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Fazekas T, Széles ÁD, Teutsch B, Csizmarik A, Vékony B, Váradi A, Kói T, Lang Z, Ács N, Kopa Z, Hegyi P, Hadaschik B, Grünwald V, Nyirády P, Szarvas T. Therapeutic sensitivity to standard treatments in BRCA positive metastatic castration-resistant prostate cancer patients-a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2023; 26:665-672. [PMID: 36509931 PMCID: PMC10638083 DOI: 10.1038/s41391-022-00626-2] [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: 09/06/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Recent oncology guidelines recommend BRCA1/2 testing for a wide range of prostate cancer (PCa) patients. In addition, PARP inhibitors are available for mutation-positive metastatic castration-resistant PCa (mCRPC) patients following prior treatment with abiraterone, enzalutamide or docetaxel. However, the question of which of these standard treatments is the most effective for BRCA1/2 positive mCRPC patients remains to be answered. The aim of this meta-analysis was to assess the efficacy of abiraterone, enzalutamide and docetaxel in BRCA1/2 mutation-positive mCRPC patients in terms of PSA-response (PSA50), progression-free survival (PFS) and overall survival (OS). METHODS As no interventional trials are available on this topic, we performed the data synthesis of BRCA1/2 positive mCRPC patients by using both proportional and individual patient data. For PSA50 evaluation, we pooled event rates with 95% confidence intervals (CI), while for time-to-event (PFS, OS) analyses we used individual patient data with random effect Cox regression calculations. RESULTS Our meta-analysis included 16 eligible studies with 348 BRCA1/2 positive mCRPC patients. In the first treatment line, response rates for abiraterone, enzalutamide and docetaxel were 52% (CI: 25-79%), 64% (CI: 43-80%) and 55% (CI: 36-73%), respectively. Analyses of individual patient data revealed a PFS (HR: 0.47, CI: 0.26-0.83, p = 0.010) but no OS (HR: 1.41, CI: 0.82-2.42, p = 0.210) benefit for enzalutamide compared to abiraterone-treated patients. CONCLUSIONS Our PSA50 analyses revealed that all the three first-line treatments have therapeutic effect in BRCA1/2 positive mCRPC; although, based on the results of PSA50 and PFS analyses, BRCA positive mCRPC patients might better respond to enzalutamide treatment. However, molecular marker-driven interventional studies directly comparing these agents are crucial for providing higher-level evidence.
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Affiliation(s)
- Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Ádám D Széles
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Bálint Vékony
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Alex Váradi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Zsolt Lang
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Nándor Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Zsolt Kopa
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Viktor Grünwald
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
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Fazekas T, Széles ÁD, Teutsch B, Csizmarik A, Vékony B, Kói T, Ács N, Hegyi P, Hadaschik B, Nyirády P, Szarvas T. Poly (ADP-ribose) Polymerase Inhibitors Have Comparable Efficacy with Platinum Chemotherapy in Patients with BRCA-positive Metastatic Castration-resistant Prostate Cancer. A Systematic Review and Meta-analysis. Eur Urol Oncol 2023:S2588-9311(23)00174-8. [PMID: 37722977 DOI: 10.1016/j.euo.2023.09.001] [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: 04/24/2023] [Revised: 07/17/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
CONTEXT Testing for mutations in Breast Cancer Gene 1/2 (BRCA) has emerged as a novel decision-making tool for clinicians. Patients with metastatic castration-resistant prostate cancer (mCRPC) harboring pathogenic BRCA mutations can benefit from poly (ADP-ribose) polymerase inhibitor (PARPi) and platinum treatments, whereas the impact of the mutation on sensitivity to cabazitaxel and prostate-specific membrane antigen (PSMA)-ligand therapy is currently unknown. OBJECTIVE To assess the efficacy of PARPi, platinum, cabazitaxel, and PSMA-ligand therapies in BRCA-positive mCRPC. EVIDENCE ACQUISITION Databases were queried in February 2022. We performed data synthesis by using both proportional and individual patient data. For prostate-specific antigen (PSA) response rate (≥50% decrease from baseline [PSA50]) evaluation, we pooled event rates with 95% confidence intervals (CIs). Progression-free (PFS) and overall (OS) survival analyses with individual patient data were performed with the mixed-effect Cox proportional hazard model and single-arm random-effect analysis, providing pooled medians. EVIDENCE SYNTHESIS We included 23 eligible studies with 901 BRCA-positive mCRPC patients. PSA50 response rates for PARPi and platinum were 69% (CI: 53-82%), and 74% (CI: 49-90%), respectively. Analyses of OS data showed no difference between PARPi and platinum treatments (hazard ratio: 0.86; CI: 0.49-1.52; p = 0.6). The single-arm OS and PFS analyses revealed similarities among different PARPis; pooled PFS and OS medians were 9.7 mo (CI: 8.1-12.5) and 17.4 mo (CI: 12.7-20.1), respectively. CONCLUSIONS Our data revealed that different PARPis were similarly effective in terms of PFS and OS. Moreover, we found that PARPi and platinum therapy were comparable in terms of PSA50 response rate and OS, highlighting that platinum is a valid treatment option for BRCA-positive mCRPC patients. However, prospective interventional studies comparing these agents are essential to provide a higher level of evidence. PATIENT SUMMARY In this report, we found that different poly (ADP-ribose) polymerase inhibitors had similar efficacy, and platinum was a valid treatment option in BRCA-positive metastatic castration-resistant prostate cancer patients.
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Affiliation(s)
- Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Ádám D Széles
- Department of Urology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Bálint Vékony
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Nándor Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
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Csizmarik A, Nagy N, Keresztes D, Váradi M, Bracht T, Sitek B, Witzke K, Puhr M, Tornyi I, Lázár J, Takács L, Kramer G, Sevcenco S, Maj-Hes A, Hadaschik B, Nyirády P, Szarvas T. Comparative proteome and serum analysis identified FSCN1 as a marker of abiraterone resistance in castration-resistant prostate cancer. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00713-y. [PMID: 37634036 DOI: 10.1038/s41391-023-00713-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 07/14/2023] [Accepted: 08/03/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Abiraterone (Abi) is an androgen receptor signaling inhibitor that significantly improves patients' life expectancy in metastatic prostate cancer (PCa). Despite its beneficial effects, many patients have baseline or acquired resistance against Abi. The aim of this study was to identify predictive serum biomarkers for Abi treatment. METHODS We performed a comparative proteome analysis on three Abi sensitive (LNCaPabl, LAPC4, DuCaP) and resistant (LNCaPabl-Abi, LAPC4-Abi, DuCaP-Abi) PCa cell lines using liquid chromatography tandem mass spectrometry (LC-MS/MS) technique. Two bioinformatic selection workflows were applied to select the most promising candidate serum markers. Serum levels of selected proteins were assessed in samples of 100 Abi-treated patients with metastatic castration-resistant disease (mCRPC) using ELISA. Moreover, FSCN1 serum concentrations were measured in samples of 69 Docetaxel (Doc) treated mCRPC patients. RESULTS Our proteome analysis identified 68 significantly, at least two-fold upregulated proteins in Abi resistant cells. Using two filtering workflows four proteins (AMACR, KLK2, FSCN1 and CTAG1A) were selected for ELISA analyses. We found high baseline FSCN1 serum levels to be significantly associated with poor survival in Abi-treated mCRPC patients. Moreover, the multivariable analysis revealed that higher ECOG status (>1) and high baseline FSCN1 serum levels (>10.22 ng/ml by ROC cut-off) were independently associated with worse survival in Abi-treated patients (p < 0.001 and p = 0.021, respectively). In contrast, no association was found between serum FSCN1 concentrations and overall survival in Doc-treated patients. CONCLUSIONS Our analysis identified baseline FSCN1 serum levels to be independently associated with poor survival of Abi-treated, but not Doc-treated mCRPC patients, suggesting a therapy specific prognostic value for FSCN1.
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Affiliation(s)
- Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Dávid Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary
- Department of Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Melinda Váradi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Thilo Bracht
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
- Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
- Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Barbara Sitek
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
- Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
- Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Kathrin Witzke
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
- Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Martin Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ilona Tornyi
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary
| | - József Lázár
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary
| | - László Takács
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary
- Biosystems International Kft, Debrecen, Hungary
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Sabina Sevcenco
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Agnieszka Maj-Hes
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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4
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Dér B, Fazekas T, Csizmarik A, Soós Á, Fekete B, Nyirády P, Szarvas T. [Current therapeutic and familial implications of the genetic background of prostate cancer]. Magy Onkol 2023; 67:154-160. [PMID: 37314077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/03/2023] [Indexed: 06/15/2023]
Abstract
Genetic testing for prostate cancer (PC) is becoming more widely used in the clinical routine, primarily due to the introduction of PARP inhibitors targeting genetically affected patients in their BRCA1/2 and other homologous recombination repair (HRR) genes. Simultaneously, the number of available therapies that are specifically targeting genetically defined PC subgroups is steadily increasing. As a result, the selection of treatment for PC patients is likely to require testing of multiple genes to enable more specific treatment sequences that consider the genetic characteristics of the tumor. Some of the mutations discovered by genetic testing may be hereditary, necessitating the use of germline testing from normal tissue, which is only permitted within the framework of clinical counseling. This change in PC care requires the collaboration by multiple specialists, including experts in molecular pathology, bioinformatics, biology, and genetic counseling. In this review, we aim to provide an overview on the currently relevant genetic alterations in PC for therapeutic purposes and their implications for familial testing.
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Affiliation(s)
- Bálint Dér
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Tamás Fazekas
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Anita Csizmarik
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Áron Soós
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Bálint Fekete
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Péter Nyirády
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
| | - Tibor Szarvas
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem ÁOK, Budapest, Hungary.
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Kubik A, das Virgens IPA, Szabó A, Váradi M, Csizmarik A, Keszthelyi A, Majoros A, Fehérvári P, Hegyi P, Ács N, Nyirády P, Szarvas T. Comprehensive Analysis of the Prognostic Value of Circulating MMP-7 Levels in Urothelial Carcinoma: A Combined Cohort Analysis, Systematic Review, and Meta-Analysis. Int J Mol Sci 2023; 24:ijms24097859. [PMID: 37175566 PMCID: PMC10178327 DOI: 10.3390/ijms24097859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/29/2023] [Accepted: 04/08/2023] [Indexed: 05/15/2023] Open
Abstract
Lymph node (LN) status is the most significant prognostic factor for invasive urothelial bladder cancer (UBC); however, the optimal extent of LN dissection (LND) is debated. We assessed circulating matrix metalloproteinase-7 (MMP-7) as a prognostic factor and decision-making marker for the extent of LND. Preoperative serum MMP-7 levels were determined in two independent UBC cohorts (n = 188; n = 68) and in one control cohort (n = 97) by using the ELISA method. A systematic review and meta-analysis on the prognostic role of circulating pretreatment MMP-7 levels were performed. Serum MMP-7 levels were higher in patients compared to controls (p < 0.001) with the highest levels in LN-positive cases. Half of LN-positive UBC patients had low MMP-7 levels, whereas the survival of LN-negative patients with high serum MMP-7 findings was poor. MMP-7 levels were independently associated with poor survival in both cohorts (p = 0.006, p < 0.001). Accordingly, our systematic review of six eligible publications revealed a 2.5-fold higher mortality risk in patients with high MMP-7 levels. In conclusion, preoperative MMP-7 level is a validated and independent prognostic factor in urothelial cancer. It cannot be used to decide between regional or extended LND but may be useful in identifying LN-negative high-risk patients with potentially undetected metastases.
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Affiliation(s)
- András Kubik
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
| | | | - Anett Szabó
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
| | - Melinda Váradi
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Attila Keszthelyi
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Attila Majoros
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Péter Fehérvári
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Péter Hegyi
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, 1083 Budapest, Hungary
| | - Nándor Ács
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK), 45147 Essen, Germany
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6
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Váradi M, Horváth O, Fazekas T, Csizmarik A, Módos O, Széles Á, Kenessey I, Reis H, Oláh C, Hadaschik B, Krafft U, Ting S, Furka A, Nyirády P, Szarvas T. Molecular analysis of urothelial carcinoma to predict the efficacy of immune checkpoint inhibitor therapy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01202-2] [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] [Indexed: 02/12/2023]
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Varadi M, Nagy N, Reis H, Hadaschik B, Niedworok C, Modos O, Szendroi A, Ablat J, Black PC, Keresztes D, Csizmarik A, Olah C, Gaisa NT, Kiss A, Timar J, Toth E, Csernak E, Gerstner A, Mittal V, Karkampouna S, Kruithof de Julio M, Gyorffy B, Bedics G, Rink M, Fisch M, Nyirady P, Szarvas T. Clinical sequencing identifies potential actionable alterations in a high rate of urachal and primary bladder adenocarcinomas. Cancer Med 2023; 12:9041-9054. [PMID: 36670542 PMCID: PMC10134276 DOI: 10.1002/cam4.5639] [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: 09/20/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Administration of targeted therapies provides a promising treatment strategy for urachal adenocarcinoma (UrC) or primary bladder adenocarcinoma (PBAC); however, the selection of appropriate drugs remains difficult. Here, we aimed to establish a routine compatible methodological pipeline for the identification of the most important therapeutic targets and potentially effective drugs for UrC and PBAC. METHODS Next-generation sequencing, using a 161 cancer driver gene panel, was performed on 41 UrC and 13 PBAC samples. Clinically relevant alterations were filtered, and therapeutic interpretation was performed by in silico evaluation of drug-gene interactions. RESULTS After data processing, 45/54 samples passed the quality control. Sequencing analysis revealed 191 pathogenic mutations in 68 genes. The most frequent gain-of-function mutations in UrC were found in KRAS (33%), and MYC (15%), while in PBAC KRAS (25%), MYC (25%), FLT3 (17%) and TERT (17%) were recurrently affected. The most frequently affected pathways were the cell cycle regulation, and the DNA damage control pathway. Actionable mutations with at least one available approved drug were identified in 31/33 (94%) UrC and 8/12 (67%) PBAC patients. CONCLUSIONS In this study, we developed a data-processing pipeline for the detection and therapeutic interpretation of genetic alterations in two rare cancers. Our analyses revealed actionable mutations in a high rate of cases, suggesting that this approach is a potentially feasible strategy for both UrC and PBAC treatments.
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Affiliation(s)
- Melinda Varadi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Henning Reis
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany.,Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Christian Niedworok
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Orsolya Modos
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Attila Szendroi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Jason Ablat
- Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - Peter C Black
- Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - David Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Csilla Olah
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Nadine T Gaisa
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Andras Kiss
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Jozsef Timar
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Erika Toth
- National Institute of Oncology, Budapest, Hungary
| | | | | | - Vinay Mittal
- Thermo Fisher Scientific, Ann Arbor, Michigan, USA
| | - Sofia Karkampouna
- Department for BioMedical Research, Urology Research Laboratory, University of Bern, Bern, Switzerland
| | - Marianna Kruithof de Julio
- Department for BioMedical Research, Urology Research Laboratory, University of Bern, Bern, Switzerland.,Department of Urology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Balazs Gyorffy
- Research Centre for Natural Sciences, Cancer Biomarker Research Group, Institute of Enzymology, Budapest, Hungary.,2nd Department of Pediatrics and Department of Bioinformatics, Semmelweis University, Budapest, Hungary
| | - Gabor Bedics
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
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8
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Csizmarik A, Keresztes D, Nagy N, Bracht T, Sitek B, Witzke K, Puhr M, Tornyi I, Lázár J, Takács L, Kramer G, Sevcenco S, Maj-Hes A, Jurányi Z, Hadaschik B, Nyirády P, Szarvas T. Proteome profiling of enzalutamide-resistant cell lines and serum analysis identified ALCAM as marker of resistance in castration-resistant prostate cancer. Int J Cancer 2022; 151:1405-1419. [PMID: 35689436 PMCID: PMC9539937 DOI: 10.1002/ijc.34159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 12/05/2022]
Abstract
Enzalutamide (ENZA) is a frequently used therapy in metastatic castration‐resistant prostate cancer (mCRPC). Baseline or acquired resistance to ENZA have been observed, but the molecular mechanisms of resistance are poorly understood. We aimed to identify proteins involved in ENZA resistance and to find therapy‐predictive serum markers. We performed comparative proteome analyses on ENZA‐sensitive parental (LAPC4, DuCaP) and ‐resistant prostate cancer cell lines (LAPC4‐ENZA, DuCaP‐ENZA) using liquid chromatography tandem mass spectrometry (LC‐MS/MS). The top four most promising candidate markers were selected using bioinformatic approaches. Serum concentrations of selected markers (ALCAM, AGR2, NDRG1, IDH1) were measured in pretreatment samples of 72 ENZA‐treated mCRPC patients using ELISA. In addition, ALCAM serum levels were measured in 101 Abiraterone (ABI) and 100 Docetaxel (DOC)‐treated mCRPC patients' baseline samples. Results were correlated with clinical and follow‐up data. The functional role of ALCAM in ENZA resistance was assessed in vitro using siRNA. Our proteome analyses revealed 731 significantly differentially abundant proteins between ENZA‐sensitive and ‐resistant cells and our filtering methods identified four biomarker candidates. Serum analyses of these proteins revealed only ALCAM to be associated with poor patient survival. Furthermore, higher baseline ALCAM levels were associated with poor survival in ABI‐ but not in DOC‐treated patients. In LAPC4‐ENZA resistant cells, ALCAM silencing by siRNA knockdown resulted in significantly enhanced ENZA sensitivity. Our analyses revealed that ALCAM serum levels may help to identify ENZA‐ and ABI‐resistant patients and may thereby help to optimize future clinical decision‐making. Our functional analyses suggest the possible involvement of ALCAM in ENZA resistance.
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Affiliation(s)
- Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Dávid Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Thilo Bracht
- Medizinisches Proteom Center, Ruhr University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Barbara Sitek
- Medizinisches Proteom Center, Ruhr University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Kathrin Witzke
- Medizinisches Proteom Center, Ruhr University Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Martin Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ilona Tornyi
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary
| | | | - László Takács
- Department of Human Genetics, University of Debrecen, Debrecen, Hungary.,Biosystems International Kft, Debrecen, Hungary
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Sabina Sevcenco
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Agnieszka Maj-Hes
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Zsolt Jurányi
- Department of Radiobiology and Diagnostic Onco-Cytogenetics, Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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9
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Kovács PT, Mayer T, Csizmarik A, Váradi M, Oláh C, Széles Á, Tschirdewahn S, Krafft U, Hadaschik B, Nyirády P, Riesz P, Szarvas T. Elevated Pre-Treatment Serum MMP-7 Levels Are Associated with the Presence of Metastasis and Poor Survival in Upper Tract Urothelial Carcinoma. Biomedicines 2022; 10:biomedicines10030698. [PMID: 35327500 PMCID: PMC8945654 DOI: 10.3390/biomedicines10030698] [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: 02/12/2022] [Revised: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 12/10/2022] Open
Abstract
Upper tract urothelial carcinoma (UTUC) is a rare cancer with a barely predictable clinical behaviour. Serum MMP-7 is a validated prognostic marker in urothelial bladder cancer, a tumour entity with large clinical, histological, and molecular similarity to UTUC. The serum MMP-7 levels have not yet been investigated in UTUC. In the present study, we determined MMP-7 concentrations in an overall number of 103 serum samples from 57 UTUC patients who underwent surgical or systemic (platinum or immune checkpoint inhibitor) therapy by using the ELISA method. In addition to pre-treatment samples, the serum samples collected at predefined time points after or during therapy were also investigated. Serum MMP-7 concentrations were correlated with clinicopathological and follow-up data. Our results revealed significantly, two-fold elevated pre-treatment serum MMP-7 levels in metastatic cases of UTUC in both the radical surgery- and the chemotherapy-treated cohorts (p = 0.045 and p = 0.040, respectively). In addition, high serum MMP-7 levels significantly decreased after radical surgery, and high pre-treatment MMP-7 concentrations were associated with shorter survival both in the surgery- and chemotherapy-treated cohorts (p = 0.029 and p = 0.001, respectively). Our results revealed pre-treatment serum MMP-7 as a prognostic marker for UTUC, which may help to improve preoperative risk-stratification and thereby improve therapeutic decision-making.
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Affiliation(s)
- Petra Terézia Kovács
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Tamás Mayer
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Melinda Váradi
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Csilla Oláh
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
| | - Ádám Széles
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Stephan Tschirdewahn
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
| | - Ulrich Krafft
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
| | - Péter Nyirády
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Péter Riesz
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (P.T.K.); (T.M.); (A.C.); (M.V.); (Á.S.); (P.N.); (P.R.)
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, D-45147 Essen, Germany; (C.O.); (S.T.); (U.K.); (B.H.)
- Correspondence:
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10
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Keresztes D, Csizmarik A, Nagy N, Módos O, Fazekas T, Bracht T, Sitek B, Witzke K, Puhr M, Sevcenco S, Kramer G, Shariat S, Küronya Z, Takács L, Tornyi I, Lázár J, Hadaschik B, Lászik A, Szűcs M, Nyirády P, Szarvas T. Comparative proteome analysis identified CD44 as a possible serum marker for docetaxel resistance in castration-resistant prostate cancer. J Cell Mol Med 2021; 26:1332-1337. [PMID: 34970839 PMCID: PMC8831956 DOI: 10.1111/jcmm.17141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
Baseline or acquired resistance to docetaxel (DOC) represents a significant risk for patients with metastatic prostate cancer (PC). In the last years, novel therapy regimens have been approved providing reasonable alternatives for DOC‐resistant patients making prediction of DOC resistance of great clinical importance. We aimed to identify serum biomarkers, which are able to select patients who will not benefit from DOC treatment. DOC‐resistant PC3‐DR and DU145‐DR sublines and their sensitive parental cell lines (DU145, PC3) were comparatively analyzed using liquid chromatography‐coupled tandem mass spectrometry (LC‐MS/MS). Results were filtered using bioinformatics approaches to identify promising serum biomarkers. Serum levels of five proteins were determined in serum samples of 66 DOC‐treated metastatic castration‐resistant PC patients (mCRPC) using ELISA. Results were correlated with clinicopathological and survival data. CD44 was subjected to further functional cell culture analyses. We found at least 177 two‐fold significantly overexpressed proteins in DOC‐resistant cell lines. Our bioinformatics method suggested 11/177 proteins to be secreted into the serum. We determined serum levels of five (CD44, MET, GSN, IL13RA2 and LNPEP) proteins in serum samples of DOC‐treated patients and found high CD44 serum levels to be independently associated with poor overall survival (p = 0.001). In accordance, silencing of CD44 in DU145‐DR cells resulted in re‐sensitization to DOC. In conclusion, high serum CD44 levels may help identify DOC‐resistant patients and may thereby help optimize clinical decision‐making regarding type and timing of therapy for mCRPC patients. In addition, our in vitro results imply the possible functional involvement of CD44 in DOC resistance.
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Affiliation(s)
- Dávid Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Thilo Bracht
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Barbara Sitek
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Kathrin Witzke
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Martin Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Shahrokh Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Zsófia Küronya
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - László Takács
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Biosystems International Kft., Debrecen, Hungary
| | - Ilona Tornyi
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - József Lázár
- Biosystems International Kft., Debrecen, Hungary
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - András Lászik
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Miklós Szűcs
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, University of Duisburg-Essen, Essen, Germany
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11
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Nagy ND, Fazekas T, Baghy K, Papp G, Csizmarik A, Szűcs M, Nyirády P, Szarvas T. Efficacy of carboplatin chemotherapy in a metastatic, castration-resistant BRCA2 mutation positive prostate cancer patient. Orv Hetil 2021; 162:1004-1008. [PMID: 34148027 DOI: 10.1556/650.2021.32112] [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: 11/17/2020] [Accepted: 12/12/2020] [Indexed: 11/19/2022]
Abstract
Összefoglaló. A sérült BRCA1/2 gént hordozó prosztatadaganatok klinikai szempontból elkülönülő, agresszív altípust képviselnek. Ugyanakkor a BRCA1/2 gén sérülése a DNS-támadáspontú kemoterápiákkal szemben érzékennyé teszi a daganatot, ami terápiás szempontból kihasználható. A platinaalapú kemoterápia hatékonysága prosztatarákban klinikai vizsgálatokkal nincs alátámasztva, ezért annak alkalmazására igen ritkán kerül sor. Közleményünkben egy előrehaladott stádiumú, agresszív prosztata adenocarcinomával diagnosztizált beteg esetét mutatjuk be, akinél a BRCA2-gén patogén mutációját találtuk, és akinél az előzőleg alkalmazott androgénmegvonásos, valamint docetaxelkezelések sikertelensége miatt karboplatinkezelést alkalmaztunk - ez a beteg állapotának, valamint radiológiai és biokémiai paramétereinek látványos javulásához vezetett. Ez az eset rámutat a DNS-hiba-javító mechanizmusban szerepet játszó gének terápiás szempontból történő felhasználásának potenciális előnyeire prosztatarákban. Orv Hetil. 2021; 162(25): 1004-1008. Summary. BRCA1/2 deficient prostate cancers represent a clinically distinct aggressive subtype. However, the presence of BRCA1/2 alterations enhance the sensitivity to platinum-based chemotherapies. The efficacy of platinum-based chemotherapies in prostate cancer has not been proven in prospective clinical studies and therefore these treatments are rarely used in prostate adenocarcinomas. Here we present a case of BRCA2 mutant prostate cancer, which was diagnosed at a metastatic stage and showed no or only little response to androgen deprivation and docetaxel therapies. Therefore, we started carboplatin chemotherapy which resulted in an exceptional response regarding biochemical, radiographic parameters accompanied by significant improvement of patients' physical condition. This case underlines the potential therapeutic benefits of testing for genes involved in the DNA repair mechanism. Orv Hetil. 2021; 162(25): 1004-1008.
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Affiliation(s)
- Noémi Dalma Nagy
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Tamás Fazekas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Kornélia Baghy
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Patológiai és Kísérleti Rákkutató Intézet, Budapest
| | - Gergő Papp
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Patológiai és Kísérleti Rákkutató Intézet, Budapest
| | - Anita Csizmarik
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Miklós Szűcs
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Péter Nyirády
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Tibor Szarvas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082.,3 Essen-Duisburgi Egyetem, Urológiai Klinika, Essen, Németország
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12
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Krafft U, Olah C, Reis H, Kesch C, Darr C, Grünwald V, Tschirdewahn S, Hadaschik B, Horvath O, Kenessey I, Nyirady P, Varadi M, Modos O, Csizmarik A, Szarvas T. High Serum PD-L1 Levels Are Associated with Poor Survival in Urothelial Cancer Patients Treated with Chemotherapy and Immune Checkpoint Inhibitor Therapy. Cancers (Basel) 2021; 13:cancers13112548. [PMID: 34067347 PMCID: PMC8196869 DOI: 10.3390/cancers13112548] [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: 03/19/2021] [Revised: 05/15/2021] [Accepted: 05/20/2021] [Indexed: 01/08/2023] Open
Abstract
Serum PD-L1 (sPD-L1) levels are associated with prognosis in various tumors but has not yet been investigated in advanced bladder cancer. We assessed pretreatment serum samples from 83 BC patients who received platinum chemotherapy and from 12 patients who underwent immune checkpoint inhibitor (ICI) therapy. In addition, on-treatment samples from further therapy cycles were collected during chemotherapy (n = 58) and ICI therapy (n = 11). Serum PD-L1 levels were determined using ELISA. High baseline sPD-L1 levels were associated with worse ECOG status (p = 0.007) and shorter overall survival for both chemotherapy- and ICI-treated patients (p = 0.002 and p = 0.040, respectively). Multivariate analysis revealed high baseline sPD-L1 level as an independent predictor of poor survival for platinum-treated patients (p = 0.002). A correlation analysis between serum concentrations of PD-L1 and matrix metalloprotease-7 (MMP-7)-a protease which was recently found to cleave PD-L1-revealed a positive correlation (p = 0.001). No significant sPD-L1 changes were detected during chemotherapy, while in contrast we found a strong, 25-fold increase in sPD-L1 levels during atezolizumab treatment. In conclusion, our work demonstrates that pretreatment sPD-L1 levels are associated with a poor prognosis of BC patients undergoing platinum and ICI therapy. Future research should prospectively address the value of sPD-L1 in predicting treatment response.
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Affiliation(s)
- Ulrich Krafft
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Csilla Olah
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Henning Reis
- Institute of Pathology, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Claudia Kesch
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Christopher Darr
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Viktor Grünwald
- Clinic for Urology and Clinic for Medical Oncology, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
| | - Stephan Tschirdewahn
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Boris Hadaschik
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
| | - Orsolya Horvath
- Department of Genitourinary Medical Oncology and Pharmacology, National Institute of Oncology, 1122 Budapest, Hungary;
| | - Istvan Kenessey
- 2nd Department of Pathology, Semmelweis University, 1122 Budapest, Hungary;
- National Cancer Registry and Centre for Biostatistics, National Institute of Oncology, 1122 Budapest, Hungary
| | - Peter Nyirady
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
| | - Melinda Varadi
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
| | - Orsolya Modos
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
| | - Tibor Szarvas
- West German Cancer Center, Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (U.K.); (C.O.); (C.K.); (C.D.); (S.T.); (B.H.)
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (M.V.); (O.M.); (A.C.)
- Correspondence: ; Tel.: +49-201-723-4547
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13
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Szarvas T, Hoffmann MJ, Olah C, Szekely E, Kiss A, Hess J, Tschirdewahn S, Hadaschik B, Grotheer V, Nyirady P, Csizmarik A, Varadi M, Reis H. MMP-7 Serum and Tissue Levels Are Associated with Poor Survival in Platinum-Treated Bladder Cancer Patients. Diagnostics (Basel) 2020; 11:diagnostics11010048. [PMID: 33396213 PMCID: PMC7824149 DOI: 10.3390/diagnostics11010048] [Citation(s) in RCA: 4] [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: 11/17/2020] [Revised: 12/19/2020] [Accepted: 12/26/2020] [Indexed: 01/09/2023] Open
Abstract
Chemotherapy resistance is a main cause of therapeutic failure and death in bladder cancer. With the approval of immune checkpoint inhibitors, prediction of platinum treatment became of great clinical importance. Matrix metalloproteinase-7 (MMP-7) was shown to be involved in cisplatin resistance. Therefore, tissue and circulating MMP-7 levels were evaluated in 124 bladder cancer patients who received postoperative platinum-based chemotherapy. Tissue MMP-7 levels were analyzed by immunohistochemistry in 72 formalin-fixed, paraffin-embedded chemo-naïve tumor samples, while MMP-7 serum concentrations were determined in 132 serum samples of an independent cohort of 52 patients. MMP-7 tissue and serum levels were correlated with clinicopathological and follow-up data. MMP-7 gene expression was determined by RT-qPCR in 20 urothelial cancer cell lines and two non-malignant urothelial cell lines. MMP-7 was overexpressed in RT-112 and T-24 cells by stable transfection, to assess its functional involvement in platinum sensitivity. High MMP-7 tissue expression and pretreatment serum concentrations were independently associated with poor overall survival (tissue HR = 2.296, 95%CI = 1.235–4.268 and p = 0.009; serum HR = 2.743, 95%CI = 1.258–5.984 and p = 0.011). Therefore, MMP-7 tissue and serum analysis may help to optimize therapeutic decisions. Stable overexpression in RT-112 and T-24 cells did not affect platinum sensitivity.
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Affiliation(s)
- Tibor Szarvas
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (A.C.); (M.V.)
- Correspondence: ; Tel.: +49-201-7238-4967
| | - Michèle J. Hoffmann
- Department of Urology, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany;
| | - Csilla Olah
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
| | - Eszter Szekely
- 2nd Department of Pathology, Semmelweis University, 1091 Budapest, Hungary; (E.S.); (A.K.)
| | - Andras Kiss
- 2nd Department of Pathology, Semmelweis University, 1091 Budapest, Hungary; (E.S.); (A.K.)
| | - Jochen Hess
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
| | - Stephan Tschirdewahn
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, 45147 Essen, Germany; (C.O.); (J.H.); (S.T.); (B.H.)
| | - Vera Grotheer
- Department of Orthopedics and Trauma Surgery, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany;
| | - Peter Nyirady
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (A.C.); (M.V.)
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (A.C.); (M.V.)
| | - Melinda Varadi
- Department of Urology, Semmelweis University, 1089 Budapest, Hungary; (P.N.); (A.C.); (M.V.)
| | - Henning Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
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Szarvas T, Csizmarik A, Váradi M, Fazekas T, Hüttl A, Nyirády P, Hadaschik B, Grünwald V, Tschirdewahn S, Shariat SF, Sevcenco S, Maj-Hes A, Kramer G. The prognostic value of serum MMP-7 levels in prostate cancer patients who received docetaxel, abiraterone, or enzalutamide therapy. Urol Oncol 2020; 39:296.e11-296.e19. [PMID: 33046366 DOI: 10.1016/j.urolonc.2020.09.005] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/06/2020] [Accepted: 09/12/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The rapidly changing treatment landscape in metastatic castration-resistant prostate cancer (mCRPC) calls for biomarkers to guide treatment decisions. We recently identified MMP-7 as a potential serum marker for the prediction of response and survival in mCRPC patients who received docetaxel (DOC) chemotherapy. Here, we aimed to test this finding in an independent patient cohort and in addition to explore the prognostic potential of serum MMP-7 in abiraterone (ABI) or enzalutamide (ENZA) treated patients. METHODS AND MATERIALS MMP-7 levels were measured in 836 serum samples from 320 mCRPC patients collected before and during DOC (n = 95), ABI (n = 140), or ENZA (n = 85) treatment by using the ELISA method. Results were correlated with clinical and follow-up data. RESULTS MMP-7 baseline levels were similar between the 3 treatment groups. In the ABI and ENZA cohorts, baseline MMP-7 levels were lower in patients with prior radical prostatectomy (P = 0.058 and P = 0.041, respectively). Baseline MMP-7 levels above the median were associated with shorter overall survival for the DOC (P = 0.001) and ENZA (P = 0.006) cohorts. Multivariable analyses in the DOC and ENZA cohorts revealed that high pretreatment MMP-7 level is an independent risk factor for patients' survival. In addition, in DOC-treated patients with high baseline MMP-7 level, marker decrease at the third DOC cycle was associated with improved survival. Patients with high baseline MMP-7 levels had better survival when treated with ABI compared to DOC or ENZA. CONCLUSIONS We confirmed the prognostic value of pretreatment MMP-7 serum level and its changes as independent predictors of survival in DOC-treated mCRPC patients. In addition, high MMP-7 was a negative predictor in ENZA-treated but not in ABI-treated patients. These results warrant further research to confirm the predictive value of serum MMP-7 and to explore the potential mechanistic involvement of MMP-7 in DOC and ENZA resistance of mCRPC patients.
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Affiliation(s)
- T Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - A Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - M Váradi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - T Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - A Hüttl
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - P Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - B Hadaschik
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - V Grünwald
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S Tschirdewahn
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S F Shariat
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - S Sevcenco
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - A Maj-Hes
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - G Kramer
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
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Nagy N, Reis H, Hadaschik B, Niedworok C, Módos O, Szendrői A, Bíró K, Hager T, Herold T, Ablat J, Black PC, Okon K, Tolkach Y, Csizmarik A, Oláh C, Keresztes D, Bremmer F, Gaisa NT, Kriegsmann J, Kovalszky I, Kiss A, Tímár J, Szász MA, Rink M, Fisch M, Nyirády P, Szarvas T. Prevalence of APC and PTEN Alterations in Urachal Cancer. Pathol Oncol Res 2020; 26:2773-2781. [PMID: 32754865 PMCID: PMC7471184 DOI: 10.1007/s12253-020-00872-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023]
Abstract
Urachal carcinoma (UrC) is a rare tumor with remarkable histological and molecular similarities to colorectal cancer (CRC). Adenomatous polyposis coli (APC) is the most frequently affected gene in CRC, but the prevalence and significance of its alterations in UrC is poorly understood. In addition, loss of phosphatase and tensin homologue (PTEN) was shown to be associated with therapy resistance in CRC. Our primary aim was to assess specific genetic alterations including APC and PTEN in a large series of UrC samples in order to identify clinically significant genomic alterations. We analyzed a total of 40 UrC cases. Targeted 5-gene (APC, PTEN, DICER1, PRKAR1A, TSHR, WRN) panel sequencing was performed on the Illumina MiSeq platform (n = 34). In addition, ß-catenin (n = 38) and PTEN (n = 30) expressions were assessed by immunohistochemistry. APC and PTEN genes were affected in 15% (5/34) and 6% (2/34) of cases. Two of five APC alterations (p.Y1075*, p.K1199*) were truncating pathogenic mutations. One of the two PTEN variants was a pathogenic frameshift insertion (p.C211fs). In 29% (11/38) of samples, at least some weak nuclear ß-catenin immunostaining was detected and PTEN loss was observed in 20% (6/30) of samples. The low prevalence of APC mutations in UrC represents a characteristic difference to CRC. Based on APC and ß-catenin results, the Wnt pathway seems to be rarely affected in UrC. Considering the formerly described involvement of PTEN protein loss in anti-EGFR therapy-resistance its immunohistochemical testing may have therapeutic relevance.
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Affiliation(s)
- Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Henning Reis
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Christian Niedworok
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Attila Szendrői
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | | | - Thomas Hager
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Thomas Herold
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany
| | - Jason Ablat
- Vancouver Prostate Centre, University of British Columbia, Vancouver, V6H 3Z6, Canada
| | - Peter C Black
- Vancouver Prostate Centre, University of British Columbia, Vancouver, V6H 3Z6, Canada
| | - Krzysztof Okon
- Department of Pathomorphology, Jagiellonian University, 30252, Cracow, Poland
| | - Yuri Tolkach
- Institute of Pathology, University of Bonn, 53113, Bonn, Germany
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Csilla Oláh
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - David Keresztes
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Felix Bremmer
- Institute of Pathology, University of Göttingen, 37073, Göttingen, Germany
| | - Nadine T Gaisa
- Institute of Pathology, RWTH Aachen University, 52074, Aachen, Germany
| | - Joerg Kriegsmann
- Cytology and Molecular Diagnostics Trier, Center for Histology, 54296, Trier, Germany
| | - Ilona Kovalszky
- 1st Institute of Pathology and Expreimental Cancer Research, Semmelweis University, Budapest, 1085, Hungary
| | - András Kiss
- 2nd Department of Pathology, Semmelweis University, Budapest, 1091, Hungary
| | - József Tímár
- 2nd Department of Pathology, Semmelweis University, Budapest, 1091, Hungary
| | - Marcell A Szász
- Cancer Center, Semmelweis University, Budapest, 1083, Hungary
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, 1082, Hungary.
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, 45147, Essen, Germany.
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Fazekas T, Szarvas T, Csizmarik A, Hadaschik B, Nyirády P. Correction to: COVID-19 research: promising tracks leading to uro-oncology. Int Urol Nephrol 2020; 53:95. [PMID: 32816158 PMCID: PMC7439631 DOI: 10.1007/s11255-020-02613-9] [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] [Indexed: 11/03/2022]
Affiliation(s)
- Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary.
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17
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Szarvas T, Csizmarik A, Fazekas T, Hüttl A, Nyirády P, Hadaschik B, Grünwald V, Püllen L, Jurányi Z, Kocsis Z, Shariat SF, Sevcenco S, Maj-Hes A, Kramer G. Comprehensive analysis of serum chromogranin A and neuron-specific enolase levels in localized and castration-resistant prostate cancer. BJU Int 2020; 127:44-55. [PMID: 32314509 DOI: 10.1111/bju.15086] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 12/09/2022]
Abstract
OBJECTIVES To assess chromogranin A (CGA) and neuron-specific enolase (NSE) levels and changes in these at different stages of prostatic adenocarcinoma (PCA). METHODS Overall, 1095 serum samples from 395 patients, divided into three treatment groups, were analysed; the radical prostatectomy (RP) cohort (n = 157) included patients with clinically localized PCA, while the docetaxel (DOC) and the abiraterone (ABI)/enzalutamide (ENZA) cohorts included 95 and 143 patients, respectively, with metastatic castration-resistant prostate cancer. CGA, NSE and total PSA levels were measured using the KRYPTOR method. RESULTS Baseline CGA and NSE levels were higher in castration-resistant (DOC and ABI/ENZA cohorts) than in hormone-naïve, clinically localized PCA (P < 0.001). High baseline CGA levels were independently associated with poor overall survival in both the DOC and the ABI/ENZA cohorts, with a stronger association in the ABI/ENZA cohort. In the ABI/ENZA cohort, a > 50% CGA increase at 3 months was associated with poor survival, especially in patients with high baseline CGA levels. CONCLUSIONS The two- to threefold higher neuroendocrine marker levels in castration-resistant compared to hormone-naïve PCA support the presence of neuroendocrine transdifferentiation under androgen deprivation therapy. Our results showed patients with high baseline CGA levels who experienced a further CGA increase during ABI and ENZA treatment had the poorest prognosis. Serum CGA levels could help in tailoring and monitoring therapy in advanced PCA.
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Affiliation(s)
- Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - András Hüttl
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Boris Hadaschik
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Viktor Grünwald
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Lukas Püllen
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Zsolt Jurányi
- Department of Radiobiology and Diagnostic Onco-Cytogenetics, Centre of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Zsuzsa Kocsis
- Department of Radiobiology and Diagnostic Onco-Cytogenetics, Centre of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | | | - Sabina Sevcenco
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Agnieszka Maj-Hes
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
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18
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Szarvas T, Csizmarik A, Nagy N, Keresztes D, Váradi M, Küronya Z, Riesz P, Nyirády P. Az áttétes kasztrációrezisztens prosztatarák gyógyszer-rezisztenciájának molekuláris vonatkozásai. Orv Hetil 2020; 161:813-820. [DOI: 10.1556/650.2020.31734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Absztrakt:
A metasztatikus kasztrációrezisztens prosztatarák kezelésére az elmúlt években
számos új, különböző hatásmechanizmusú gyógyszeres kezelés vált elérhetővé. Ez a
fejlődés a terápiás döntéshozatalt egyre nehezebbé teszi. Az újabb kezelésekkel
szemben is megfigyelhető az alapvonali, a szerzett és a keresztrezisztencia
jelensége is. Ezért tehát az elsődleges terápia helyes megválasztása mellett, az
azt követő vonalakban alkalmazott kezelések sorrendje és alkalmazásuk ideje is
optimalizálásra szorul. Az újabb kezelésekkel kapcsolatos
rezisztenciamechanizmusok egyre nagyobb mértékben válnak ismertté. Ezzel a
terápiatervezés az eddigi empirikus – főleg a kipróbálásra építő – irányából
egyre inkább a racionális – az adott daganat molekuláris sajátságait is
figyelembe vevő –, személyre szabott kezelés irányába mozdul el. Ebben az
összefoglaló közleményben ismertetjük azokat a rezisztenciamechanizmusokat,
amelyek a metasztatikus kasztrációrezisztens prosztatarák kezelésében
leggyakrabban használt három gyógyszerrel – docetaxel, abirateron és enzalutamid
– kapcsolatosak. Többek között áttekintést nyújtunk a MDR- (multidrogrezisztens)
fehérjéken keresztül megvalósuló, az androgénreceptor-, a Wnt-, a p53-szignálút,
valamint a DNS hibajavító mechanizmusában részt vevő gének (mint például a
BRCA és ATM) sérüléseivel összefüggésben
kialakuló és a neuroendokrin differenciáció által kiváltott
rezisztenciamechanizmusokról. Orv Hetil. 2020; 161(20): 813–820.
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Affiliation(s)
- Tibor Szarvas
- 1 Általános Orvostudományi Kar, Urológiai Klinika, Semmelweis Egyetem Budapest, Üllői út 78/B, 1082
- 2 Urológiai Klinika, Duisburg-Esseni Egyetem Essen
| | - Anita Csizmarik
- 1 Általános Orvostudományi Kar, Urológiai Klinika, Semmelweis Egyetem Budapest, Üllői út 78/B, 1082
| | - Nikolett Nagy
- 1 Általános Orvostudományi Kar, Urológiai Klinika, Semmelweis Egyetem Budapest, Üllői út 78/B, 1082
| | - Dávid Keresztes
- 1 Általános Orvostudományi Kar, Urológiai Klinika, Semmelweis Egyetem Budapest, Üllői út 78/B, 1082
| | - Melinda Váradi
- 1 Általános Orvostudományi Kar, Urológiai Klinika, Semmelweis Egyetem Budapest, Üllői út 78/B, 1082
| | - Zsófia Küronya
- 3 Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet Budapest
| | - Péter Riesz
- 1 Általános Orvostudományi Kar, Urológiai Klinika, Semmelweis Egyetem Budapest, Üllői út 78/B, 1082
| | - Péter Nyirády
- 1 Általános Orvostudományi Kar, Urológiai Klinika, Semmelweis Egyetem Budapest, Üllői út 78/B, 1082
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Szarvas T, Jardin-Watelet B, Bourgoin N, Hoffmann MJ, Nyirády P, Oláh C, Széll T, Csizmarik A, Hadaschik B, Reis H. High-soluble CGA levels are associated with poor survival in bladder cancer. Endocr Connect 2019; 8:625-633. [PMID: 30999279 PMCID: PMC6510714 DOI: 10.1530/ec-19-0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/17/2019] [Indexed: 11/26/2022]
Abstract
Recently, a neuroendocrine-like molecular subtype has been discovered in muscle-invasive urothelial bladder cancer (BC). Chromogranin A (CGA) is a widely used tissue and serum marker in neuroendocrine tumors. Our aim was to evaluate serum CGA (sCGA) concentrations and their associations with clinical and follow-up data in BC and renal cell carcinoma (RCC). sCGA concentrations were analyzed in the following cohorts: (1) BC training set (n = 188), (2) BC validation set (n = 125), (3) RCC patients (n = 77), (4) healthy controls (n = 97). CGA immunohistochemistry and RT-qPCR analyses were performed in 20 selected FFPE and 29 frozen BC tissue samples. Acquired data were correlated with clinicopathological parameters including comorbidities with known effect on sCGA as well as with patients' follow-up data. sCGA levels were significantly higher in BC but not in RCC patients compared to healthy controls. High sCGA levels were independently associated with poor overall and disease-specific survival both in the BC training (P < 0.001, P = 0.002) and validation set (P = 0.009, P = 0.017). sCGA levels were inversely correlated with glomerulus filtrating rate (GFR) and linearly correlated with creatinine clearance and urea concentrations. These correlations were not related to the prognostic value of sCGA. Tissue CGA levels were low to absent independently of sCGA concentrations. Our results demonstrate elevated levels and an independent prognostic value for sCGA in BC but not in RCC. Despite the significant correlation between sCGA and GFR, the prognostic relevance of sCGA seems not related to impaired renal function or other comorbidities.
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Affiliation(s)
- T Szarvas
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Urology, Semmelweis University, Budapest, Hungary
- Correspondence should be addressed to T Szarvas:
| | - B Jardin-Watelet
- Thermo Fisher Scientific Cezanne SAS, Clinical Diagnostics Division, Nimes, France
| | - N Bourgoin
- Thermo Fisher Scientific Cezanne SAS, Clinical Diagnostics Division, Nimes, France
| | - M J Hoffmann
- Department of Urology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - P Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - C Oláh
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - T Széll
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - A Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - B Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - H Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Abstract
Abstract: In the last few years, the emergence of new high throughput molecular technologies allowed a never-before-seen insight into the genetic, epigenetic, transcriptomic and proteomic background of cancers. These studies have been performed in a large number of patients’ samples and provided a great amount of data. Current efforts to translate these new findings into therapeutic strategies are ongoing, but already provided significant information which may change clinical practice in the near future. As a result of this development, the most frequent molecular alterations and affected pathways responsible for the formation and progression of prostate cancer have been identified. In this review, we provide an overview on the current progress in primary and metastatic prostate cancer research focusing on the molecular subtype classification and the most frequently dysregulated pathways, such as androgen signaling, PI3K pathway, cell cycle and DNA repair regulation. In this context, we highlight therapies already approved or are currently under clinical investigation for prostate cancer. Orv Hetil. 2019; 160(7): 252–263.
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Affiliation(s)
- Tibor Szarvas
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Anita Csizmarik
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Miklós Szűcs
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Péter Nyirády
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
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21
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Darr C, Krafft U, Hadaschik B, Tschirdewahn S, Sevcenco S, Csizmarik A, Nyirady P, Küronya Z, Reis H, Maj-Hes A, Shariat SF, Kramer G, Szarvas T. The Role of YKL-40 in Predicting Resistance to Docetaxel Chemotherapy in Prostate Cancer. Urol Int 2018; 101:65-73. [PMID: 29949801 DOI: 10.1159/000489891] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/07/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION High baseline YKL-40 serum levels are associated with drug resistance in several solid tumours. However, their role in predicting docetaxel (DOC) resistance in prostate cancer (PCa) is unknown. METHODS Pre-treatment serum levels of YKL-40 and prostate-specific antigen (PSA) were analyzed in 109 castration-resistant prostate cancer patients who underwent DOC-therapy. Responsive patients were retreated by repeated series of DOC. Results were compared with the clinical parameters as well as overall (OS) and disease-specific survival (DSS). RESULTS YKL-40 but not PSA serum levels were significantly higher in patients with baseline resistance to DOC (p = 0.035). Higher YKL-40 and PSA levels were detected in patients with bone metastasis (p = 0.032; p = 0.010) and in those who were not pre-treated with radical prostatectomy (p = 0.011, p = 0.008). High YKL-40 levels were associated with shorter OS (p = 0.037) and DSS (p = 0.017) in patients who received DOC in the first-line setting. In multivariable analysis, ECOG performance status (p = 0.009), presence of any metastases (p = 0.016) and high PSA levels (p = 0.005) remained independent predictors for DSS. CONCLUSIONS YKL-40 may help to identify patients with baseline resistance to DOC and therefore may help to optimize treatment decisions. In accordance, high pre-treatment YKL-40 serum levels were associated with shorter OS and DSS in patients who received DOC as first-line therapy.
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Affiliation(s)
- Christopher Darr
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Ulrich Krafft
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Stephan Tschirdewahn
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | | | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Budapest, Hungary
| | | | - Henning Reis
- Institute of Pathology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Agnieszka Maj-Hes
- Department of Urology, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Gero Kramer
- Department of Urology, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Tibor Szarvas
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany.,Department of Urology, Semmelweis University, Budapest, Hungary
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Szarvas T, Sevcenco S, Módos O, Keresztes D, Nyirády P, Csizmarik A, Ristl R, Puhr M, Hoffmann MJ, Niedworok C, Hadaschik B, Maj-Hes A, Shariat SF, Kramer G. Matrix metalloproteinase 7, soluble Fas and Fas ligand serum levels for predicting docetaxel resistance and survival in castration-resistant prostate cancer. BJU Int 2018; 122:695-704. [PMID: 29802777 DOI: 10.1111/bju.14415] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To assess the predictive value of pre-chemotherapy matrix metalloproteinase 7 (MMP-7), soluble Fas (sFas) and Fas ligand (FasL) serum levels, as well as their changes during therapy. PATIENTS AND METHODS Serum levels of MMP-7, Fas and FasL were determined by ELISA in 96 patients with castration-resistant prostate cancer (CRPC): 21 docetaxel-resistant patients who received one single series and 75 docetaxel-sensitive patients who received repeated series of docetaxel. In addition to the 96 pretreatment serum samples, 987 sera collected during chemotherapy were also analysed. RESULTS Higher pretreatment serum MMP-7, sFas and prostate-specific antigen (PSA) levels were significantly associated with both docetaxel resistance (P = 0.007, P = 0.001, P < 0.001, respectively) and shorter cancer-specific survival (P < 0.001, P = 0.041, P < 0.001, respectively). High MMP-7 level remained an independent predictor of both docetaxel resistance (hazard ratio [HR] 2.298, 95% confidence interval [CI]: 1.354-3.899; P = 0.002) and poor cancer-specific survival (HR 2.11, 95% CI: 1.36-3.30; P = 0.001) in multivariable analyses. Greater increase in MMP-7 levels in the second treatment holiday and greater increase in PSA levels in the first and second treatment holidays were predictive of survival. CONCLUSIONS Pretreatment serum MMP-7 levels may help to select patients with CRPC who are likely to benefit from docetaxel chemotherapy. Furthermore, MMP-7 levels alone or in combination with PSA levels could be used for therapy monitoring. Correlative studies embedded in clinical trials are necessary to validate these biomarkers for clinical decision-making.
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Affiliation(s)
- Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, Vienna General Hospital, Medical University Vienna, Vienna, Austria.,Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Sabina Sevcenco
- Department of Urology, Vienna General Hospital, Medical University Vienna, Vienna, Austria
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Dávid Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Robin Ristl
- Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Martin Puhr
- Experimental Urology, Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michèle J Hoffmann
- Department of Urology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Christian Niedworok
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Agnieszka Maj-Hes
- Department of Urology, Vienna General Hospital, Medical University Vienna, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Vienna General Hospital, Medical University Vienna, Vienna, Austria
| | - Gero Kramer
- Department of Urology, Vienna General Hospital, Medical University Vienna, Vienna, Austria
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