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Zamani-Siahkali N, Mirshahvalad SA, Farbod A, Divband G, Pirich C, Veit-Haibach P, Cook G, Beheshti M. SPECT/CT, PET/CT, and PET/MRI for Response Assessment of Bone Metastases. Semin Nucl Med 2024; 54:356-370. [PMID: 38172001 DOI: 10.1053/j.semnuclmed.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 01/05/2024]
Abstract
Recent developments in hybrid SPECT/CT systems and the use of cadmium-zinc-telluride (CZT) detectors have improved the diagnostic accuracy of bone scintigraphy. These advancements have paved the way for novel quantitative approaches to accurate and reproducible treatment monitoring of bone metastases. PET/CT imaging using [18F]F-FDG and [18F]F-NaF have shown promising clinical utility in bone metastases assessment and monitoring response to therapy and prediction of treatment response in a broad range of malignancies. Additionally, specific tumor-targeting tracers like [99mTc]Tc-PSMA, [68Ga]Ga-PSMA, or [11C]C- or [18F]F-Choline revealed high diagnostic performance for early assessment and prognostication of bone metastases, particularly in prostate cancer. PET/MRI appears highly accurate imaging modality, but has associated limitations notably, limited availability, more complex logistics and high installation costs. Advances in artificial intelligence (Al) seem to improve the accuracy of imaging modalities and provide an assistant role in the evaluation of treatment response of bone metastases.
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Affiliation(s)
- Nazanin Zamani-Siahkali
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mirshahvalad
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Joint Department of Medical Imaging, University Medical Imaging Toronto, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, Canada
| | - Abolfazl Farbod
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Christian Pirich
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Patrick Veit-Haibach
- Joint Department of Medical Imaging, University Medical Imaging Toronto, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, Canada
| | - Gary Cook
- Cancer Imaging Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria.
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2
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Liu X, Duan Z, Fang S, Wang S. Imaging Assessment of the Efficacy of Chemotherapy in Primary Malignant Bone Tumors: Recent Advances in Qualitative and Quantitative Magnetic Resonance Imaging and Radiomics. J Magn Reson Imaging 2024; 59:7-31. [PMID: 37154415 DOI: 10.1002/jmri.28760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/10/2023] Open
Abstract
Recent studies have shown that MRI demonstrates promising results for evaluating the chemotherapy efficacy in bone sarcomas. This article reviews current methods for evaluating the efficacy of malignant bone tumors and the application of MRI in this area, and emphasizes the advantages and limitations of each modality. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Xiaoge Liu
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, China
| | - Zhiqing Duan
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, China
| | - Shaobo Fang
- Department of Medical Imaging, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Shaowu Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, China
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3
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Mohseninia N, Zamani-Siahkali N, Harsini S, Divband G, Pirich C, Beheshti M. Bone Metastasis in Prostate Cancer: Bone Scan Versus PET Imaging. Semin Nucl Med 2024; 54:97-118. [PMID: 37596138 DOI: 10.1053/j.semnuclmed.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 08/20/2023]
Abstract
Prostate cancer is the second most common cause of malignancy among men, with bone metastasis being a significant source of morbidity and mortality in advanced cases. Detecting and treating bone metastasis at an early stage is crucial to improve the quality of life and survival of prostate cancer patients. This objective strongly relies on imaging studies. While CT and MRI have their specific utilities, they also possess certain drawbacks. Bone scintigraphy, although cost-effective and widely available, presents high false-positive rates. The emergence of PET/CT and PET/MRI, with their ability to overcome the limitations of standard imaging methods, offers promising alternatives for the detection of bone metastasis. Various radiotracers targeting cell division activity or cancer-specific membrane proteins, as well as bone seeking agents, have been developed and tested. The use of positron-emitting isotopes such as fluorine-18 and gallium-68 for labeling allows for a reduced radiation dose and unaffected biological properties. Furthermore, the integration of artificial intelligence (AI) and radiomics techniques in medical imaging has shown significant advancements in reducing interobserver variability, improving accuracy, and saving time. This article provides an overview of the advantages and limitations of bone scan using SPECT and SPECT/CT and PET imaging methods with different radiopharmaceuticals and highlights recent developments in hybrid scanners, AI, and radiomics for the identification of prostate cancer bone metastasis using molecular imaging.
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Affiliation(s)
- Nasibeh Mohseninia
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Nazanin Zamani-Siahkali
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Department of Nuclear Medicine, Research center for Nuclear Medicine and Molecular Imaging, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Harsini
- Department of Molecular Oncology, BC Cancer Research Institute, Vancouver, BC, Canada
| | | | - Christian Pirich
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria.
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4
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Franchi S, Asti M, Di Marco V, Tosato M. The Curies' element: state of the art and perspectives on the use of radium in nuclear medicine. EJNMMI Radiopharm Chem 2023; 8:38. [PMID: 37947909 PMCID: PMC10638329 DOI: 10.1186/s41181-023-00220-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The alpha-emitter radium-223 (223Ra) is presently used in nuclear medicine for the palliative treatment of bone metastases from castration-resistant prostate cancer. This application arises from its advantageous decay properties and its intrinsic ability to accumulate in regions of high bone turnover when injected as a simple chloride salt. The commercial availability of [223Ra]RaCl2 as a registered drug (Xofigo®) is a further additional asset. MAIN BODY The prospect of extending the utility of 223Ra to targeted α-therapy of non-osseous cancers has garnered significant interest. Different methods, such as the use of bifunctional chelators and nanoparticles, have been explored to incorporate 223Ra in proper carriers designed to precisely target tumor sites. Nevertheless, the search for a suitable scaffold remains an ongoing challenge, impeding the diffusion of 223Ra-based radiopharmaceuticals. CONCLUSION This review offers a comprehensive overview of the current role of radium radioisotopes in nuclear medicine, with a specific focus on 223Ra. It also critically examines the endeavors conducted so far to develop constructs capable of incorporating 223Ra into cancer-targeting drugs. Particular emphasis is given to the chemical aspects aimed at providing molecular scaffolds for the bifunctional chelator approach.
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Affiliation(s)
- Sara Franchi
- Department of Chemical Sciences, University of Padova, Via Marzolo 1, 35131, Padua, Italy
| | - Mattia Asti
- Radiopharmaceutical Chemistry Section, Nuclear Medicine Unit, AUSL di Reggio Emilia: Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Valerio Di Marco
- Department of Chemical Sciences, University of Padova, Via Marzolo 1, 35131, Padua, Italy
| | - Marianna Tosato
- Radiopharmaceutical Chemistry Section, Nuclear Medicine Unit, AUSL di Reggio Emilia: Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy.
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5
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Kitajima K, Kuyama J, Kawahara T, Suga T, Otani T, Sugawara S, Kono Y, Tamaki Y, Seko-Nitta A, Ishiwata Y, Ito K, Toriihara A, Watanabe S, Hosono M, Miyake H, Yamamoto S, Sasaki R, Narita M, Yamakado K. Assessing Therapeutic Response to Radium-223 with an Automated Bone Scan Index among Metastatic Castration-Resistant Prostate Cancer Patients: Data from Patients in the J-RAP-BSI Trial. Cancers (Basel) 2023; 15:2784. [PMID: 37345121 DOI: 10.3390/cancers15102784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 06/23/2023] Open
Abstract
To evaluate the usefulness of change in the automated bone scan index (aBSI) value derived from bone scintigraphy findings as an imaging biomarker for the assessment of treatment response and survival prediction in metastatic castration-resistant prostate cancer (mCRPC) patients treated with Ra-223. This study was a retrospective investigation of a Japanese cohort of 205 mCRPC patients who received Ra-223 in 14 hospitals between July 2016 and August 2020 and for whom bone scintigraphy before and after radium-223 treatment was available. Correlations of aBSI change, with changes in the serum markers alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were evaluated. Additionally, the association of those changes with overall survival (OS) was assessed using the Cox proportional-hazards model and Kaplan-Meier curve results. Of the 205 patients enrolled, 165 (80.5%) completed six cycles of Ra-223. Following treatment, ALP decline (%ALP < 0%) was noted in 72.2% (148/205), aBSI decline (%aBSI < 0%) in 52.7% (108/205), and PSA decline (%PSA < 0%) in 27.8% (57/205). Furthermore, a reduction in both aBSI and ALP was seen in 87 (42.4%), a reduction in only ALP was seen in 61 (29.8%), a reduction in only aBSI was seen in 21 (10.2%), and in both aBSI and ALP increasing/stable (≥0%) was seen in 36 (17.6%) patients. Multiparametric analysis showed changes in PSA [hazard ratio (HR) 4.30, 95% confidence interval (CI) 2.32-8.77, p < 0.0001], aBSI (HR 2.22, 95%CI 1.43-3.59, p = 0.0003), and ALP (HR 2.06, 95%CI 1.35-3.14, p = 0.0008) as significant prognostic factors for OS. For mCRPC patients treated with Ra-223, aBSI change is useful as an imaging biomarker for treatment response assessment and survival prediction.
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Affiliation(s)
- Kazuhiro Kitajima
- Department of Radiology, Hyogo Medical University, Hyogo 663-8131, Japan
| | - Junpei Kuyama
- Nuclear Medicine, Chiba Cancer Center, Chiba 260-8717, Japan
| | - Takashi Kawahara
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Kanagawa 232-0024, Japan
| | - Tsuyoshi Suga
- Department of Radiology, Kobe City Medical Center General Hospital, Hyogo 650-0047, Japan
| | - Tomoaki Otani
- Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8303, Japan
| | - Shigeyasu Sugawara
- Advanced Clinical Research Center, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Yumiko Kono
- Department of Radiology, Kansai Medical University, Osaka 573-1191, Japan
| | - Yukihisa Tamaki
- Department of Radiation Oncology, Faculty of Medicine, Shimane University, Shimane 693-0021, Japan
| | - Ayumi Seko-Nitta
- Department of Radiology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Yoshinobu Ishiwata
- Department of Radiology, Yokohama City University Hospital, Kanagawa 236-0004, Japan
| | - Kimiteru Ito
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Akira Toriihara
- PET Imaging Center, Asahi General Hospital, Toyama, 939-0741, Japan
| | - Shiro Watanabe
- Department of Nuclear Medicine, Hokkaido University Hospital, Hokkaido 060-8648, Japan
| | - Makoto Hosono
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osaka 577-8502, Japan
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, Shizuoka 431-3125, Japan
| | - Shingo Yamamoto
- Department of Urology, Hyogo Medical University, Hyogo 663-8131, Japan
| | - Ryohei Sasaki
- Department of Radiation Oncology, Graduate School of Medicine, Kobe University, Hyogo 650-0017, Japan
| | - Mitsuhiro Narita
- Department of Urology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Koichiro Yamakado
- Department of Radiology, Hyogo Medical University, Hyogo 663-8131, Japan
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6
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De Feo MS, Frantellizzi V, Bauckneht M, Farcomeni A, Filippi L, Rizzini EL, Lavelli V, Stazza ML, Di Raimondo T, Fornarini G, Rebuzzi SE, Filippo M, Mammucci P, Marongiu A, Monari F, Rubini G, Spanu A, De Vincentis G. The DASciS Software for BSI Calculation as a Valuable Prognostic Tool in mCRPC Treated with 223RaCl2: A Multicenter Italian Study. Biomedicines 2023; 11:biomedicines11041103. [PMID: 37189721 DOI: 10.3390/biomedicines11041103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND/AIM Radium-223 dichloride (223RaCl2) represents a therapeutic option for metastatic castration-resistant prostate cancer (mCRPC) patients dealing with symptomatic bone metastases. The identification of baseline variables potentially affecting the life-prolonging role of 223RaCl2 is still ongoing. Bone scan index (BSI) defines the total load of bone metastatic disease detected on a bone scan (BS) and is expressed as a percentage value of the whole bone mass. The aim of this multicenter study was to assess the impact of baseline BSI on overall survival (OS) in mCRPC patients treated with 223RaCl2. For this purpose, the DASciS software developed by the Sapienza University of Rome for BSI calculation was shared between six Italian Nuclear Medicine Units. METHODS 370 pre-treatment BS were analyzed through the DASciS software. Other clinical variables relevant to OS analysis were taken into account for the statistical analysis. RESULTS Of a total of 370 patients, 326 subjects had died at the time of our retrospective analysis. The median OS time from the first cycle of 223RaCl2 to the date of death from any cause or last contact was 13 months (95%CI 12-14 months). The mean BSI value resulted in 2.98% ± 2.42. The center-adjusted univariate analysis showed that baseline BSI was significantly associated with OS as an independent risk factor (HR 1.137, 95%CI: 1.052-1.230, p = 0.001), meaning that patients with higher BSI values had worse OS. When adjusting for other measures on multivariate analysis, in addition to Gleason score and baseline values of Hb, tALP, and PSA, baseline BSI was confirmed to be a statistically significant parameter (HR 1.054, 95%CI: 1.040-1.068, p < 0.001). CONCLUSIONS Baseline BSI significantly predicts OS in mCRPC treated with 223RaCl2. The DASciS software was revealed to be a valuable tool for BSI calculation, showing rapid processing time and requiring no more than a single demonstrative training for each participating center.
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Affiliation(s)
- Maria Silvia De Feo
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy
| | - Viviana Frantellizzi
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy
| | - Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Alessio Farcomeni
- Department of Economics & Finance, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, 04100 Latina, Italy
| | - Elisa Lodi Rizzini
- Radiation Oncology, IRCSS Azienza Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Valentina Lavelli
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Maria Lina Stazza
- Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Tania Di Raimondo
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Sara Elena Rebuzzi
- Medical Oncology, Ospedale San Paolo, 17100 Savona, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
| | - Mammini Filippo
- Radiation Oncology, IRCSS Azienza Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Radiation Oncology, Department of Medical and Surgical Siences (DIMEC), Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Paolo Mammucci
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Andrea Marongiu
- Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Fabio Monari
- Radiation Oncology, IRCSS Azienza Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Radiation Oncology, Department of Medical and Surgical Siences (DIMEC), Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Giuseppe Rubini
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Angela Spanu
- Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Giuseppe De Vincentis
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00161 Rome, Italy
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7
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Bauckneht M, Marini C, Cossu V, Campi C, Riondato M, Bruno S, Orengo AM, Vitale F, Carta S, Chiola S, Chiesa S, Miceli A, D’Amico F, Fornarini G, Terrone C, Piana M, Morbelli S, Signori A, Barboro P, Sambuceti G. Gene's expression underpinning the divergent predictive value of [18F]F-fluorodeoxyglucose and prostate-specific membrane antigen positron emission tomography in primary prostate cancer: a bioinformatic and experimental study. J Transl Med 2023; 21:3. [PMID: 36600265 PMCID: PMC9811737 DOI: 10.1186/s12967-022-03846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Positron Emission Tomography (PET) imaging with Prostate-Specific Membrane Antigen (PSMA) and Fluorodeoxyglucose (FDG) represent promising biomarkers for risk-stratification of Prostate Cancer (PCa). We verified whether the expression of genes encoding for PSMA and enzymes regulating FDG cellular uptake are independent and additive prognosticators in PCa. METHODS mRNA expression of genes involved in glucose metabolism and PSMA regulation obtained from primary PCa specimens were retrieved from open-source databases and analyzed using an integrative bioinformatics approach. Machine Learning (ML) techniques were used to create predictive Progression-Free Survival (PFS) models. Cellular models of primary PCa with different aggressiveness were used to compare [18F]F-PSMA-1007 and [18F]F-FDG uptake kinetics in vitro. Confocal microscopy, immunofluorescence staining, and quantification analyses were performed to assess the intracellular and cellular membrane PSMA expression. RESULTS ML analyses identified a predictive functional network involving four glucose metabolism-related genes: ALDOB, CTH, PARP2, and SLC2A4. By contrast, FOLH1 expression (encoding for PSMA) did not provide any additive predictive value to the model. At a cellular level, the increase in proliferation rate and migratory potential by primary PCa cells was associated with enhanced FDG uptake and decreased PSMA retention (paralleled by the preferential intracellular localization). CONCLUSIONS The overexpression of a functional network involving four glucose metabolism-related genes identifies a higher risk of disease progression since the earliest phases of PCa, in agreement with the acknowledged prognostic value of FDG PET imaging. By contrast, the prognostic value of PSMA PET imaging is independent of the expression of its encoding gene FOLH1. Instead, it is influenced by the protein docking to the cell membrane, regulating its accessibility to tracer binding.
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Affiliation(s)
- Matteo Bauckneht
- grid.5606.50000 0001 2151 3065Department of Health Sciences, University of Genoa, 16132 Genoa, Italy ,grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Cecilia Marini
- grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy ,grid.428490.30000 0004 1789 9809CNR, Institute of Molecular Bioimaging and Physiology (IBFM), 20054 Milan, Italy
| | - Vanessa Cossu
- grid.5606.50000 0001 2151 3065Department of Health Sciences, University of Genoa, 16132 Genoa, Italy ,grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Cristina Campi
- grid.5606.50000 0001 2151 3065LISCOMP Lab, Department of Mathematics (DIMA), University of Genoa, 16132 Genoa, Italy
| | - Mattia Riondato
- grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Silvia Bruno
- grid.5606.50000 0001 2151 3065Department of Experimental Medicine, Human Anatomy, University of Genoa, 16132 Genoa, Italy
| | - Anna Maria Orengo
- grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Francesca Vitale
- grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Sonia Carta
- grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Silvia Chiola
- grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Sabrina Chiesa
- grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Alberto Miceli
- grid.5606.50000 0001 2151 3065Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Francesca D’Amico
- grid.5606.50000 0001 2151 3065Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Giuseppe Fornarini
- grid.410345.70000 0004 1756 7871Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Carlo Terrone
- grid.410345.70000 0004 1756 7871Department of Urology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy ,grid.5606.50000 0001 2151 3065Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16132 Genoa, Italy
| | - Michele Piana
- grid.5606.50000 0001 2151 3065LISCOMP Lab, Department of Mathematics (DIMA), University of Genoa, 16132 Genoa, Italy ,grid.482259.00000 0004 1774 9464CNR-SPIN Genoa, 16132 Genoa, Italy
| | - Silvia Morbelli
- grid.5606.50000 0001 2151 3065Department of Health Sciences, University of Genoa, 16132 Genoa, Italy ,grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Alessio Signori
- grid.5606.50000 0001 2151 3065Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Paola Barboro
- grid.410345.70000 0004 1756 7871Proteomic and Mass Spectrometry Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianmario Sambuceti
- grid.5606.50000 0001 2151 3065Department of Health Sciences, University of Genoa, 16132 Genoa, Italy ,grid.410345.70000 0004 1756 7871Nuclear Medicine Unit, IRCCS, Ospedale Policlinico San Martino, 16132 Genoa, Italy
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8
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Unterrainer LM, Beyer L, Zacherl MJ, Gildehaus FJ, Todica A, Kunte SC, Holzgreve A, Sheikh GT, Herlemann A, Casuscelli J, Brendel M, Albert NL, Wenter V, Schmidt-Hegemann NS, Kunz WG, Cyran CC, Ricke J, Stief CG, Bartenstein P, Ilhan H, Unterrainer M. Total Tumor Volume on 18F-PSMA-1007 PET as Additional Imaging Biomarker in mCRPC Patients Undergoing PSMA-Targeted Alpha Therapy with 225Ac-PSMA-I&T. Biomedicines 2022; 10:biomedicines10050946. [PMID: 35625683 PMCID: PMC9138410 DOI: 10.3390/biomedicines10050946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 01/25/2023] Open
Abstract
Background: PSMA-based alpha therapy using 225Ac-PSMA-I&T provides treatment for metastatic castration-resistant prostate cancer (mCRPC), even after the failure of 177Lu-PSMA radioligand therapy (RLT). In clinical routine, the total tumor volume (TTV) on PSMA PET impacts therapy outcomes and plays an increasing role in mCRPC patients. Hence, we aimed to assess TTV and its changes during 225Ac-PSMA-I&T RLT. Methods: mCRPC patients undergoing RLT with 225Ac-PSMA-I&T with available 18F-PSMA-1007 PET/CT prior to therapy initiation were included. TTV was assessed in all patients using established cut-off values. Image derived, clinical and biochemistry parameters (PSA, LDH, AP, pain score) were analyzed prior to and after two cycles of 225Ac-PSMA. Changes in TTV and further parameters were directly compared and then correlated with established response criteria, such as RECIST 1.1 or mPERCIST. Results: 13 mCRPC patients were included. The median overall survival (OS) was 10 months. Prior to 225Ac-PSMA RLT, there was no significant correlation between TTV with other clinical parameters (p > 0.05 each). Between short-term survivors (STS, <10 months OS) and long-term survivors (LTS, ≥10 months OS), TTV and PSA were comparable (p = 0.592 & p = 0.286, respectively), whereas AP was significantly lower in the LTS (p = 0.029). A total of 7/13 patients completed two cycles and underwent a follow-up 18F-PSMA-1007 PET/CT. Among these patients, there was a significant decrease in TTV (median 835 vs. 201 mL, p = 0.028) and PSA (median 687 ng/dL vs. 178 ng/dL, p = 0.018) after two cycles of 225Ac-PSMA RLT. Here, percentage changes of TTV after two cycles showed no direct correlation to all other clinical parameters (p > 0.05 each). In two patients, new PET-avid lesions were detected on 18F-PSMA-1007 PET/CT. However, TTV and PSA were decreasing or stable. Conclusion: PET-derived assessment of TTV is an easily applicable imaging biomarker independent of other established parameters prior to 225Ac-PSMA RLT in these preliminary follow-up data. Even after the failure of 177Lu-PSMA, patients with extensive TTV seem to profit from RLT. All but one patient who was eligible for ≥2 cycles of 225Ac-PSMA-RLT demonstrated drastic TTV decreases without direct correlation to other biomarkers, such as serum PSA changes. Changes in TTV might hence improve the response assessment compared to standard classifiers by reflecting the current tumor load independent of the occurrence of new lesions.
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Affiliation(s)
- Lena M. Unterrainer
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
- Correspondence: ; Tel.: +49-89-4400-74646
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Mathias J. Zacherl
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Franz J. Gildehaus
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Andrei Todica
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Sophie C. Kunte
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Adrien Holzgreve
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Gabriel T. Sheikh
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Annika Herlemann
- Department of Urology, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (A.H.); (J.C.); (C.G.S.)
| | - Jozefina Casuscelli
- Department of Urology, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (A.H.); (J.C.); (C.G.S.)
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Nathalie L. Albert
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Vera Wenter
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Nina-Sophie Schmidt-Hegemann
- Department of Radiation Oncology, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany;
| | - Wolfgang G. Kunz
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (W.G.K.); (C.C.C.); (J.R.); (M.U.)
| | - Clemens C. Cyran
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (W.G.K.); (C.C.C.); (J.R.); (M.U.)
| | - Jens Ricke
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (W.G.K.); (C.C.C.); (J.R.); (M.U.)
| | - Christian G. Stief
- Department of Urology, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (A.H.); (J.C.); (C.G.S.)
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (L.B.); (M.J.Z.); (F.J.G.); (A.T.); (S.C.K.); (A.H.); (G.T.S.); (M.B.); (N.L.A.); (V.W.); (P.B.); (H.I.)
| | - Marcus Unterrainer
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich (LMU Munich), 81377 Munich, Germany; (W.G.K.); (C.C.C.); (J.R.); (M.U.)
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9
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Bauckneht M, Rebuzzi SE, Ponzano M, Borea R, Signori A, Frantellizzi V, Lodi Rizzini E, Mascia M, Lavelli V, Miceli A, De Feo MS, Pisani AR, Nuvoli S, Tripoli V, Morganti AG, Mammucci P, Caponnetto S, Mantica G, Di Nicola AD, Villano C, Cindolo L, Morbelli S, Sambuceti G, Fanti S, Costa RP, Spanu A, Rubini G, Monari F, De Vincentis G, Fornarini G. Prognostic Value of the BIO-Ra Score in Metastatic Castration-Resistant Prostate Cancer Patients Treated with Radium-223 after the European Medicines Agency Restricted Use: Secondary Investigations of the Multicentric BIO-Ra Study. Cancers (Basel) 2022; 14. [PMID: 35406515 DOI: 10.3390/cancers14071744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023] Open
Abstract
The multicentric retrospective BIO-Ra study combined inflammatory indices from peripheral blood and clinical factors in a composite prognostic score for metastatic castration-resistant prostate cancer patients receiving Radium-223 (Ra-223). In the present study, we evaluated (i) the prognostic power of the BIO-Ra score in the framework of the restricted use of Ra-223 promoted by the European Medicines Agency in 2018; (ii) the treatment completion prediction of the BIO-Ra score. Four hundred ninety-four patients from the BIO-Ra cohort were divided into three risk classes according to the BIO-Ra score to predict the treatment completion rate (p < 0.001 among all the three groups). Patients receiving Ra-223 after restriction (89/494) were at later stages of the disease compared with the pre-restriction cohort (405/494), as a higher percentage of BIO-Ra high-risk classes (46.1% vs. 34.6%) and lower median Overall survival (12.4 vs. 23.7 months, p < 0.001) was observed. Despite this clinically relevant difference, BIO-Ra classes still predicted divergent treatment completion rates in the post-restriction subgroup (72%, 52.2%, and 46.3% of patients belonging to low-, intermediate-, and high-risk classes, respectively). Although the restricted use has increased patients at higher risk with unfavourable outcome after Ra-223 treatment, the BIO-Ra score maintains its prognostic value.
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10
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Borea R, Favero D, Miceli A, Donegani MI, Raffa S, Gandini A, Cremante M, Marini C, Sambuceti G, Zanardi E, Morbelli S, Fornarini G, Rebuzzi SE, Bauckneht M. Beyond the Prognostic Value of 2-[18F]FDG PET/CT in Prostate Cancer: A Case Series and Literature Review Focusing on the Diagnostic Value and Impact on Patient Management. Diagnostics (Basel) 2022; 12:diagnostics12030581. [PMID: 35328134 PMCID: PMC8947589 DOI: 10.3390/diagnostics12030581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 12/04/2022] Open
Abstract
The role of 2-deoxy-2-[18F]fluoro-D-glucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) in the management of prostate cancer (PCa) patients is increasingly recognised. However, its clinical role is still controversial. Many published studies showed that FDG PET/CT might have a prognostic value in the metastatic castration-resistant phase of the disease, but its role in other settings of PCa and, more importantly, its impact on final clinical management remains to be further investigated. We describe a series of six representative clinical cases of PCa in different clinical settings, but all characterised by a measurable clinical impact of FDG PET/CT on the patients’ management. Starting from their clinical history, we report a concise narrative literature review on the advantages and limitations of FDG PET/CT beyond its prognostic value in PCa. What emerges is that in selected cases, this imaging technique may represent a useful tool in managing PCa patients. However, in the absence of dedicated studies to define the optimal clinical setting of its application, no standard recommendations on its use in PCa patients can be made.
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Affiliation(s)
- Roberto Borea
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
| | - Diletta Favero
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
- Medical Oncology Unit 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Annalice Gandini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
| | - Malvina Cremante
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), 20054 Segrate, Italy
| | - Gianmario Sambuceti
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Sara Elena Rebuzzi
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
- Medical Oncology Unit, Ospedale San Paolo, 17100 Savona, Italy
| | - Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Correspondence:
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11
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Bauckneht M, Lai R, D'Amico F, Miceli A, Donegani MI, Campi C, Schenone D, Raffa S, Chiola S, Lanfranchi F, Rebuzzi SE, Zanardi E, Cremante M, Marini C, Fornarini G, Morbelli S, Piana M, Sambuceti G. Opportunistic skeletal muscle metrics as prognostic tools in metastatic castration-resistant prostate cancer patients candidates to receive Radium-223. Ann Nucl Med 2022; 36:373-383. [PMID: 35044592 PMCID: PMC8938339 DOI: 10.1007/s12149-022-01716-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/07/2022] [Indexed: 12/11/2022]
Abstract
Objective Androgen deprivation therapy alters body composition promoting a significant loss in skeletal muscle (SM) mass through inflammation and oxidative damage. We verified whether SM anthropometric composition and metabolism are associated with unfavourable overall survival (OS) in a retrospective cohort of metastatic castration-resistant prostate cancer (mCRPC) patients submitted to 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) imaging before receiving Radium-223. Patients and methods Low-dose CT were opportunistically analysed using a cross-sectional approach to calculate SM and adipose tissue areas at the third lumbar vertebra level. Moreover, a 3D computational method was used to extract psoas muscles to evaluate their volume, Hounsfield Units (HU) and FDG retention estimated by the standardized uptake value (SUV). Baseline established clinical, lab and imaging prognosticators were also recorded. Results SM area predicted OS at univariate analysis. However, this capability was not additive to the power of mean HU and maximum SUV of psoas muscles volume. These factors were thus combined in the Attenuation Metabolic Index (AMI) whose power was tested in a novel uni- and multivariable model. While Prostate-Specific Antigen (PSA), Alkaline Phosphatase (ALP), Lactate Dehydrogenase and Hemoglobin, Metabolic Tumor Volume, Total Lesion Glycolysis and AMI were associated with long-term OS at the univariate analyses, only PSA, ALP and AMI resulted in independent prognosticator at the multivariate analysis. Conclusion The present data suggest that assessing individual 'patients' SM metrics through an opportunistic operator-independent computational analysis of FDG PET/CT imaging provides prognostic insights in mCRPC patients candidates to receive Radium-223. Graphical abstract ![]()
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Affiliation(s)
- Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy. .,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - Rita Lai
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Francesca D'Amico
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | | | - Cristina Campi
- LISCOMP, Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Daniela Schenone
- LISCOMP, Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Silvia Chiola
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Sara Elena Rebuzzi
- Medical Oncology, Ospedale San Paolo, Savona, Italy.,Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Genoa, Italy
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Malvina Cremante
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Bioimaging and Physiology (IBFM), CNR Institute of Molecular, Segrate, Milan, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Michele Piana
- LISCOMP, Department of Mathematics (DIMA), University of Genoa, Genoa, Italy.,CNR-SPIN Genoa, Genoa, Italy
| | - Gianmario Sambuceti
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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12
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Bauckneht M, Bertagna F, Donegani MI, Durmo R, Miceli A, De Biasi V, Laudicella R, Fornarini G, Berruti A, Baldari S, Versari A, Giubbini R, Sambuceti G, Morbelli S, Albano D. The prognostic power of 18F-FDG PET/CT extends to estimating systemic treatment response duration in metastatic castration-resistant prostate cancer (mCRPC) patients. Prostate Cancer Prostatic Dis 2021; 24:1198-1207. [PMID: 34012060 PMCID: PMC8616756 DOI: 10.1038/s41391-021-00391-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/16/2021] [Accepted: 04/30/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND We aimed to test whether the prognostic value of 18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in metastatic castration-resistant prostate cancer (mCRPC) extends to the estimation of systemic treatment response duration. METHODS mCRPC patients submitted to FDG-PET/CT in four Italian centers from 2005 to 2020 were retrospectively enrolled. Clinical and biochemical data at the time of imaging were collected, and SUV max of the hottest lesion, total metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated. The correlation between PET- and biochemical-derived parameters with Overall Survival (OS) was analysed. The prediction of treatment response duration was assessed in the subgroup submitted to FDG-PET/CT in the six months preceding Chemotherapy (namely Docetaxel or Cabazitaxel, 24 patients) or Androgen-Receptor Targeted Agents (ARTA, namely Abiraterone or Enzalutamide, 20 patients) administration. RESULTS We enrolled 114 mCRPC patients followed-up for a median interval lasting 15 months. While at univariate analysis, prostate-specific antigen (PSA), Alkaline Phosphatase (ALP), MTV, and TLG were associated with OS, at the multivariate Cox regression analysis, the sole MTV could independently predict OS (p < 0.0001). In the subgroup submitted to FDG-PET/CT before the systemic treatment initiation, PSA and TLG could also predict treatment response duration independently (p < 0.05). Of note, while PSA could not indicate the best treatment choice, lower TLG was associated with higher success rates for ARTA but had no impact on chemotherapy efficacy. CONCLUSIONS FDG-PET/CT's prognostic value extends to predicting treatment response duration in mCRPC, thus potentially guiding the systemic treatment selection.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.
| | - Francesco Bertagna
- Nuclear Medicine, Spedali Civili of Brescia and University of Brescia, Brescia, Italy
| | - Maria Isabella Donegani
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Rexhep Durmo
- Nuclear Medicine, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Alberto Miceli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | | | - Riccardo Laudicella
- Nuclear Medicine, Department of Biomedical and Dental Sciences and of Morpho-functional Imaging, University of Messina, Messina, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alfredo Berruti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology Unit, Università degli Studi di Brescia, ASST Spedali Civili, Brescia, Italy
| | - Sergio Baldari
- Nuclear Medicine, Department of Biomedical and Dental Sciences and of Morpho-functional Imaging, University of Messina, Messina, Italy
| | - Annibale Versari
- Nuclear Medicine, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Raffaele Giubbini
- Nuclear Medicine, Spedali Civili of Brescia and University of Brescia, Brescia, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Domenico Albano
- Nuclear Medicine, Spedali Civili of Brescia and University of Brescia, Brescia, Italy
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13
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Oprea-Lager DE, Cysouw MC, Boellaard R, Deroose CM, de Geus-Oei LF, Lopci E, Bidaut L, Herrmann K, Fournier LS, Bäuerle T, deSouza NM, Lecouvet FE. Bone Metastases Are Measurable: The Role of Whole-Body MRI and Positron Emission Tomography. Front Oncol 2021; 11:772530. [PMID: 34869009 PMCID: PMC8640187 DOI: 10.3389/fonc.2021.772530] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/04/2021] [Indexed: 12/14/2022] Open
Abstract
Metastatic tumor deposits in bone marrow elicit differential bone responses that vary with the type of malignancy. This results in either sclerotic, lytic, or mixed bone lesions, which can change in morphology due to treatment effects and/or secondary bone remodeling. Hence, morphological imaging is regarded unsuitable for response assessment of bone metastases and in the current Response Evaluation Criteria In Solid Tumors 1.1 (RECIST1.1) guideline bone metastases are deemed unmeasurable. Nevertheless, the advent of functional and molecular imaging modalities such as whole-body magnetic resonance imaging (WB-MRI) and positron emission tomography (PET) has improved the ability for follow-up of bone metastases, regardless of their morphology. Both these modalities not only have improved sensitivity for visual detection of bone lesions, but also allow for objective measurements of bone lesion characteristics. WB-MRI provides a global assessment of skeletal metastases and for a one-step "all-organ" approach of metastatic disease. Novel MRI techniques include diffusion-weighted imaging (DWI) targeting highly cellular lesions, dynamic contrast-enhanced MRI (DCE-MRI) for quantitative assessment of bone lesion vascularization, and multiparametric MRI (mpMRI) combining anatomical and functional sequences. Recommendations for a homogenization of MRI image acquisitions and generalizable response criteria have been developed. For PET, many metabolic and molecular radiotracers are available, some targeting tumor characteristics not confined to cancer type (e.g. 18F-FDG) while other targeted radiotracers target specific molecular characteristics, such as prostate specific membrane antigen (PSMA) ligands for prostate cancer. Supporting data on quantitative PET analysis regarding repeatability, reproducibility, and harmonization of PET/CT system performance is available. Bone metastases detected on PET and MRI can be quantitatively assessed using validated methodologies, both on a whole-body and individual lesion basis. Both have the advantage of covering not only bone lesions but visceral and nodal lesions as well. Hybrid imaging, combining PET with MRI, may provide complementary parameters on the morphologic, functional, metabolic and molecular level of bone metastases in one examination. For clinical implementation of measuring bone metastases in response assessment using WB-MRI and PET, current RECIST1.1 guidelines need to be adapted. This review summarizes available data and insights into imaging of bone metastases using MRI and PET.
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Affiliation(s)
- Daniela E. Oprea-Lager
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Matthijs C.F. Cysouw
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Christophe M. Deroose
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
- Nuclear Medicine & Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, Netherlands
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS – Humanitas Research Hospital, Milan, Italy
| | - Luc Bidaut
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- College of Science, University of Lincoln, Lincoln, United Kingdom
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Laure S. Fournier
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale (INSERM), Radiology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Hopital europeen Georges Pompidou, Université de Paris, Paris, France
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
| | - Tobias Bäuerle
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Nandita M. deSouza
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Frederic E. Lecouvet
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Roy J, White ME, Basuli F, Opina ACL, Wong K, Riba M, Ton AT, Zhang X, Jansson KH, Edmondson E, Butcher D, Lin FI, Choyke PL, Kelly K, Jagoda EM. Monitoring PSMA Responses to ADT in Prostate Cancer Patient-Derived Xenograft Mouse Models Using [ 18F]DCFPyL PET Imaging. Mol Imaging Biol 2021; 23:745-755. [PMID: 33891265 PMCID: PMC9910584 DOI: 10.1007/s11307-021-01605-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE PSMA overexpression has been associated with aggressive prostate cancer (PCa). However, PSMA PET imaging has revealed highly variable changes in PSMA expression in response to ADT treatment ranging from increases to moderate decreases. To better understand these PSMA responses and potential relationship to progressive PCa, the PET imaging agent, [18F]DCFPyL, was used to assess changes in PSMA expression in response to ADT using genomically characterized LuCaP patient-derived xenograft mouse models (LuCaP-PDXs) which were found to be sensitive to ADT (LuCaP73 and LuCaP136;CS) or resistant (LuCaP167;CR). METHODS [18F]DCFPyL (2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) was used to assess PSMA in vitro (saturation assays) in LuCaP tumor membrane homogenates and in vivo (imaging/biodistribution) in LuCaP-PDXs. Control and ADT-treated LuCaPs were imaged before ADT (0 days) and 2-, 7-, 14-, and 21-days post-ADT from which tumor:muscle ratios (T:Ms) were determined and concurrently tumor volumes were measured (caliper). After the 21-day imaging, biodistributions and histologic/genomic (PSMA, AR) analysis were done. RESULTS [18F]DCFPyL exhibited high affinity for PSMA and distinguished different levels of PSMA in LuCaP tumors. Post-ADT CS LuCaP73 and LuCaP136 tumor volumes significantly decreased at day 7 or 14 respectively vs controls, whereas the CR LuCaP167 tumor volumes were minimally changed. [18F]DCFPyL imaging T:Ms were increased 3-5-fold in treated LuCaP73 tumors vs controls, while treated LuCaP136 T:Ms remained unchanged which was confirmed by day 21 biodistribution results. For treated LuCaP167, T:Ms were decreased (~ 45 %) vs controls but due to low T:M values (<2) may not be indicative of PSMA level changes. LuCaP73 tumor PSMA histologic/genomic results were comparable to imaging/biodistribution results, whereas the results for other tumor types varied. CONCLUSION Tumor responses to ADT varied from sensitive to resistant among these LuCaP PDXs, while only the high PSMA expressing LuCaP model exhibited an increase in PSMA levels in response to ADT. These models may be useful in understanding the clinical relevance of PSMA PET responses to ADT and potentially the relationship to disease progression as it may relate to the genomic signature.
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Affiliation(s)
- Jyoti Roy
- Molecular Imaging Program, NCI/NIH, Center for Cancer Research, National Cancer Institute, Building 10, Room B3B406, Bethesda, MD, 20892, USA
| | - Margaret E. White
- Laboratory of Genitourinary Cancer Pathogenesis NCI/NIH, Bethesda, MD, USA
| | - Falguni Basuli
- Chemistry and Synthesis Center, NHLBI/NIH, Rockville, MD, USA
| | | | - Karen Wong
- Molecular Imaging Program, NCI/NIH, Center for Cancer Research, National Cancer Institute, Building 10, Room B3B406, Bethesda, MD, 20892, USA
| | - Morgan Riba
- Laboratory of Genitourinary Cancer Pathogenesis NCI/NIH, Bethesda, MD, USA
| | - Anita T. Ton
- Molecular Imaging Program, NCI/NIH, Center for Cancer Research, National Cancer Institute, Building 10, Room B3B406, Bethesda, MD, 20892, USA
| | - Xiang Zhang
- Chemistry and Synthesis Center, NHLBI/NIH, Rockville, MD, USA
| | - Keith H. Jansson
- Laboratory of Genitourinary Cancer Pathogenesis NCI/NIH, Bethesda, MD, USA
| | - Elijah Edmondson
- Pathology/Histotechnology Laboratory, Leidos, Inc./Frederick National Laboratory for Cancer Research, NCI, Frederick, MD, USA
| | - Donna Butcher
- Pathology/Histotechnology Laboratory, Leidos, Inc./Frederick National Laboratory for Cancer Research, NCI, Frederick, MD, USA
| | - Frank I. Lin
- Molecular Imaging Program, NCI/NIH, Center for Cancer Research, National Cancer Institute, Building 10, Room B3B406, Bethesda, MD, 20892, USA
| | - Peter L. Choyke
- Molecular Imaging Program, NCI/NIH, Center for Cancer Research, National Cancer Institute, Building 10, Room B3B406, Bethesda, MD, 20892, USA
| | - Kathleen Kelly
- Laboratory of Genitourinary Cancer Pathogenesis NCI/NIH, Bethesda, MD, USA
| | - Elaine M. Jagoda
- Molecular Imaging Program, NCI/NIH, Center for Cancer Research, National Cancer Institute, Building 10, Room B3B406, Bethesda, MD, 20892, USA
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Cattrini C, España R, Mennitto A, Bersanelli M, Castro E, Olmos D, Lorente D, Gennari A. Optimal Sequencing and Predictive Biomarkers in Patients with Advanced Prostate Cancer. Cancers (Basel) 2021; 13:4522. [PMID: 34572748 PMCID: PMC8467385 DOI: 10.3390/cancers13184522] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 12/12/2022] Open
Abstract
The treatment landscape of advanced prostate cancer has completely changed during the last decades. Chemotherapy (docetaxel, cabazitaxel), androgen-receptor signaling inhibitors (ARSi) (abiraterone acetate, enzalutamide), and radium-223 have revolutionized the management of metastatic castration-resistant prostate cancer (mCRPC). Lutetium-177-PSMA-617 is also going to become another treatment option for these patients. In addition, docetaxel, abiraterone acetate, apalutamide, enzalutamide, and radiotherapy to primary tumor have demonstrated the ability to significantly prolong the survival of patients with metastatic hormone-sensitive prostate cancer (mHSPC). Finally, apalutamide, enzalutamide, and darolutamide have recently provided impactful data in patients with nonmetastatic castration-resistant disease (nmCRPC). However, which is the best treatment sequence for patients with advanced prostate cancer? This comprehensive review aims at discussing the available literature data to identify the optimal sequencing approaches in patients with prostate cancer at different disease stages. Our work also highlights the potential impact of predictive biomarkers in treatment sequencing and exploring the role of specific agents (i.e., olaparib, rucaparib, talazoparib, niraparib, and ipatasertib) in biomarker-selected populations of patients with prostate cancer (i.e., those harboring alterations in DNA damage and response genes or PTEN).
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Affiliation(s)
- Carlo Cattrini
- Medical Oncology, “Maggiore della Carità” University Hospital, 28100 Novara, Italy; (C.C.); (A.M.); (A.G.)
- Department of Translational Medicine (DIMET), University of Eastern Piedmont (UPO), 28100 Novara, Italy
- Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, 16132 Genoa, Italy
| | - Rodrigo España
- Urology Unit, Hospital Regional de Málaga, University of Malaga, 29910 Málaga, Spain;
| | - Alessia Mennitto
- Medical Oncology, “Maggiore della Carità” University Hospital, 28100 Novara, Italy; (C.C.); (A.M.); (A.G.)
- Department of Translational Medicine (DIMET), University of Eastern Piedmont (UPO), 28100 Novara, Italy
| | - Melissa Bersanelli
- Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy;
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Elena Castro
- Genitourinary Cancer Translational Research Group, Instituto de Investigación Biomédica de Málaga, 29010 Málaga, Spain;
- Medical Oncology, UGCI, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, 29010 Málaga, Spain
| | - David Olmos
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre, 28029 Madrid, Spain;
- Genitourinary Cancer Translational Research Group, The Institute of Biomedical Research in Málaga, 29010 Málaga, Spain
| | - David Lorente
- Medical Oncology, Hospital Provincial de Castellón, 12002 Castellón de la Plana, Spain
| | - Alessandra Gennari
- Medical Oncology, “Maggiore della Carità” University Hospital, 28100 Novara, Italy; (C.C.); (A.M.); (A.G.)
- Department of Translational Medicine (DIMET), University of Eastern Piedmont (UPO), 28100 Novara, Italy
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Bauckneht M, Rebuzzi SE, Signori A, Frantellizzi V, Murianni V, Lodi Rizzini E, Mascia M, Lavelli V, Donegani MI, Ponzano M, Gaudiano A, Stazza ML, Licari M, Cavallini L, Laghi V, Cindolo L, Maggi M, Sciarra A, Mammucci P, Sambuceti G, Costa RP, Spanu A, Rubini G, Monari F, De Vincentis G, Fornarini G. The prognostic power of inflammatory indices and clinical factors in metastatic castration-resistant prostate cancer patients treated with radium-223 (BIO-Ra study). Eur J Nucl Med Mol Imaging 2021; 49:1063-1074. [PMID: 34486070 PMCID: PMC8803683 DOI: 10.1007/s00259-021-05550-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/29/2021] [Indexed: 01/04/2023]
Abstract
Purpose To combine peripheral blood indices and clinical factors in a prognostic score for metastatic castration-resistant prostate cancer (mCRPC) patients treated with radium-223 dichloride ([223Ra]RaCl2). Patients and methods Baseline neutrophil-to-lymphocyte ratio (NLR), derived NLR (donor), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), Eastern Cooperative Oncology Group performance status (ECOG PS), Gleason score (GS) group, number of bone metastases, prostate-specific antigen (PSA), alkaline phosphatase (ALP), line of therapy, previous chemotherapy, and the presence of lymphadenopathies were collected from seven Italian centers between 2013 and 2020. Lab and clinical data were assessed in correlation with the overall survival (OS). Inflammatory indices were then included separately in the multivariable analyses with the prognostic clinical factors. The model with the highest discriminative ability (c-index) was chosen to develop the BIO-Ra score. Results Five hundred and nineteen mCRPC patients (median OS: 19.9 months) were enrolled. Higher NLR, dNLR, PLR, and SII and lower LMR predicted worse OS (all with a p < 0.001). The multivariable model including NLR, ECOG PS, number of bone metastases, ALP, and PSA (c-index: 0.724) was chosen to develop the BIO-Ra score. Using the Schneeweiss scoring system, the BIO-Ra score identified three prognostic groups (36%, 27.3%, and 36.6% patients, respectively) with distinct median OS (31, 26.6, and 9.6 months, respectively; hazard ratio: 1.62, p = 0.008 for group 2 vs. 1 and 5.77, p < 0.001 for group 3 vs. 1). Conclusions The BIO-Ra score represents an easy and widely applicable tool for the prognostic stratification of mCRPC patients treated with [223Ra]RaCl2 with no additional costs. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05550-6.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy. .,Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.
| | - Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties, University of Genova, Genova, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Viviana Frantellizzi
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy
| | - Veronica Murianni
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties, University of Genova, Genova, Italy
| | - Elisa Lodi Rizzini
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Manlio Mascia
- Unit of Nuclear Medicine, Spirito Santo Hospital, Pescara, Italy
| | - Valentina Lavelli
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Isabella Donegani
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Marta Ponzano
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Angela Gaudiano
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Lina Stazza
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Maria Licari
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Letizia Cavallini
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.,Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum Bologna University, Bologna, Italy
| | - Viola Laghi
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.,Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum Bologna University, Bologna, Italy
| | - Luca Cindolo
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy
| | - Martina Maggi
- Department of Urology, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Alessandro Sciarra
- Department of Urology, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Paolo Mammucci
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Renato Patrizio Costa
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Angela Spanu
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giuseppe Rubini
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Fabio Monari
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Giuseppe De Vincentis
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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van der Zande K, Oyen WJG, Zwart W, Bergman AM. Radium-223 Treatment of Patients with Metastatic Castration Resistant Prostate Cancer: Biomarkers for Stratification and Response Evaluation. Cancers (Basel) 2021; 13:cancers13174346. [PMID: 34503156 PMCID: PMC8431634 DOI: 10.3390/cancers13174346] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Radium-223 dichloride ([223Ra]RaCl2; Ra-223) is an alpha-emitting radiopharmaceutical treatment for patients with metastatic castration resistant prostate cancer (mCRPC) with predominantly bone metastases. While responses to chemotherapeutic and antihormonal mCRPC treatments can be assessed by serum PSA levels, a decrease of serum PSA levels is not expected during Ra-223 therapy. Moreover, radiographic evaluation of bone metastases response is challenging. Therefore, novel biomarkers to select patients for Ra-223 treatment and monitoring response are urgently needed. In this review, we discuss the currently used and exploratory biomarkers for this purpose, including soluble and cellular factors detected in the peripheral blood, genetic defects and radiographic assessments. We conclude that some biomarkers, including metabolic products of collagen degradation and novel PET scan techniques, might hold promise as predictors of response to Ra-223 treatment. However, these biomarkers have not been extensively studied. Consequently, currently, no biomarker has established a place in patient stratification and response evaluation. Abstract Radium-223 dichloride ([223Ra]RaCl2; Ra-223) is a targeted alpha-emitting radiopharmaceutical which results in an overall survival and health related quality of life (HRQoL) benefit in symptomatic patients with metastatic castration resistant prostate cancer (mCRPC) and predominantly bone metastasis. Although effective, options to select patients who will derive treatment benefit and to monitor and predict treatment outcomes are limited. PSA response and radiographic evaluation are commonly used in mCRPC treatment assessment but are not informative in Ra-223 treated patients. Consequently, there is a clear need for predictive and prognostic tools. In this review, we discuss the physiology of bone metastases and the mechanism of action and efficacy of Ra-223 treatment, as well as offering an outline of current innovative prognostic and predictive biomarkers.
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Affiliation(s)
- Kim van der Zande
- Department of Medical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;
- Division of Oncogenomics, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Wim J. G. Oyen
- Department of Nuclear Medicine, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands;
| | - Wilbert Zwart
- Division of Oncogenomics, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Oncode Institute, 3521 AL Utrecht, The Netherlands
- Correspondence: (W.Z.); (A.M.B.); Tel.: +31-2051-28156 (W.Z.); +31-2051-22569 (A.M.B.)
| | - Andries M. Bergman
- Department of Medical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;
- Division of Oncogenomics, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Correspondence: (W.Z.); (A.M.B.); Tel.: +31-2051-28156 (W.Z.); +31-2051-22569 (A.M.B.)
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Vorster M, Michael Sathekge M. Theranostics in Metastatic Castrate Resistant Prostate Cancer. In: Bott SR, Lim Ng K, editors. Prostate Cancer. Exon Publications; 2021. pp. 81-96. [DOI: 10.36255/exonpublications.prostatecancer.theranostics.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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Klain M, Gaudieri V, Petretta M, Zampella E, Storto G, Nappi C, Buonerba C, Crocetto F, Gallicchio R, Volpe F, Pace L, Schlumberger M, Cuocolo A. Combined bone scintigraphy and fluorocholine PET/computed tomography predicts response to radium-223 therapy in patients with prostate cancer. Future Sci OA 2021; 7:FSO719. [PMID: 34295537 PMCID: PMC8288237 DOI: 10.2144/fsoa-2021-0053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
Aim To assess the value of bone scintigraphy and 18F-fluorocholine PET/computed tomography (CT) in predicting outcome in patients with prostate cancer and bone metastases treated with 223radium. Materials & methods Retrospective analysis of 48 patients that underwent 223radium therapy. End points were pain relief and overall survival. Results After therapy, pain relief was observed in 27 patients. Patients without pain relief had more bone lesions at PET/CT than at bone scintigraphy (pretherapy imaging mismatch). In 39 patients who completed treatment protocol, post-therapy alkaline phosphatase and pretherapy imaging mismatch were independent predictors of poor overall survival. Conclusion Patients with more lesions at 18F-fluorocholine PET/CT than at bone scintigraphy had a poor prognosis. The combined imaging approach could be useful to predict outcome after 223radium therapy.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giovanni Storto
- Nuclear Medicine Unit, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Carlo Buonerba
- Department of Oncology & Hematology, Regional Reference Center for Rare Tumors, AOU Federico II of Naples, Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Human Reproduction & Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Rosj Gallicchio
- Nuclear Medicine Unit, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Leonardo Pace
- Department of Medicine, Surgery & Dentistry, University of Salerno, Salerno, Italy
| | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Filippi L, Frantellizzi V, Chiaravalloti A, Pontico M, De Feo MS, Corica F, Montebello M, Schillaci O, De Vincentis G, Bagni O. Prognostic and Theranostic Applications of Positron Emission Tomography for a Personalized Approach to Metastatic Castration-Resistant Prostate Cancer. Int J Mol Sci 2021; 22:3036. [PMID: 33809749 DOI: 10.3390/ijms22063036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 01/25/2023] Open
Abstract
Metastatic castration-resistant prostate cancer (mCRPC) represents a condition of progressive disease in spite of androgen deprivation therapy (ADT), with a broad spectrum of manifestations ranging from no symptoms to severe debilitation due to bone or visceral metastatization. The management of mCRPC has been profoundly modified by introducing novel therapeutic tools such as antiandrogen drugs (i.e., abiraterone acetate and enzalutamide), immunotherapy through sipuleucel-T, and targeted alpha therapy (TAT). This variety of approaches calls for unmet need of biomarkers suitable for patients’ pre-treatment selection and prognostic stratification. In this scenario, imaging with positron emission computed tomography (PET/CT) presents great and still unexplored potential to detect specific molecular and metabolic signatures, some of whom, such as the prostate specific membrane antigen (PSMA), can also be exploited as therapeutic targets, thus combining diagnosis and therapy in the so-called “theranostic” approach. In this review, we performed a web-based and desktop literature research to investigate the prognostic and theranostic potential of several PET imaging probes, such as 18F-FDG, 18F-choline and 68Ga-PSMA-11, also covering the emerging tracers still in a pre-clinical phase (e.g., PARP-inhibitors’ analogs and the radioligands binding to gastrin releasing peptide receptors/GRPR), highlighting their potential for defining personalized care pathways in mCRPC.
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21
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Bauckneht M, Morbelli S, Miceli A, Rebuzzi SE, Fornarini G. Neuroendocrine Differentiation of Prostate Cancer Is Not Systematically Associated with Increased 18F-FDG Uptake. Diagnostics (Basel) 2021; 11:diagnostics11030468. [PMID: 33800158 PMCID: PMC7998830 DOI: 10.3390/diagnostics11030468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/05/2021] [Accepted: 03/07/2021] [Indexed: 01/05/2023] Open
Abstract
Neuroendocrine differentiation (NED) of prostate cancer represents an acknowledged predictor of resistant and more aggressive disease. NED can be functionally exploited in vivo using PET/CT imaging with somatostatin analogs radiolabeled with 68Ga. Many previous reports have shown that 18F-FDG PET/CT should also be used in cases such as guiding management, as NED is systematically associated with increased glycolysis. We hereby discuss the case of a metastatic prostate cancer patient in which 68Ga-Dotatoc PET/CT revealed the occurrence of NED with low FDG-avidity.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy;
- Correspondence:
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy;
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy;
| | - Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (G.F.)
- Department of Internal Medicine and Medical Specialities (Di.M.I.), University of Genova, 16132 Genova, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (G.F.)
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22
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Abstract
2-[18F]-fluoro-2-deoxyglucose (FDG) is the most commonly used radiotracer and provides valuable information about glucose metabolism. With the advent of newer receptor-based tracers in the management of hormonally active malignancies, the focus has been shifted from FDG. These tracers might be more specific than FDG because they target specific hormone receptors. But because FDG is widely available, this review discusses what information still can be harnessed from this workhorse of molecular imaging. The personalized implementation of FDG imaging in undifferentiated malignancies will help in characterization of tumor and may aid in patient management.
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Affiliation(s)
- Divya Yadav
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Diagnostic Nuclear Medicine Division, Department of Nuclear Medicine, AIIMS, Ansari nagar, New Delhi 110029, India.
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23
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Filippi L, Chiaravalloti A, Basile P, Schillaci O, Bagni O. Molecular and metabolic imaging of castration-resistant prostate cancer: state of art and future prospects. Curr Mol Med 2021; 22:25-36. [PMID: 33573553 DOI: 10.2174/1566524021666210211112423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/23/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022]
Abstract
Prostate cancer (PCa) represents the most common tumor in male and one of the most relevant causes of death in Western countries. Androgen deprivation therapy (ADT) constitutes a widely used approach in advanced PCa. When PCa progresses in spite of ADT and castrate levels of testosterone, the severe clinical condition termed as metastatic castration-resistant prostate cancer (mCRPC) takes place. The only approach to mCRPC has been represented by chemotherapy with taxanes for many years. Nevertheless, recently introduced treatments such as 2nd generation antiandrogens (i.e. enzalutamide and abiraterone), cell immunotherapy with sipuleucel-T or targeted alpha therapy with 223Ra-dichloride, have dramatically changed mCRPC prognosis. These novel therapies call for an unmet need for imaging biomarkers suitable for patients' pre-treatment stratification and response assessment. In this scenario, nuclear medicine can provide several metabolic and molecular probes for investigating pathological processes at a cellular and sub-cellular level. The aim of this paper is to review the most relevant findings of the literature published to date on this topic, giving particular emphasis to the pros and cons of each tracer and also covering future prospects for defining personalized therapeutic approaches.
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Affiliation(s)
- Luca Filippi
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome. Italy
| | - Pietro Basile
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome. Italy
| | - Oreste Bagni
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
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24
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Bauckneht M, Rebuzzi SE, Signori A, Donegani MI, Murianni V, Miceli A, Borea R, Raffa S, Damassi A, Ponzano M, Catalano F, Martelli V, Marini C, Boccardo F, Morbelli S, Sambuceti G, Fornarini G. The Prognostic Role of Baseline Metabolic Tumor Burden and Systemic Inflammation Biomarkers in Metastatic Castration-Resistant Prostate Cancer Patients Treated with Radium-223: A Proof of Concept Study. Cancers (Basel) 2020; 12:cancers12113213. [PMID: 33142739 PMCID: PMC7693606 DOI: 10.3390/cancers12113213] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Abstract
Over the last years has emerged the urgent need for the identification of reliable prognostic biomarkers able to potentially identify metastatic castration-resistant prostate cancer (mCRPC) patients most likely to benefit from Radium-223 (Ra-223) since baseline. In the present monocentric retrospective study, we analyzed the prognostic power of systemic inflammation biomarkers and 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET)-derived parameters and their potential interplay in this clinical setting. The following baseline laboratory parameters were collected in 59 mCRPC patients treated with Ra-223: neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelets-to-lymphocyte ratio (PLR), and systemic inflammation index (SII), while maximum Standardized Uptake Value, Metabolic Tumor Volume (MTV), and Total Lesion Glycolysis (TLG) were calculated in the 48 of them submitted to baseline FDG-PET. At the univariate analysis, NLR, dNLR, MTV, and TLG were able to predict the overall survival (OS). However, only NLR and MTV were independent predictors of OS at the multivariate analysis. Additionally, the occurrence of both increased NLR and MTV at baseline identified mCRPC patients at higher risk for lower long-term survival after treatment with Ra-223. In conclusion, the degree of systemic inflammation, the quantification of the metabolically active tumor burden and their combination might represent potentially valuable tools for identifying mCRPC patients who are most likely to benefit from Ra-223. However, further studies are needed to reproduce these findings in larger settings.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- Correspondence:
| | - Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Veronica Murianni
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Roberto Borea
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Alessandra Damassi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Marta Ponzano
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Fabio Catalano
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Valentino Martelli
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), 20090 Segrate (MI), Italy
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, 16132 Genova, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
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25
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Evangelista L, Fanti S. What Is the Role of Imaging in Cancers? Cancers (Basel) 2020; 12:cancers12061494. [PMID: 32521685 PMCID: PMC7352968 DOI: 10.3390/cancers12061494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Laura Evangelista
- Nuclear Medicine Unit, Department of Medicine (DIMED), University of Padua, 35128 Padua, Italy
- Correspondence: ; Tel.: +39-0498211310; Fax: +39-0498213008
| | - Stefano Fanti
- Department of Nuclear Medicine, Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy;
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26
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Hartrampf PE, Heinrich M, Seitz AK, Brumberg J, Sokolakis I, Kalogirou C, Schirbel A, Kübler H, Buck AK, Lapa C, Krebs M. Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy-Do Different Software Solutions Deliver Comparable Results? J Clin Med 2020; 9:jcm9051390. [PMID: 32397223 PMCID: PMC7290891 DOI: 10.3390/jcm9051390] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Prostate-specific membrane antigen (PSMA)-derived tumour volume (PSMA-TV) and total lesion PSMA (TL-PSMA) from PSMA PET/CT scans are promising biomarkers for assessing treatment response in prostate cancer (PCa). Currently, it is unclear whether different software tools for assessing PSMA-TV and TL-PSMA produce comparable results. (2) Methods: 68Ga-PSMA PET/CT scans from n = 21 patients with castration-resistant PCa (CRPC) receiving chemotherapy were identified from our single-centre database. PSMA-TV and TL-PSMA were calculated with Syngo.via (Siemens) as well as the freely available Beth Israel plugin for FIJI (Fiji Is Just ImageJ) before and after chemotherapy. While statistical comparability was illustrated and quantified via Bland-Altman diagrams, the clinical agreement was estimated by matching PSMA-TV, TL-PSMA and relative changes of both variables during chemotherapy with changes in serum PSA (ΔPSA) and PERCIST (Positron Emission Response Criteria in Solid Tumors). (3) Results: Comparing absolute PSMA-TV and TL-PSMA as well as Bland-Altman plotting revealed a good statistical comparability of both software algorithms. For clinical agreement, classifying therapy response did not differ between PSMA-TV and TL-PSMA for both software solutions and showed highly positive correlations with BR. (4) Conclusions: due to the high levels of statistical and clinical agreement in our CRPC patient cohort undergoing taxane chemotherapy, comparing PSMA-TV and TL-PSMA determined by Syngo.via and FIJI appears feasible.
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Affiliation(s)
- Philipp E. Hartrampf
- Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany; (M.H.); (J.B.); (A.S.); (A.K.B.); (C.L.)
- Correspondence:
| | - Marieke Heinrich
- Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany; (M.H.); (J.B.); (A.S.); (A.K.B.); (C.L.)
| | - Anna Katharina Seitz
- Department of Urology and Paediatric Urology, University Hospital Würzburg, 97080 Würzburg, Germany; (A.K.S.); (C.K.); (H.K.); (M.K.)
| | - Joachim Brumberg
- Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany; (M.H.); (J.B.); (A.S.); (A.K.B.); (C.L.)
| | - Ioannis Sokolakis
- Department of Urology, Martha-Maria Hospital Nuremberg, 90491 Nuremberg, Germany;
| | - Charis Kalogirou
- Department of Urology and Paediatric Urology, University Hospital Würzburg, 97080 Würzburg, Germany; (A.K.S.); (C.K.); (H.K.); (M.K.)
| | - Andreas Schirbel
- Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany; (M.H.); (J.B.); (A.S.); (A.K.B.); (C.L.)
| | - Hubert Kübler
- Department of Urology and Paediatric Urology, University Hospital Würzburg, 97080 Würzburg, Germany; (A.K.S.); (C.K.); (H.K.); (M.K.)
| | - Andreas K. Buck
- Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany; (M.H.); (J.B.); (A.S.); (A.K.B.); (C.L.)
| | - Constantin Lapa
- Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany; (M.H.); (J.B.); (A.S.); (A.K.B.); (C.L.)
- Nuclear Medicine, Medical Faculty, University of Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Markus Krebs
- Department of Urology and Paediatric Urology, University Hospital Würzburg, 97080 Würzburg, Germany; (A.K.S.); (C.K.); (H.K.); (M.K.)
- Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, 97080 Würzburg, Germany
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