of the global landmark achievements in prostate cancer proteomics biomarker discovery and the potential for clinical implementation of these biomarkers in Africa. Biomarker validation processes at the preclinical, translational and clinical research level are discussed here, as are the challenges and prospects for the evaluation and use of novel proteomic prostate cancer biomarkers.
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25
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Nowinski S, Santaolalla A, O'Leary B, Loda M, Mirchandani A, Emberton M, Van Hemelrijck M, Grigoriadis A. Systematic identification of functionally relevant risk alleles to stratify aggressive versus indolent prostate cancer. Oncotarget 2018; 9:12812-12824. [PMID: 29560112 PMCID: PMC5849176 DOI: 10.18632/oncotarget.24400] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/25/2018] [Indexed: 12/20/2022] Open
Abstract
Novel approaches for classification, including molecular features, are needed to direct therapy for men with low-grade prostate cancer (PCa), especially men on active surveillance. Risk alleles identified from genome-wide association studies (GWAS) could improve prognostication. Those risk alleles that coincided with genes and somatic copy number aberrations associated with progression of PCa were selected as the most relevant for prognostication. In a systematic literature review, a total of 698 studies were collated. Fifty-three unique SNPs residing in 29 genomic regions, including 8q24, 10q11 and 19q13, were associated with PCa progression. Functional studies implicated 21 of these single nucleotide polymorphisms (SNPs) as modulating the expression of genes in the androgen receptor pathway and several other oncogenes. In particular, 8q24, encompassing MYC, harbours a high density of SNPs conferring unfavourable pathological characteristics in low-grade PCa, while a copy number gain of MYC in low-grade PCa was associated with prostate-specific antigen recurrence after radical prostatectomy. By combining GWAS data with gene expression and structural rearrangements, risk alleles were identified that could provide a new basis for developing a prognostication tool to guide therapy for men with early prostate cancer.
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Affiliation(s)
- Salpie Nowinski
- Cancer Bioinformatics, Innovation Hub, Guy's Cancer Centre, King's College London, London, UK
| | - Aida Santaolalla
- Translational Oncology & Urology Research, King's College London, London, UK
| | - Ben O'Leary
- Breast Cancer NOW Centre, The Institute of Cancer Research, The Royal Marsden Hospital, London, UK
| | - Massimo Loda
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Ayesha Mirchandani
- Cancer Bioinformatics, Innovation Hub, Guy's Cancer Centre, King's College London, London, UK
| | - Mark Emberton
- Division of Surgery and Interventional Science, University College London, London, UK
| | | | - Anita Grigoriadis
- Cancer Bioinformatics, Innovation Hub, Guy's Cancer Centre, King's College London, London, UK
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26
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Nyame YA, Grimberg DC, Greene DJ, Gupta K, Kartha GK, Berglund R, Gong M, Stephenson AJ, Magi-Galluzzi C, Klein EA. Genomic Scores are Independent of Disease Volume in Men with Favorable Risk Prostate Cancer: Implications for Choosing Men for Active Surveillance. J Urol 2018; 199:438-444. [DOI: 10.1016/j.juro.2017.09.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Yaw A. Nyame
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Dominic C. Grimberg
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Daniel J. Greene
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Karishma Gupta
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ganesh K. Kartha
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ryan Berglund
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Michael Gong
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Andrew J. Stephenson
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Cristina Magi-Galluzzi
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Eric A. Klein
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
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Germline variants in IL4, MGMT and AKT1 are associated with prostate cancer-specific mortality: An analysis of 12,082 prostate cancer cases. Prostate Cancer Prostatic Dis 2018; 21:228-237. [PMID: 29298992 PMCID: PMC6026113 DOI: 10.1038/s41391-017-0029-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 11/09/2017] [Accepted: 11/20/2017] [Indexed: 02/08/2023]
Abstract
Background Prostate cancer (PCa) is a leading cause of mortality and genetic factors can influence tumour aggressiveness. Several germline variants have been associated with PCa-specific mortality (PCSM), but further replication evidence is needed. Methods Twenty-two previously identified PCSM-associated genetic variants were genotyped in seven PCa cohorts (12,082 patients; 1544 PCa deaths). For each cohort, Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for risk of PCSM associated with each variant. Data were then combined using a meta-analysis approach. Results Fifteen SNPs were associated with PCSM in at least one of the seven cohorts. In the meta-analysis, after adjustment for clinicopathological factors, variants in the MGMT (rs2308327; HR 0.90; p-value = 3.5 × 10−2) and IL4 (rs2070874; HR 1.22; p-value = 1.1 × 10−3) genes were confirmed to be associated with risk of PCSM. In analyses limited to men diagnosed with local or regional stage disease, a variant in AKT1, rs2494750, was also confirmed to be associated with PCSM risk (HR 0.81; p-value = 3.6 × 10−2). Conclusions This meta-analysis confirms the association of three genetic variants with risk of PCSM, providing further evidence that genetic background plays a role in PCa-specific survival. While these variants alone are not sufficient as prognostic biomarkers, these results may provide insights into the biological pathways modulating tumour aggressiveness.
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Elevated preoperative neutrophil-lymphocyte ratio predicts upgrading at radical prostatectomy. Prostate Cancer Prostatic Dis 2017; 21:100-105. [PMID: 29230007 DOI: 10.1038/s41391-017-0015-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/15/2017] [Accepted: 09/06/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Neutrophil-lymphocyte ratio (NLR) is a widely used, representative marker of systemic inflammatory response within the body. NLR can be calculated from simple, inexpensive peripheral blood samples. High NLR is a negative prognostic factor in a variety of malignancies including urological tumors. In this study, we aim to assess the prognostic value of preoperative neutrophil- lymphocyte ratio (NLR) in patients treated with radical prostatectomy (RP) for localized prostate cancer (PCa). MATERIALS AND METHODS Records of 7426 patients were retrospectively analyzed from prospectively collected datasets. A cut-off point of 3 was taken for NLR based on ROC analyses and previous literature. RESULTS 23% (n = 1707) of patients had an NLR of ≥3. Patients with NLR ≥3 were more likely to harbor unfavorable pathological features such as higher biopsy Gleason score (GS), higher RP GS, higher rates of extra capsular extension, nodal involvement (all p < 0.001) and positive surgical margins (p = 0.002). On multivariable analyses, NLR ≥ 3 was associated with higher RP GS (OR 2.32; p < 0.001), seminal vesicle invasion (OR 1.60; p < 0.001) and nodal involvement (OR 1.43; p < 0.001). On multivariable analyses, NLR ≥ 3 was significantly associated with GS upgrading at RP (OR 1.39 p < 0.001). During a median follow up of 45 months, NLR ≥ 3 was associated with higher risk of BCR (p = 0.001). However, on multivariable Cox regression analysis such association was not shown (HR 0.86; p = 0.4). CONCLUSION Preoperative NLR ≥ 3 was associated with aggressive PCa, such as upgrading at RP. Even though its effect on clinical-decision making seems to be limited when all clinical and pathological confounders are taken into account, preoperative NLR may still be useful in selected patients to identify aggressive PCa helping patient selection for active surveillance protocols. Conversely, it does not predict BCR when adjusted for the effect of pathological features.
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Herlemann A, Washington SL, Eapen RS, Cooperberg MR. Whom to Treat: Postdiagnostic Risk Assessment with Gleason Score, Risk Models, and Genomic Classifier. Urol Clin North Am 2017; 44:547-555. [PMID: 29107271 DOI: 10.1016/j.ucl.2017.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Management of prostate cancer presents unique challenges because of the disease's variable natural history. Accurate risk stratification at the time of diagnosis in clinically localized disease is crucial in providing optimal counseling about management options. To accurately distinguish pathologically indolent tumors from aggressive disease, risk groups are no longer sufficient. Rather, multivariable prognostic models reflecting the complete information known at time of diagnosis offer improved accuracy and interpretability. After diagnosis, further testing with genomic assays or other biomarkers improves risk classification. These postdiagnostic risk assessment tools should not supplant shared decision making, but rather facilitate risk classification and enable more individualized care.
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Affiliation(s)
- Annika Herlemann
- Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, Box 0981, San Francisco, CA 94143-0981, USA; Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Samuel L Washington
- Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, Box 0981, San Francisco, CA 94143-0981, USA
| | - Renu S Eapen
- Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, Box 0981, San Francisco, CA 94143-0981, USA
| | - Matthew R Cooperberg
- Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, Box 0981, San Francisco, CA 94143-0981, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, 550 16th Street, San Francisco, CA 94143, USA.
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Pinker K, Shitano F, Sala E, Do RK, Young RJ, Wibmer AG, Hricak H, Sutton EJ, Morris EA. Background, current role, and potential applications of radiogenomics. J Magn Reson Imaging 2017; 47:604-620. [PMID: 29095543 DOI: 10.1002/jmri.25870] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 09/17/2017] [Accepted: 09/19/2017] [Indexed: 12/17/2022] Open
Abstract
With the genomic revolution in the early 1990s, medical research has been driven to study the basis of human disease on a genomic level and to devise precise cancer therapies tailored to the specific genetic makeup of a tumor. To match novel therapeutic concepts conceived in the era of precision medicine, diagnostic tests must be equally sufficient, multilayered, and complex to identify the relevant genetic alterations that render cancers susceptible to treatment. With significant advances in training and medical imaging techniques, image analysis and the development of high-throughput methods to extract and correlate multiple imaging parameters with genomic data, a new direction in medical research has emerged. This novel approach has been termed radiogenomics. Radiogenomics aims to correlate imaging characteristics (ie, the imaging phenotype) with gene expression patterns, gene mutations, and other genome-related characteristics and is designed to facilitate a deeper understanding of tumor biology and capture the intrinsic tumor heterogeneity. Ultimately, the goal of radiogenomics is to develop imaging biomarkers for outcome that incorporate both phenotypic and genotypic metrics. Due to the noninvasive nature of medical imaging and its ubiquitous use in clinical practice, the field of radiogenomics is rapidly evolving and initial results are encouraging. In this article, we briefly discuss the background and then summarize the current role and the potential of radiogenomics in brain, liver, prostate, gynecological, and breast tumors. LEVEL OF EVIDENCE 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;47:604-620.
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Affiliation(s)
- Katja Pinker
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Austria
| | - Fuki Shitano
- Department of Radiology, Body Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Evis Sala
- Department of Radiology, Body Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard K Do
- Department of Radiology, Body Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Robert J Young
- Department of Radiology, Neuroradiology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Andreas G Wibmer
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hedvig Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Elizabeth J Sutton
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Elizabeth A Morris
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Abstract
PURPOSE OF REVIEW Active surveillance has been increasingly utilized as a strategy for the management of favorable-risk, localized prostate cancer. In this review, we describe contemporary management strategies of active surveillance, with a focus on traditional stratification schemes, new prognostic tools, and patient outcomes. RECENT FINDINGS Patient selection, follow-up strategy, and indication for delayed intervention for active surveillance remain centered around PSA, digital rectal exam, and biopsy findings. Novel tools which include imaging, biomarkers, and genetic assays have been investigated as potential prognostic adjuncts; however, their role in active surveillance remains institutionally dependent. Although 30-50% of patients on active surveillance ultimately undergo delayed treatment, the vast majority will remain free of metastasis with a low risk of dying from prostate cancer. The optimal method for patient selection into active surveillance is unknown; however, cancer-specific mortality rates remain excellent. New prognostication tools are promising, and long-term prospective, randomized data regarding their use in active surveillance will be beneficial.
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Abe J, Lobo JM, Trifiletti DM, Showalter TN. Providing guidance for genomics-based cancer treatment decisions: insights from stakeholder engagement for post-prostatectomy radiation therapy. BMC Med Inform Decis Mak 2017; 17:128. [PMID: 28836985 PMCID: PMC5571582 DOI: 10.1186/s12911-017-0526-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 08/18/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Despite the emergence of genomics-based risk prediction tools in oncology, there is not yet an established framework for communication of test results to cancer patients to support shared decision-making. We report findings from a stakeholder engagement program that aimed to develop a framework for using Markov models with individualized model inputs, including genomics-based estimates of cancer recurrence probability, to generate personalized decision aids for prostate cancer patients faced with radiation therapy treatment decisions after prostatectomy. METHODS We engaged a total of 22 stakeholders, including: prostate cancer patients, urological surgeons, radiation oncologists, genomic testing industry representatives, and biomedical informatics faculty. Slides were at each meeting to provide background information regarding the analytical framework. Participants were invited to provide feedback during the meeting, including revising the overall project aims. Stakeholder meeting content was reviewed and summarized by stakeholder group and by theme. RESULTS The majority of stakeholder suggestions focused on aspects of decision aid design and formatting. Stakeholders were enthusiastic about the potential value of using decision analysis modeling with personalized model inputs for cancer recurrence risk, as well as competing risks from age and comorbidities, to generate a patient-centered tool to assist decision-making. Stakeholders did not view privacy considerations as a major barrier to the proposed decision aid program. A common theme was that decision aids should be portable across multiple platforms (electronic and paper), should allow for interaction by the user to adjust model inputs iteratively, and available to patients both before and during consult appointments. Emphasis was placed on the challenge of explaining the model's composite result of quality-adjusted life years. CONCLUSIONS A range of stakeholders provided valuable insights regarding the design of a personalized decision aid program, based upon Markov modeling with individualized model inputs, to provide a patient-centered framework to support for genomic-based treatment decisions for cancer patients. The guidance provided by our stakeholders may be broadly applicable to the communication of genomic test results to patients in a patient-centered fashion that supports effective shared decision-making that represents a spectrum of personal factors such as age, medical comorbidities, and individual priorities and values.
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Affiliation(s)
- James Abe
- Department of Radiation Oncology, University of Virginia School of Medicine, 1240 Lee Street, Box 800383, Charlottesville, VA 22908 USA
| | - Jennifer M. Lobo
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA USA
| | - Daniel M. Trifiletti
- Department of Radiation Oncology, University of Virginia School of Medicine, 1240 Lee Street, Box 800383, Charlottesville, VA 22908 USA
| | - Timothy N. Showalter
- Department of Radiation Oncology, University of Virginia School of Medicine, 1240 Lee Street, Box 800383, Charlottesville, VA 22908 USA
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Moschini M, Carroll PR, Eggener SE, Epstein JI, Graefen M, Montironi R, Parker C. Low-risk Prostate Cancer: Identification, Management, and Outcomes. Eur Urol 2017; 72:238-249. [PMID: 28318726 DOI: 10.1016/j.eururo.2017.03.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/03/2017] [Indexed: 01/12/2023]
Abstract
CONTEXT The incidence of low-risk prostate cancer (PCa) has increased as a consequence of prostate-specific antigen testing. OBJECTIVE In this collaborative review article, we examine recent literature regarding low-risk PCa and the available prognostic and therapeutic options. EVIDENCE ACQUISITION We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms: prostate cancer, low risk, active surveillance, focal therapy, radical prostatectomy, watchful waiting, biomarker, magnetic resonance imaging, alone or in combination. EVIDENCE SYNTHESIS Prospective randomized trials have failed to show an impact of radical treatments on cancer-specific survival in low-risk PCa patients. Several series have reported the risk of adverse pathologic outcomes at radical prostatectomy. However, it is not clear if these patients are at higher risk of death from PCa. Long-term follow-up indicates the feasibility of active surveillance in low-risk PCa patients, although approximately 30% of men starting active surveillance undergo treatment within 5 yr. Considering focal therapies, robust data investigating its impact on long-term survival outcomes are still required and therefore should be considered experimental. Magnetic resonance imaging and tissue biomarkers may help to predict clinically significant PCa in men initially diagnosed with low-risk disease. CONCLUSIONS The incidence of low-risk PCa has increased in recent years. Only a small proportion of men with low-risk PCa progress to clinical symptoms, metastases, or death and prospective trials have not shown a benefit for immediate radical treatments. Tissue biomarkers, magnetic resonance imaging, and ongoing surveillance may help to identify those men with low-risk PCa who harbor more clinically significant disease. PATIENT SUMMARY Low-risk prostate cancer is very common. Active surveillance has excellent long-term results, while randomized trials have failed to show a beneficial impact of immediate radical treatments on survival. Biomarkers and magnetic resonance imaging may help to identify which men may benefit from early treatment.
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Affiliation(s)
- Marco Moschini
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, URI, Milan, Italy.
| | - Peter R Carroll
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Scott E Eggener
- University of Chicago Medical Center, Section of Urology, Chicago, IL, USA
| | | | - Markus Graefen
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rodolfo Montironi
- Section of Pathological Anatomy, Marche Polytechnic University, School of Medicine, United Hospitals, Ancona, Italy
| | - Christopher Parker
- Academic Urology Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey, UK
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34
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Sundi D, Schaeffer EM. Progress in Prognosis and Prediction for Men with Prostate Cancer. Eur Urol 2017; 72:32-33. [DOI: 10.1016/j.eururo.2016.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 10/27/2016] [Indexed: 11/29/2022]
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Spiciarich DR, Nolley R, Maund SL, Purcell SC, Herschel J, Iavarone AT, Peehl DM, Bertozzi CR. Bioorthogonal Labeling of Human Prostate Cancer Tissue Slice Cultures for Glycoproteomics. Angew Chem Int Ed Engl 2017. [DOI: 10.1002/ange.201701424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- David R. Spiciarich
- College of Chemistry; University of California, Berkeley; Berkeley CA 94720 USA
| | - Rosalie Nolley
- Department of Urology; Stanford University School of Medicine; Stanford CA 94305 USA
| | - Sophia L. Maund
- Department of Urology; Stanford University School of Medicine; Stanford CA 94305 USA
| | - Sean C. Purcell
- College of Chemistry; University of California, Berkeley; Berkeley CA 94720 USA
| | - Jason Herschel
- Department of Mathematics; California State University; East Bay Hayward CA 94542 USA
| | - Anthony T. Iavarone
- QB3/Chemistry Mass Spectrometry Facility; UC Berkeley; Berkeley CA 94720 USA
| | - Donna M. Peehl
- Department of Urology; Stanford University School of Medicine; Stanford CA 94305 USA
| | - Carolyn R. Bertozzi
- Department of Chemistry; Stanford University; Stanford CA 94305-4401 USA
- Howard Hughes Medical Institute; USA
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36
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Spiciarich DR, Nolley R, Maund SL, Purcell SC, Herschel J, Iavarone AT, Peehl DM, Bertozzi CR. Bioorthogonal Labeling of Human Prostate Cancer Tissue Slice Cultures for Glycoproteomics. Angew Chem Int Ed Engl 2017. [PMID: 28649697 DOI: 10.1002/anie.201701424] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sialylated glycans are found at elevated levels in many types of cancer and have been implicated in disease progression. However, the specific glycoproteins that contribute to the cancer cell-surface sialylation are not well characterized, specifically in bona fide human disease tissue. Metabolic and bioorthogonal labeling methods have previously enabled the enrichment and identification of sialoglycoproteins from cultured cells and model organisms. Herein, we report the first application of this glycoproteomic platform to human tissues cultured ex vivo. Both normal and cancerous prostate tissues were sliced and cultured in the presence of the azide-functionalized sialic acid biosynthetic precursor Ac4 ManNAz. The compound was metabolized to the azidosialic acid and incorporated into cell surface and secreted sialoglycoproteins. Chemical biotinylation followed by enrichment and mass spectrometry led to the identification of glycoproteins that were found at elevated levels or uniquely in cancerous prostate tissue. This work therefore extends the use of bioorthogonal labeling strategies to problems of clinical relevance.
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Affiliation(s)
- David R Spiciarich
- College of Chemistry, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Rosalie Nolley
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Sophia L Maund
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Sean C Purcell
- College of Chemistry, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Jason Herschel
- Department of Mathematics, California State University, East Bay Hayward, CA, 94542, USA
| | - Anthony T Iavarone
- QB3/Chemistry Mass Spectrometry Facility, UC Berkeley, Berkeley, CA, 94720, USA
| | - Donna M Peehl
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Carolyn R Bertozzi
- Department of Chemistry, Stanford University, Stanford, CA, 94305-4401, USA.,Howard Hughes Medical Institute, USA
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37
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Punnen S, Parekh DJ. Genomic Tests Should be Used to Help Guide Treatment of Prostate Cancer: No. J Urol 2017. [PMID: 28629663 DOI: 10.1016/j.juro.2017.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sanoj Punnen
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida
| | - Dipen J Parekh
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida
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Improving accuracy of RNA-based diagnosis and prognosis of oral cancer by using noninvasive methods. Oral Oncol 2017; 69:62-67. [PMID: 28559022 DOI: 10.1016/j.oraloncology.2017.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 03/23/2017] [Accepted: 04/01/2017] [Indexed: 12/13/2022]
Abstract
RNA-based diagnosis and prognosis of squamous cell carcinoma has been slow to come to the clinic. Improvements in RNA measurement, statistical evaluation, and sample preservation, along with increased sample numbers, have not made these methods reproducible enough to be used clinically. We propose that, in the case of squamous cell carcinoma of the oral cavity, a chief source of variability is sample dissection, which leads to variable amounts of stroma mixed in with tumor epithelium. This heterogeneity of the samples, which requires great care to avoid, makes it difficult to see changes in RNA levels specific to tumor cells. An evaluation of the data suggests that, paradoxically, brush biopsy samples of oral lesions may provide a more reproducible method than surgical acquisition of samples for miRNA measurement. The evidence also indicates that body fluid samples can show similar changes in miRNAs with oral squamous cell carcinoma (OSCC) as those seen in tumor brush biopsy samples - suggesting much of the miRNA in these samples is coming from the same source: tumor epithelium. We conclude that brush biopsy or body fluid samples may be superior to surgical samples in allowing miRNA-based diagnosis and prognosis of OSCC in that they feature a rapid method to obtain homogeneous tumor cells and/or RNA.
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Parnes HL. Commentary: Prostate cancer screening-A long run for a short slide. Semin Oncol 2017; 44:57-59. [PMID: 28395764 DOI: 10.1053/j.seminoncol.2017.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Howard L Parnes
- Prostate and Urologic Cancer Research Group, Division of Cancer Prevention, National Cancer Institute Bethesda, MD.
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40
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Correlation between Chromosome 9p21 Locus Deletion and Prognosis in Clinically Localized Prostate Cancer. Int J Biol Markers 2017; 32:e248-e254. [DOI: 10.5301/jbm.5000242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2016] [Indexed: 01/16/2023]
Abstract
Background Some studies have reported that deletions at chromosome arm 9p occur frequently and represent a critical step in carcinogenesis of some neoplasms. Our aim was to evaluate the deletion of locus 9p21 and chromosomes 3, 7 and 17 in localized prostate cancer (PC) and correlate these alterations with prognostic factors and biochemical recurrence after surgery. Methods We retrospectively evaluated surgical specimens from 111 patients with localized PC who underwent radical prostatectomy. Biochemical recurrence was defined as a prostate-specific antigen (PSA) >0.2 ng/mL and the mean postoperative follow-up was 123 months. The deletions were evaluated using fluorescence in situ hybridization with centromeric and locus-specific probes in a tissue microarray containing 2 samples from each patient. We correlated the occurrence of any deletion with pathological stage, Gleason score, ISUP grade group, PSA and biochemical recurrence. Results We observed a loss of any probe in only 8 patients (7.2%). The most common deletion was the loss of locus 9p21, which occurred in 6.4% of cases. Deletions of chromosomes 3, 7 and 17 were observed in 2.3%, 1.2% and 1.8% patients, respectively. There was no correlation between chromosome loss and Gleason score, ISUP, PSA or stage. Biochemical recurrence occurred in 83% cases involving 9p21 deletions. Loss of 9p21 locus was significantly associated with time to recurrence (p = 0.038). Conclusions We found low rates of deletion in chromosomes 3, 7 and 17 and 9p21 locus. We observed that 9p21 locus deletion was associated with worse prognosis in localized PC treated by radical prostatectomy.
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Spratt DE, Yousefi K, Deheshi S, Ross AE, Den RB, Schaeffer EM, Trock BJ, Zhang J, Glass AG, Dicker AP, Abdollah F, Zhao SG, Lam LLC, du Plessis M, Choeurng V, Haddad Z, Buerki C, Davicioni E, Weinmann S, Freedland SJ, Klein EA, Karnes RJ, Feng FY. Individual Patient-Level Meta-Analysis of the Performance of the Decipher Genomic Classifier in High-Risk Men After Prostatectomy to Predict Development of Metastatic Disease. J Clin Oncol 2017; 35:1991-1998. [PMID: 28358655 DOI: 10.1200/jco.2016.70.2811] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To perform the first meta-analysis of the performance of the genomic classifier test, Decipher, in men with prostate cancer postprostatectomy. Methods MEDLINE, EMBASE, and the Decipher genomic resource information database were searched for published reports between 2011 and 2016 of men treated by prostatectomy that assessed the benefit of the Decipher test. Multivariable Cox proportional hazards models fit to individual patient data were performed; meta-analyses were conducted by pooling the study-specific hazard ratios (HRs) using random-effects modeling. Extent of heterogeneity between studies was determined with the I2 test. Results Five studies (975 total patients, and 855 patients with individual patient-level data) were eligible for analysis, with a median follow-up of 8 years. Of the total cohort, 60.9%, 22.6%, and 16.5% of patients were classified by Decipher as low, intermediate, and high risk, respectively. The 10-year cumulative incidence metastases rates were 5.5%, 15.0%, and 26.7% ( P < .001), respectively, for the three risk classifications. Pooling the study-specific Decipher HRs across the five studies resulted in an HR of 1.52 (95% CI, 1.39 to 1.67; I2 = 0%) per 0.1 unit. In multivariable analysis of individual patient data, adjusting for clinicopathologic variables, Decipher remained a statistically significant predictor of metastasis (HR, 1.30; 95% CI, 1.14 to 1.47; P < .001) per 0.1 unit. The C-index for 10-year distant metastasis of the clinical model alone was 0.76; this increased to 0.81 with inclusion of Decipher. Conclusion The genomic classifier test, Decipher, can independently improve prognostication of patients postprostatectomy, as well as within nearly all clinicopathologic, demographic, and treatment subgroups. Future study of how to best incorporate genomic testing in clinical decision-making and subsequent treatment recommendations is warranted.
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Affiliation(s)
- Daniel E Spratt
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Kasra Yousefi
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Samineh Deheshi
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Ashley E Ross
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Robert B Den
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Edward M Schaeffer
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Bruce J Trock
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Jingbin Zhang
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Andrew G Glass
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Adam P Dicker
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Firas Abdollah
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Shuang G Zhao
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Lucia L C Lam
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Marguerite du Plessis
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Voleak Choeurng
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Zaid Haddad
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Christine Buerki
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Elai Davicioni
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Sheila Weinmann
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Stephen J Freedland
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Eric A Klein
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - R Jeffrey Karnes
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
| | - Felix Y Feng
- Daniel E. Spratt and Shuang G. Zhao, University of Michigan, Ann Arbor; Firas Abdollah, Henry Ford Health System, Detroit, MI; Kasra Yousefi, Samineh Deheshi, Jingbin Zhang, Lucia L.C. Lam, Marguerite du Plessis, Voleak Choeurng, Zaid Haddad, Christine Buerki, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; Ashley E. Ross and Bruce J. Trock, Johns Hopkins Hospital, Baltimore, MD; Robert B. Den and Adam P. Dicker, Thomas Jefferson University, Philadelphia, PA; Edward M. Schaeffer, Northwestern University, Evanston, IL; Andrew G. Glass and Sheila Weinmann, Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles; Felix Y. Feng, University of California, San Francisco, CA; Eric A. Klein, Cleveland Clinic, Cleveland, OH; and R. Jeffrey Karnes, Mayo Clinic, Rochester, MN
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Malla B, Zaugg K, Vassella E, Aebersold DM, Dal Pra A. Exosomes and Exosomal MicroRNAs in Prostate Cancer Radiation Therapy. Int J Radiat Oncol Biol Phys 2017; 98:982-995. [PMID: 28721912 DOI: 10.1016/j.ijrobp.2017.03.031] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/14/2017] [Accepted: 03/20/2017] [Indexed: 12/11/2022]
Abstract
Despite current risk stratification systems using traditional clinicopathologic factors, many localized and locally advanced prostate cancers fail radical treatment (ie, radical prostatectomy, radiation therapy with or without androgen deprivation therapy). Therefore, a pressing need exists for enhanced methods of disease stratification through novel prognostic and predictive tools that can reliably be applied in clinical practice. Exosomes are 50- to 150-nm small vesicles released by cancer cells that reflect the genetic and nongenetic materials of parent cancer cells. Cancer cells can contain distinct sets of microRNA profiles, the expression of which can change owing to stress such as radiation therapy. These alterations or distinctions in contents allow exosomes to be used as prognostic and/or predictive biomarkers and to monitor the treatment response. Additionally, microRNAs have been shown to influence multiple processes in prostate tumorigenesis, including cell proliferation, induction of apoptosis, migration, oncogene inhibition, and radioresistance. Thus, comparative exosomal microRNA profiling at different levels could help portray tumor aggressiveness and response to radiation therapy. Although technical challenges persist in exosome isolation and characterization, recent improvements in microRNA profiling have evolved toward in-depth analyses of the exosomal cargo and its functions. We have reviewed the role of exosomes and exosomal microRNAs in biologic processes of prostate cancer progression and radiation therapy response, with a particular focus on the development of clinical assays for treatment personalization.
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Affiliation(s)
- Bijaya Malla
- Department of Radiation Oncology, Bern University Hospital, Inselspital, Bern, Switzerland
| | - Kathrin Zaugg
- Department of Radiation Oncology, Bern University Hospital, Inselspital, Bern, Switzerland
| | - Erik Vassella
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Daniel M Aebersold
- Department of Radiation Oncology, Bern University Hospital, Inselspital, Bern, Switzerland
| | - Alan Dal Pra
- Department of Radiation Oncology, Bern University Hospital, Inselspital, Bern, Switzerland.
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Epigenomic Regulation of Androgen Receptor Signaling: Potential Role in Prostate Cancer Therapy. Cancers (Basel) 2017; 9:cancers9010009. [PMID: 28275218 PMCID: PMC5295780 DOI: 10.3390/cancers9010009] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/02/2017] [Accepted: 01/11/2017] [Indexed: 12/18/2022] Open
Abstract
Androgen receptor (AR) signaling remains the major oncogenic pathway in prostate cancer (PCa). Androgen-deprivation therapy (ADT) is the principle treatment for locally advanced and metastatic disease. However, a significant number of patients acquire treatment resistance leading to castration resistant prostate cancer (CRPC). Epigenetics, the study of heritable and reversible changes in gene expression without alterations in DNA sequences, is a crucial regulatory step in AR signaling. We and others, recently described the technological advance Chem-seq, a method to identify the interaction between a drug and the genome. This has permitted better understanding of the underlying regulatory mechanisms of AR during carcinogenesis and revealed the importance of epigenetic modifiers. In screening for new epigenomic modifiying drugs, we identified SD-70, and found that this demethylase inhibitor is effective in CRPC cells in combination with current therapies. The aim of this review is to explore the role of epigenetic modifications as biomarkers for detection, prognosis, and risk evaluation of PCa. Furthermore, we also provide an update of the recent findings on the epigenetic key processes (DNA methylation, chromatin modifications and alterations in noncoding RNA profiles) involved in AR expression and their possible role as therapeutic targets.
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Gnanapragasam VJ, Warren AY. Improving clinical prognostic stratification models for men with prostate cancer: a practical step closer to more individualized care without added costs. BJU Int 2016; 119:366-367. [DOI: 10.1111/bju.13721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vincent J. Gnanapragasam
- Academic Urology Group; Department of Surgery; University of Cambridge; Cambridge UK
- Department of Urology; Cambridge University Hospitals NHS Trust; Cambridge UK
| | - Anne Y. Warren
- Department of Pathology; Cambridge University Hospitals NHS Trust; Cambridge UK
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Patel KM, Gnanapragasam VJ. Novel concepts for risk stratification in prostate cancer. JOURNAL OF CLINICAL UROLOGY 2016; 9:18-23. [PMID: 28344812 PMCID: PMC5356178 DOI: 10.1177/2051415816673502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 09/07/2016] [Indexed: 01/15/2023]
Abstract
Since Partin introduced the analysis of prostate-specific antigen, clinical T-stage and Gleason scores to estimate the risk of progression in men with localised prostate cancer, our understanding of factors that modify this risk has changed drastically. There are now multiple risk stratification tools available, including look-up tables, risk stratification/classification analyses, regression-tree analyses, nomograms and artificial neural networks. Concurrently, descriptions of novel biopsy strategies, imaging modalities and biomarkers are frequently published with the aim of improving risk stratification. With an abundance of new information available, incorporating advances into clinical practice can be confusing. This article aims to outline the major novel concepts in prostate cancer risk stratification for men with biopsy confirmed prostate cancer. We will detail which of these novel techniques and tools are likely to be adopted to aid treatment decisions and enable more accurate post-diagnosis, pretreatment risk stratification.
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Affiliation(s)
- Keval M Patel
- Cancer Research UK Cambridge Institute, University of Cambridge, UK; Academic Urology Group, University of Cambridge, UK
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Musunuru HB, Yamamoto T, Klotz L, Ghanem G, Mamedov A, Sethukavalan P, Jethava V, Jain S, Zhang L, Vesprini D, Loblaw A. Active Surveillance for Intermediate Risk Prostate Cancer: Survival Outcomes in the Sunnybrook Experience. J Urol 2016; 196:1651-1658. [PMID: 27569437 DOI: 10.1016/j.juro.2016.06.102] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE To assess the applicability of active surveillance in patients with intermediate risk prostate cancer, we compared the survival outcomes of patients with low risk and intermediate risk disease. MATERIALS AND METHODS Active surveillance was offered to all patients with low risk (cT1-T2b and Gleason score 6 and prostate specific antigen 10 ng/ml or less) and select intermediate risk disease (age greater than 70 years with cT2c or prostate specific antigen 15 ng/ml or less, or Gleason score 3+4 or less). Data from November 1995 to May 2013 were extracted from a prospectively collected database. The primary outcome was metastasis-free survival, and secondary outcomes were overall survival, cause specific survival and treatment-free survival. RESULTS A total of 213 intermediate risk and 732 low risk cases were identified. Median age was 72 years (IQR 67.3, 76.8) in the intermediate risk cohort and 67 years (IQR 60.6, 71.9) in the low risk group. Median followup was comparable (6.7 years for intermediate risk vs 6.5 years for low risk). Gleason 7 disease comprised 60% of the intermediate risk cohort. The 15-year metastasis-free, overall, cause specific and treatment-free survival rates were inferior in the intermediate risk group (metastasis-free survival HR 3.14, 95% CI 1.51-6.53, p=0.001, 82% for intermediate risk vs 95% for low risk). On further evaluation the estimated 15-year metastasis-free survival for cases of Gleason 6 or less with prostate specific antigen less than 10 ng/ml was 94%, Gleason 6 or less with prostate specific antigen 10 to 20 ng/ml was 94%, Gleason 3+4 with prostate specific antigen 20 ng/ml or less was 84% and Gleason 4+3 with prostate specific antigen 20 ng/ml or less was 63%. CONCLUSIONS These data support the use of active surveillance in low risk and intermediate risk cases of Gleason 6 but not Gleason 7 prostate cancer. Multiparametric magnetic resonance imaging and novel biomarkers might be vital in detecting favorable Gleason 7 disease.
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Affiliation(s)
- Hima Bindu Musunuru
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Toshihiro Yamamoto
- Department of Surgical Urology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Laurence Klotz
- Department of Surgical Urology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Gabriella Ghanem
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Alexandre Mamedov
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Peraka Sethukavalan
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Vibhuti Jethava
- Department of Surgical Urology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Suneil Jain
- Centre for Cancer Research and Cell Biology, Queen's University, Belfast, Ireland
| | - Liying Zhang
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Danny Vesprini
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Loblaw
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Ontario, Canada.
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Reiter RE. Risk stratification of prostate cancer 2016. Scandinavian Journal of Clinical and Laboratory Investigation 2016; 245:S54-9. [DOI: 10.1080/00365513.2016.1208453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Tonry CL, Leacy E, Raso C, Finn SP, Armstrong J, Pennington SR. The Role of Proteomics in Biomarker Development for Improved Patient Diagnosis and Clinical Decision Making in Prostate Cancer. Diagnostics (Basel) 2016; 6:E27. [PMID: 27438858 PMCID: PMC5039561 DOI: 10.3390/diagnostics6030027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/28/2016] [Accepted: 07/07/2016] [Indexed: 02/06/2023] Open
Abstract
Prostate Cancer (PCa) is the second most commonly diagnosed cancer in men worldwide. Although increased expression of prostate-specific antigen (PSA) is an effective indicator for the recurrence of PCa, its intended use as a screening marker for PCa is of considerable controversy. Recent research efforts in the field of PCa biomarkers have focused on the identification of tissue and fluid-based biomarkers that would be better able to stratify those individuals diagnosed with PCa who (i) might best receive no treatment (active surveillance of the disease); (ii) would benefit from existing treatments; or (iii) those who are likely to succumb to disease recurrence and/or have aggressive disease. The growing demand for better prostate cancer biomarkers has coincided with the development of improved discovery and evaluation technologies for multiplexed measurement of proteins in bio-fluids and tissues. This review aims to (i) provide an overview of these technologies as well as describe some of the candidate PCa protein biomarkers that have been discovered using them; (ii) address some of the general limitations in the clinical evaluation and validation of protein biomarkers; and (iii) make recommendations for strategies that could be adopted to improve the successful development of protein biomarkers to deliver improvements in personalized PCa patient decision making.
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Affiliation(s)
- Claire L Tonry
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Emma Leacy
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Cinzia Raso
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Stephen P Finn
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
| | | | - Stephen R Pennington
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
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