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Mahon KL, Sutherland SI, Lin HM, Stockler MR, Gurney H, Mallesara G, Briscoe K, Marx G, Higano CS, de Bono JS, Chi KN, Clark G, Breit SN, Brown DA, Horvath LG. Clinical validation of circulating GDF15/MIC-1 as a marker of response to docetaxel and survival in men with metastatic castration-resistant prostate cancer. Prostate 2024; 84:747-755. [PMID: 38544345 DOI: 10.1002/pros.24691] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Elevated circulating growth differentiation factor (GDF15/MIC-1), interleukin 4 (IL4), and IL6 levels were associated with resistance to docetaxel in an exploratory cohort of men with metastatic castration-resistant prostate cancer (mCRPC). This study aimed to establish level 2 evidence of cytokine biomarker utility in mCRPC. METHODS IntVal: Plasma samples at baseline (BL) and Day 21 docetaxel (n = 120). ExtVal: Serum samples at BL and Day 42 of docetaxel (n = 430). IL4, IL6, and GDF15 levels were measured by ELISA. Monocytes and dendritic cells were treated with 10% plasma from men with high or low GDF15 or recombinant GDF15. RESULTS IntVal: Higher GDF15 levels at BL and Day 21 were associated with shorter overall survival (OS) (BL; p = 0.03 and Day 21; p = 0.004). IL4 and IL6 were not associated with outcomes. ExtVal: Higher GDF15 levels at BL and Day 42 predicted shorter OS (BL; p < 0.0001 and Day 42; p < 0.0001). Plasma from men with high GDF15 caused an increase in CD86 expression on monocytes (p = 0.03), but was not replicated by recombinant GDF15. CONCLUSIONS Elevated circulating GDF15 is associated with poor prognosis in men with mCRPC receiving docetaxel and may be a marker of changes in the innate immune system in response to docetaxel resistance. These findings provide a strong rationale to consider GDF15 as a biomarker to guide a therapeutic trial of drugs targeting the innate immune system in combination with docetaxel in mCRPC.
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Affiliation(s)
- Kate L Mahon
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Prostate Cancer Research Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Im Sutherland
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Prostate Cancer Research Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Cancer Research Group, The ANZAC Research Institute, Sydney, New South Wales, Australia
| | - Hui Ming Lin
- Prostate Cancer Research Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- School of Clinical Medicine, University of NSW, Sydney, New South Wales, Australia
| | - Martin R Stockler
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Westmead Hospital, Sydney, New South Wales, Australia
| | - Howard Gurney
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Calvary Mater, Newcastle, New South Wales, Australia
| | - Girish Mallesara
- Medical Oncology Department, Mid North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia
| | - Karen Briscoe
- Northern Haematology Oncology Group, Sydney, New South Wales, Australia
| | - Gavin Marx
- BC Cancer Agency, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Johann S de Bono
- St Vincent's Centre for Applied Medical Research, Sydney, New South Wales, Australia
| | - Kim N Chi
- Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - Georgina Clark
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Cancer Research Group, The ANZAC Research Institute, Sydney, New South Wales, Australia
| | - Samuel N Breit
- School of Clinical Medicine, University of NSW, Sydney, New South Wales, Australia
- Concord Hospital, Sydney, New South Wales, Australia
| | - David A Brown
- School of Clinical Medicine, University of NSW, Sydney, New South Wales, Australia
- Concord Hospital, Sydney, New South Wales, Australia
| | - Lisa G Horvath
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Prostate Cancer Research Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- School of Clinical Medicine, University of NSW, Sydney, New South Wales, Australia
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Yeung N, Li T, Lin HM, Timmins HC, Goldstein D, Harrison M, Friedlander M, Mahon KL, Giles C, Meikle PJ, Park SB, Horvath LG. Plasma Lipidomic Profiling Identifies Elevated Triglycerides as Potential Risk Factor in Chemotherapy-Induced Peripheral Neuropathy. JCO Precis Oncol 2024; 8:e2300690. [PMID: 38691814 DOI: 10.1200/po.23.00690] [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: 12/13/2023] [Revised: 02/11/2024] [Accepted: 03/07/2024] [Indexed: 05/03/2024] Open
Abstract
PURPOSE Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side effect of cytotoxic cancer treatment, often necessitating dose reduction (DR) or chemotherapy discontinuation (CD). Studies on peripheral neuropathy related to chemotherapy, obesity, and diabetes have implicated lipid metabolism. This study examined the association between circulating lipids and CIPN. METHODS Lipidomic analysis was performed on plasma samples from 137 patients receiving taxane-based treatment. CIPN was graded using Total Neuropathy Score-clinical version (TNSc) and patient-reported outcome measure European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN (EORTC-QLQ-CIPN20). RESULTS A significant proportion of elevated baseline lipids were associated with high-grade CIPN defined by TNSc and EORTC-QLQ-CIPN20 including triacylglycerols (TGs). Multivariable Cox regression on lipid species, adjusting for BMI, age, and diabetes, showed several elevated baseline TG associated with shorter time to DR/CD. Latent class analysis identified two baseline lipid profiles with differences in risk of CIPN (hazard ratio, 2.80 [95% CI, 1.50 to 5.23]; P = .0013). The higher risk lipid profile had several elevated TG species and was independently associated with DR/CD when modeled with other clinical factors (diabetes, age, BMI, or prior numbness/tingling). CONCLUSION Elevated baseline plasma TG is associated with an increased risk of CIPN development and warrants further validation in other cohorts. Ultimately, this may enable therapeutic intervention.
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Affiliation(s)
- Nicole Yeung
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Tiffany Li
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
- The University of Sydney, Camperdown, NSW, Australia
| | - Hui-Ming Lin
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW, Australia
| | - Hannah C Timmins
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
- The University of Sydney, Camperdown, NSW, Australia
| | - David Goldstein
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | | | - Michael Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Kate L Mahon
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- The University of Sydney, Camperdown, NSW, Australia
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Corey Giles
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiovascular Research, Translation and Implementation, La Trobe University, Bundoora, VIC, Australia
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiovascular Research, Translation and Implementation, La Trobe University, Bundoora, VIC, Australia
| | - Susanna B Park
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Lisa G Horvath
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- The University of Sydney, Camperdown, NSW, Australia
- St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW, Australia
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
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3
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Mak B, Lin HM, Duong T, Mahon KL, Joshua AM, Stockler MR, Gurney H, Parnis F, Zhang A, Scheinberg T, Wittert G, Butler LM, Sullivan D, Hoy AJ, Meikle PJ, Horvath LG. Modulation of Plasma Lipidomic Profiles in Metastatic Castration-Resistant Prostate Cancer by Simvastatin. Cancers (Basel) 2022; 14:cancers14194792. [PMID: 36230715 PMCID: PMC9563053 DOI: 10.3390/cancers14194792] [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: 08/22/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Elevated circulating sphingolipids are associated with shorter overall survival and therapeutic resistance in metastatic castration-resistant prostate cancer (mCRPC), suggesting that perturbations in sphingolipid metabolism promotes prostate cancer growth. This study assessed whether addition of simvastatin to standard treatment for mCRPC can modify a poor prognostic circulating lipidomic profile represented by a validated 3-lipid signature (3LS). Men with mCRPC (n = 27) who were not on a lipid-lowering agent, were given simvastatin for 12 weeks (40 mg orally, once daily) with commencement of standard treatment. Lipidomic profiling was performed on their plasma sampled at baseline and after 12 weeks of treatment. Only 11 men had the poor prognostic 3LS at baseline, of whom five (45%) did not retain the 3LS after simvastatin treatment (expected conversion rate with standard treatment = 19%). At baseline, the plasma profiles of men with the 3LS displayed higher levels (p < 0.05) of sphingolipids (ceramides, hexosylceramides and sphingomyelins) than those of men without the 3LS. These plasma sphingolipids were reduced after statin treatment in men who lost the 3LS (mean decrease: 23−52%, p < 0.05), but not in men with persistent 3LS, and were independent of changes to plasma cholesterol, LDL-C or triacylglycerol. In conclusion, simvastatin in addition to standard treatment can modify the poor prognostic circulating lipidomic profile in mCRPC into a more favourable profile at twice the expected conversion rate.
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Affiliation(s)
- Blossom Mak
- Medical Oncology, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
| | - Hui-Ming Lin
- Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
- St Vincent’s Clinical School, UNSW Sydney, Darlinghurst, NSW 2010, Australia
| | - Thy Duong
- Metabolomics Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Kate L. Mahon
- Medical Oncology, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Anthony M. Joshua
- Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
- St Vincent’s Clinical School, UNSW Sydney, Darlinghurst, NSW 2010, Australia
- Kinghorn Cancer Centre, St Vincent’s Hospital, Darlinghurst, NSW 2010, Australia
| | - Martin R. Stockler
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - Howard Gurney
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Francis Parnis
- Adelaide Cancer Centre, Kurralta Park, SA 5037, Australia
| | - Alison Zhang
- Medical Oncology, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Tahlia Scheinberg
- Medical Oncology, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
| | - Gary Wittert
- South Australian Immunogenomics Cancer Institute and Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA 5005, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Lisa M. Butler
- South Australian Immunogenomics Cancer Institute and Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA 5005, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - David Sullivan
- Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
- NSW Health Pathology, Department of Chemical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Andrew J. Hoy
- School of Medical Sciences, Charles Perkins Centre, University of Sydney, Sydney, NSW 2050, Australia
| | - Peter J. Meikle
- Metabolomics Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- Department of Cardiovascular Research Translation and Implementation, La Trobe University, Bundoora, VIC 3086, Australia
| | - Lisa G. Horvath
- Medical Oncology, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
- St Vincent’s Clinical School, UNSW Sydney, Darlinghurst, NSW 2010, Australia
- Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
- Correspondence: ; Tel.: +61-2-8514-0142
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Conduit C, Mak B, Qu W, Lulio JD, Burder R, Bressel M, Cusick T, Dhillon HM, Lourenço RDA, Underhill C, Torres J, Crumbaker M, Honeyball F, Linton A, Allen R, Davis ID, Clark SJ, Horvath LG, Mahon KL. GUIDE: a randomised non-comparative phase II trial of biomarker-driven intermittent docetaxel versus standard-of-care docetaxel in metastatic castration-resistant prostate cancer (clinical trial protocol). Ther Adv Med Oncol 2022; 14:17588359221092486. [PMID: 35465297 PMCID: PMC9019311 DOI: 10.1177/17588359221092486] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/21/2022] [Indexed: 11/26/2022] Open
Abstract
Objective: To determine the efficacy and safety of intermittent docetaxel chemotherapy guided by circulating methylated glutathione S-transferase Pi-1 (mGSTP1) in men with metastatic castration-resistant prostate cancer (CRPC). Patients and Methods: GUIDE (NCT04918810) is a randomised, two-arm, non-comparative phase-2 trial recruiting 120 patients at six Australian centres. Patients with Prostate Cancer Working Group-3 defined metastatic CRPC who are commencing docetaxel 75 mg/m2 q3w will be pre-screened for detectable mGSTP1 at baseline ± following two cycles of treatment. Those with detectable plasma mGSTP1 at baseline that becomes undetectable after two cycles of chemotherapy will be eligible for GUIDE. Prior to Cycle 4 of docetaxel, these patients are randomised 2:1 to one of two treatment arms: Arm A (cease docetaxel and reinstitute if mGSTP1 becomes detectable) or Arm B (continue docetaxel 75 mg/m2 q3w in accordance with clinician’s usual practice). The primary endpoint is radiographic progression-free survival. Secondary endpoints include time on treatment holidays, safety, patient-reported outcomes, overall survival, health resource use, and cost associated with treatment. Enrolment commenced November 2021. Results and Conclusion: The results of this trial will generate data on the clinical utility of mGSTP1 as a novel biomarker to guide treatment de-escalation in metastatic CRPC.
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Affiliation(s)
- Ciara Conduit
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Blossom Mak
- Chris O’Brien Lifehouse, Camperdown, NSW, Australia Garvan Institute of Medical Research, Darlinghurst, NSW, Australia The University of Sydney, Sydney, NSW, Australia
| | - Wenjia Qu
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Juliana Di Lulio
- Centre for Biostatistics and Clinical Trials (BaCT), Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Ronan Burder
- Centre for Biostatistics and Clinical Trials (BaCT), Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Matthias Bressel
- Centre for Biostatistics and Clinical Trials (BaCT), Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Thomas Cusick
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Haryana M. Dhillon
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Richard De Abreu Lourenço
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Craig Underhill
- Border Medical Oncology Research Unit, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia University of NSW Rural Clinical School, Albury, NSW, Australia
| | - Javier Torres
- Goulburn Valley Health, Shepparton, VIC, Australia Rural Medical School, The University of Melbourne, Shepparton, VIC, Australia
| | - Megan Crumbaker
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia St. Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia The Kinghorn Cancer Centre, St. Vincent’s Hospital Sydney, Darlinghurst, NSW, Australia
| | - Florian Honeyball
- Dubbo Base Hospital, Dubbo, NSW, Australia School of Rural Health, The University of Sydney, Dubbo, NSW, Australia
| | - Anthony Linton
- The University of Sydney, Sydney, NSW, Australia Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Ray Allen
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Ian D. Davis
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia Eastern Health, Box Hill, VIC, Australia
| | - Susan J. Clark
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia UNSW Sydney, Sydney, NSW, Australia
| | - Lisa G. Horvath
- Chris O’Brien Lifehouse, Camperdown, NSW, Australia Garvan Institute of Medical Research, Darlinghurst, Sydney, NSW, Australia The University of Sydney, Sydney, NSW, Australia Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Kate L. Mahon
- Chris O’Brien Lifehouse, 119-143 Missenden Rd, Camperdown, NSW 2050, Australia
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- The University of Sydney, Sydney, NSW, AustraliaRoyal Prince Alfred Hospital, Camperdown, NSW, Australia
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5
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Lin HM, Mak B, Yeung N, Huynh K, Meikle TG, Mellett NA, Kwan EM, Fettke H, Tran B, Davis ID, Mahon KL, Zhang A, Stockler MR, Briscoe K, Marx G, Crumbaker M, Stricker PD, Du P, Yu J, Jia S, Scheinberg T, Fitzpatrick M, Bonnitcha P, Sullivan DR, Joshua AM, Azad AA, Butler LM, Meikle PJ, Horvath LG. Overcoming enzalutamide resistance in metastatic prostate cancer by targeting sphingosine kinase. EBioMedicine 2021; 72:103625. [PMID: 34656931 PMCID: PMC8526762 DOI: 10.1016/j.ebiom.2021.103625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/05/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 02/06/2023] Open
Abstract
Background Intrinsic resistance to androgen receptor signalling inhibitors (ARSI) occurs in 20–30% of men with metastatic castration-resistant prostate cancer (mCRPC). Ceramide metabolism may have a role in ARSI resistance. Our study's aim is to investigate the association of the ceramide-sphingosine-1-phosphate (ceramide-S1P) signalling axis with ARSI resistance in mCRPC. Methods Lipidomic analysis (∼700 lipids) was performed on plasma collected from 132 men with mCRPC, before commencing enzalutamide or abiraterone. AR gene aberrations in 77 of these men were identified by deep sequencing of circulating tumour DNA. Associations between circulating lipids, radiological progression-free survival (rPFS) and overall survival (OS) were examined by Cox regression. Inhibition of ceramide-S1P signalling with sphingosine kinase (SPHK) inhibitors (PF-543 and ABC294640) on enzalutamide efficacy was investigated with in vitro assays, and transcriptomic and lipidomic analyses of prostate cancer (PC) cell lines (LNCaP, C42B, 22Rv1). Findings Men with elevated circulating ceramide levels had shorter rPFS (HR=2·3, 95% CI=1·5–3·6, p = 0·0004) and shorter OS (HR=2·3, 95% CI=1·4–36, p = 0·0005). The combined presence of an AR aberration with elevated ceramide levels conferred a worse prognosis than the presence of only one or none of these characteristics (median rPFS time = 3·9 vs 8·3 vs 17·7 months; median OS time = 8·9 vs 19·8 vs 34·4 months). SPHK inhibitors enhanced enzalutamide efficacy in PC cell lines. Transcriptomic and lipidomic analyses indicated that enzalutamide combined with SPHK inhibition enhanced PC cell death by SREBP-induced lipotoxicity. Interpretation Ceramide-S1P signalling promotes ARSI resistance, which can be reversed with SPHK inhibitors.
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Affiliation(s)
- Hui-Ming Lin
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; St Vincent's Clinical School, UNSW Sydney, Darlinghurst, New South Wales, Australia
| | - Blossom Mak
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; Chris O' Brien Lifehouse, Camperdown, New South Wales, Australia; University of Sydney, Camperdown, New South Wales, Australia
| | - Nicole Yeung
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Thomas G Meikle
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Edmond M Kwan
- Department of Medical Oncology, Monash Health, Clayton, Victoria, Australia; Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Heidi Fettke
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Ben Tran
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Ian D Davis
- Cancer Services, Eastern Health, Box Hill, Victoria, Australia; Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Kate L Mahon
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; St Vincent's Clinical School, UNSW Sydney, Darlinghurst, New South Wales, Australia; Chris O' Brien Lifehouse, Camperdown, New South Wales, Australia; University of Sydney, Camperdown, New South Wales, Australia; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Alison Zhang
- Chris O' Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Martin R Stockler
- Chris O' Brien Lifehouse, Camperdown, New South Wales, Australia; University of Sydney, Camperdown, New South Wales, Australia; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Karen Briscoe
- Mid North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia
| | - Gavin Marx
- Sydney Adventist Hospital, Wahroonga, New South Wales, Australia
| | - Megan Crumbaker
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; St Vincent's Clinical School, UNSW Sydney, Darlinghurst, New South Wales, Australia; The Kinghorn Cancer Centre, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Phillip D Stricker
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; St Vincent's Clinical School, UNSW Sydney, Darlinghurst, New South Wales, Australia
| | - Pan Du
- Predicine, Inc., Hayward, CA, USA
| | | | | | - Tahlia Scheinberg
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; Chris O' Brien Lifehouse, Camperdown, New South Wales, Australia; University of Sydney, Camperdown, New South Wales, Australia
| | | | - Paul Bonnitcha
- University of Sydney, Camperdown, New South Wales, Australia; NSW Health Pathology, Camperdown, New South Wales, Australia
| | - David R Sullivan
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; NSW Health Pathology, Camperdown, New South Wales, Australia
| | - Anthony M Joshua
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; St Vincent's Clinical School, UNSW Sydney, Darlinghurst, New South Wales, Australia; The Kinghorn Cancer Centre, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Arun A Azad
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Lisa M Butler
- Adelaide Medical School and Freemason's Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, South Australia, Australia; South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Lisa G Horvath
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; St Vincent's Clinical School, UNSW Sydney, Darlinghurst, New South Wales, Australia; Chris O' Brien Lifehouse, Camperdown, New South Wales, Australia; University of Sydney, Camperdown, New South Wales, Australia; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
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Lin HM, Huynh K, Kohli M, Tan W, Azad AA, Yeung N, Mahon KL, Mak B, Sutherland PD, Shepherd A, Mellett N, Docanto M, Giles C, Centenera MM, Butler LM, Meikle PJ, Horvath LG. Aberrations in circulating ceramide levels are associated with poor clinical outcomes across localised and metastatic prostate cancer. Prostate Cancer Prostatic Dis 2021; 24:860-870. [PMID: 33746214 PMCID: PMC8387438 DOI: 10.1038/s41391-021-00338-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/10/2021] [Accepted: 01/28/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Dysregulated lipid metabolism is associated with more aggressive pathology and poorer prognosis in prostate cancer (PC). The primary aim of the study is to assess the relationship between the plasma lipidome and clinical outcomes in localised and metastatic PC. The secondary aim is to validate a prognostic circulating 3-lipid signature specific to metastatic castration-resistant PC (mCRPC). PATIENTS AND METHODS Comprehensive lipidomic analysis was performed on pre-treatment plasma samples from men with localised PC (N = 389), metastatic hormone-sensitive PC (mHSPC)(N = 44), or mCRPC (validation cohort, N = 137). Clinical outcomes from our previously published mCRPC cohort (N = 159) that was used to derive the prognostic circulating 3-lipid signature, were updated. Associations between circulating lipids and clinical outcomes were examined by Cox regression and latent class analysis. RESULTS Circulating lipid profiles featuring elevated levels of ceramide species were associated with metastatic relapse in localised PC (HR 5.80, 95% CI 3.04-11.1, P = 1 × 10-6), earlier testosterone suppression failure in mHSPC (HR 3.70, 95% CI 1.37-10.0, P = 0.01), and shorter overall survival in mCRPC (HR 2.54, 95% CI 1.73-3.72, P = 1 × 10-6). The prognostic significance of circulating lipid profiles in localised PC was independent of standard clinicopathological and metabolic factors (P < 0.0002). The 3-lipid signature was verified in the mCRPC validation cohort (HR 2.39, 95% CI 1.63-3.51, P = 1 × 10-5). CONCLUSIONS Elevated circulating ceramide species are associated with poorer clinical outcomes across the natural history of PC. These clinically actionable lipid profiles could be therapeutically targeted in prospective clinical trials to potentially improve PC outcomes.
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Affiliation(s)
- Hui-Ming Lin
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia,St Vincent’s Clinical School, UNSW Sydney, New South Wales, Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Manish Kohli
- Huntsman Cancer Institute, Division of Oncology, Department of Medicine, 2000 Circle of Hope Drive, Salt Lake City, UT 84012, United States of America
| | - Winston Tan
- Mayo Clinic Florida, Jacksonville, Florida, United States of America
| | - Arun A. Azad
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia,Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia,Monash University, Victoria, Australia
| | - Nicole Yeung
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia
| | - Kate L. Mahon
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia,Monash University, Victoria, Australia,Chris O’ Brien Lifehouse, Camperdown, New South Wales , Australia,University of Sydney, Sydney, New South Wales, Australia
| | - Blossom Mak
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia,Chris O’ Brien Lifehouse, Camperdown, New South Wales , Australia,University of Sydney, Sydney, New South Wales, Australia
| | | | - Andrew Shepherd
- Royal Adelaide Hospital, Adelaide, South Australia, Australia,Adelaide Medical School and Freemason’s Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Natalie Mellett
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Corey Giles
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Margaret M. Centenera
- Adelaide Medical School and Freemason’s Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia,South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Lisa M. Butler
- Adelaide Medical School and Freemason’s Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia,South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Peter J. Meikle
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Lisa G. Horvath
- Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia,St Vincent’s Clinical School, UNSW Sydney, New South Wales, Australia,Chris O’ Brien Lifehouse, Camperdown, New South Wales , Australia,University of Sydney, Sydney, New South Wales, Australia,Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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7
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Nindra U, Shahnam A, Mahon KL. Review of systemic chemotherapy in unresectable colorectal peritoneal carcinomatosis. Asia Pac J Clin Oncol 2021; 18:7-12. [PMID: 33609014 DOI: 10.1111/ajco.13552] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/02/2020] [Indexed: 01/02/2023]
Abstract
Colorectal cancer remains the third most common malignancy in Australia with the peritoneum being the second most common metastatic site. Colorectal peritoneal carcinomatosis (CPC) can be treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy but this is only limited to a small subset of patients. Those with inoperable disease have a particularly poor prognosis. While the ideal systemic regimen has not been defined, 5-fluorouracil-based chemotherapy regimens appear to provide overall and progression free survival benefits. The role of targeted agents such as bevacizumab (vascular endothelial growth factor inhibitor) or cetuximab (epidermal growth factor inhibitor) in the setting of CPC is still evolving. Currently, retrospective analyses have shown promising results for the use of bevacizumab in addition to systemic chemotherapy but similar results have not been seen with cetuximab or panitumumab. However, there is significant heterogeneity in the trial data, lack of prospective randomized controlled trials and demonstrated treatment variability based on age and tumour characteristics. This review summarises the current literature in regard to treatment in the unresectable CPC setting as well as discussing issues with the current data and highlighting the need for further trials.
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Affiliation(s)
- Udit Nindra
- Royal Prince Alfred Hospital, Sydney, Australia.,Chris O'Brien Lifehouse, Sydney, Australia
| | - Adel Shahnam
- Royal Prince Alfred Hospital, Sydney, Australia.,Chris O'Brien Lifehouse, Sydney, Australia
| | - Kate L Mahon
- Chris O'Brien Lifehouse, Sydney, Australia.,Garvan Institute of Medical Research, Sydney, Australia.,University of NSW, Sydney, Australia.,University of Sydney, Sydney, Australia
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8
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Scheinberg T, Goodwin A, Ip E, Linton A, Mak B, Smith DP, Stockler MR, Strach MC, Tran B, Young AL, Zhang AY, Mahon KL, Horvath LG. Evaluation of a Mainstream Model of Genetic Testing for Men With Prostate Cancer. JCO Oncol Pract 2020; 17:e204-e216. [PMID: 32970524 DOI: 10.1200/op.20.00399] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To identify the approximately 12% with inherited cancer predisposition, all men with metastatic prostate cancer (mPC) should be offered germline genetic testing. This guides treatment choices and impacts cancer prevention in the family. Limited genetic services globally present a barrier to testing. This study tested a potential solution, "mainstreaming," where counseling and testing are performed by the patient's oncologist. PATIENTS AND METHODS Men with mPC at three Australian sites were offered germline genetic testing at their medical oncology appointment. Panel testing (ATM, BRCA1, BRCA2, BRIP1, CHEK2, EPCAM, FANCA, HOXB13, MLH1, MSH2, MSH6, NBN, PALB2, PMS2, RAD51D, and TP53) was performed on saliva/blood (Invitae, San Francisco, CA). Primary outcomes were clinician and patient satisfaction. Secondary outcomes included mutation rates and resource allocation. RESULTS Of 66 men offered testing, 63 (95%) accepted. Four pathogenic variants were identified (two BRCA2, one NBN, and one MSH6). Fifty patients and nine clinicians completed questionnaires. Satisfaction was high. All patients were pleased to have had testing overall, 98% (46 of 47) to have had testing at their usual oncology appointment, and all to receive results from their usual specialist, rather than a separate genetics appointment. A total of 88% (7 of 8) of clinicians felt confident, and all were satisfied with mainstreaming. Mainstreaming was resource efficient, requiring 87% fewer genetic consultations than traditional genetic counseling. CONCLUSION This study demonstrates that mainstreaming of men with mPC is feasible, resource efficient, and satisfactory for clinicians and patients. Widespread implementation as standard of care would facilitate timely access to genetic testing for men with mPC.
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Affiliation(s)
- Tahlia Scheinberg
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Clinical Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Annabel Goodwin
- Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Cancer Genetics, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Emilia Ip
- Cancer Genetics, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.,Cancer Genetics, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Anthony Linton
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Blossom Mak
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Clinical Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - David P Smith
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Cancer Research Division, Cancer Council NSW, New South Wales, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Martin R Stockler
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Medical Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Madeleine C Strach
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Ben Tran
- Medical Oncology, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia.,Division of Systems Biology and Personalised Medicine, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Medical Oncology, Epworth Freemasons, East Melbourne, Victoria, Australia
| | - Alison L Young
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Catalyst Translational Research Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alison Y Zhang
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Medical Oncology, Macquarie University Hospital, Macquarie University, New South Wales, Australia
| | - Kate L Mahon
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Clinical Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Medical Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Lisa G Horvath
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Clinical Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Medical Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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9
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Miladinovic D, Cusick T, Mahon KL, Haynes AM, Cortie CH, Meyer BJ, Stricker PD, Wittert GA, Butler LM, Horvath LG, Hoy AJ. Assessment of Periprostatic and Subcutaneous Adipose Tissue Lipolysis and Adipocyte Size from Men with Localized Prostate Cancer. Cancers (Basel) 2020; 12:cancers12061385. [PMID: 32481537 PMCID: PMC7352157 DOI: 10.3390/cancers12061385] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 04/25/2020] [Revised: 05/21/2020] [Accepted: 05/27/2020] [Indexed: 02/06/2023] Open
Abstract
The prostate is surrounded by periprostatic adipose tissue (PPAT), the thickness of which has been associated with more aggressive prostate cancer (PCa). There are limited data regarding the functional characteristics of PPAT, how it compares to subcutaneous adipose tissue (SAT), and whether in a setting of localized PCa, these traits are altered by obesity or disease aggressiveness. PPAT and SAT were collected from 60 men (age: 42–78 years, BMI: 21.3–35.6 kg/m2) undergoing total prostatectomy for PCa. Compared to SAT, adipocytes in PPAT were smaller, had the same basal rates of fatty acid release (lipolysis) yet released less polyunsaturated fatty acid species, and were more sensitive to isoproterenol-stimulated lipolysis. Basal lipolysis of PPAT was increased in men diagnosed with less aggressive PCa (Gleason score (GS) ≤ 3 + 4) compared to men with more aggressive PCa (GS ≥ 4 + 3) but no other measured adipocyte parameters related to PCa aggressiveness. Likewise, there was no difference in PPAT lipid biology between lean and obese men. In conclusion, lipid biological features of PPAT do differ from SAT; however, we did not observe any meaningful difference in ex vivo PPAT biology that is associated with PCa aggressiveness or obesity. As such, our findings do not support a relationship between altered PCa behavior in obese men and the metabolic reprogramming of PPAT.
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Affiliation(s)
- Dushan Miladinovic
- Discipline of Physiology, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia;
| | - Thomas Cusick
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, New South Wales 2010, Australia; (T.C.); (K.L.M.); (A.-M.H.); (P.D.S.); (L.G.H.)
| | - Kate L. Mahon
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, New South Wales 2010, Australia; (T.C.); (K.L.M.); (A.-M.H.); (P.D.S.); (L.G.H.)
- Discipline of Medicine, Central Clinical School, The University of Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia
- Department of Medical Oncology, Chris O’Brien Lifehouse, New South Wales 2050, Australia
- Royal Prince Alfred Hospital, New South Wales 2050, Australia
| | - Anne-Maree Haynes
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, New South Wales 2010, Australia; (T.C.); (K.L.M.); (A.-M.H.); (P.D.S.); (L.G.H.)
| | - Colin H. Cortie
- School of Medicine, Lipid Research Centre, Molecular Horizons, University of Wollongong, New South Wales 2522, Australia; (C.H.C.); (B.J.M.)
- Illawarra Medical Research Institute, University of Wollongong, New South Wales 2522, Australia
| | - Barbara J. Meyer
- School of Medicine, Lipid Research Centre, Molecular Horizons, University of Wollongong, New South Wales 2522, Australia; (C.H.C.); (B.J.M.)
- Illawarra Medical Research Institute, University of Wollongong, New South Wales 2522, Australia
| | - Phillip D. Stricker
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, New South Wales 2010, Australia; (T.C.); (K.L.M.); (A.-M.H.); (P.D.S.); (L.G.H.)
- St. Vincent’s Clinical School, The University of New South Wales, New South Wales 2010, Australia
- St. Vincent’s Prostate Cancer Centre, St. Vincent’s Clinic, New South Wales 2010, Australia
| | - Gary A. Wittert
- South Australian Health and Medical Research Institute, South Australia 5000, Australia; (G.A.W.); (L.M.B.)
- School of Medicine and Freemasons Foundation Centre for Men’s Health, University of Adelaide, South Australia 5000, Australia
| | - Lisa M. Butler
- South Australian Health and Medical Research Institute, South Australia 5000, Australia; (G.A.W.); (L.M.B.)
- School of Medicine and Freemasons Foundation Centre for Men’s Health, University of Adelaide, South Australia 5000, Australia
| | - Lisa G. Horvath
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, New South Wales 2010, Australia; (T.C.); (K.L.M.); (A.-M.H.); (P.D.S.); (L.G.H.)
- Discipline of Medicine, Central Clinical School, The University of Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia
- Department of Medical Oncology, Chris O’Brien Lifehouse, New South Wales 2050, Australia
- Royal Prince Alfred Hospital, New South Wales 2050, Australia
| | - Andrew J. Hoy
- Discipline of Physiology, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia;
- Correspondence:
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10
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Scheinberg T, Young A, Woo H, Goodwin A, Mahon KL, Horvath LG. Mainstream consent programs for genetic counseling in cancer patients: A systematic review. Asia Pac J Clin Oncol 2020; 17:163-177. [PMID: 32309911 DOI: 10.1111/ajco.13334] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 01/15/2020] [Accepted: 02/29/2020] [Indexed: 02/06/2023]
Abstract
As demand for germline genetic testing for cancer patients increases, novel methods of genetic counseling are required. One such method is the mainstream consent pathway, whereby a member of the oncology team (rather than a genetic specialist) is responsible for counseling, consenting, and arranging genetic testing for cancer patients. We systematically reviewed the literature for evidence evaluating mainstream pathways for patients with breast, ovarian, colorectal, and prostate cancer. Medline, EMBASE, and Cochrane Library were searched for studies that met inclusion and exclusion criteria. Article references were checked for additional studies. Trial databases were searched for ongoing studies. Of the 13 papers that met inclusion criteria, 11 individual study groups were identified (two study groups had two publications each). Ten of the 11 studies evaluated the acceptability, feasibility, and impact of BRCA testing for patients and/or clinicians in different clinical settings in breast and ovarian cancer, while the final study explored the attitudes of colorectal specialists toward genetic testing for colorectal cancer. None involved prostate cancer. Overall, mainstream pathways were acceptable and feasible. Medical oncologist- and nurse-driven pathways were particularly successful, with both patients and clinicians satisfied with this process. Although the content of pretest counseling was less consistent compared with counseling via the traditional model, patients were largely satisfied with the education they received. Further research is required to evaluate the mainstream pathway for men with prostate cancer.
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Affiliation(s)
- Tahlia Scheinberg
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.,Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Alison Young
- Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Catalyst Translational Research Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Henry Woo
- Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.,Urology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Annabel Goodwin
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Cancer Genetics, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Kate L Mahon
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.,Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Lisa G Horvath
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.,Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
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11
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Scheinberg T, Kench J, Stockler M, Mahon KL, Sebastian L, Stricker P, Joshua AM, Woo H, Thanigasalam R, Ahmadi N, Centenera MM, Butler LM, Horvath LG. Pharmacodynamics effects of CDK4/6 inhibitor LEE011 (ribociclib) in high-risk, localised prostate cancer: a study protocol for a randomised controlled phase II trial (LEEP study: LEE011 in high-risk, localised Prostate cancer). BMJ Open 2020; 10:e033667. [PMID: 31988233 PMCID: PMC7045211 DOI: 10.1136/bmjopen-2019-033667] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Despite the development of new therapies for advanced prostate cancer, it remains the most common cause of cancer and the second leading cause of cancer death in men. It is critical to develop novel agents for the treatment of prostate cancer, particularly those that target aspects of androgen receptor (AR) signalling or prostate biology other than inhibition of androgen synthesis or AR binding. Neoadjuvant pharmacodynamic studies allow for a rational approach to the decisions regarding which targeted therapies should progress to phase II/III trials. CDK4/6 inhibitors have evidence of efficacy in breast cancer, and have been shown to have activity in preclinical models of hormone sensitive and castrate resistant prostate cancer. The LEEP trial aims to assess the pharmacodynamic effects of LEE011 (ribociclib), an orally bioavailable and highly selective CDK4/6 inhibitor, in men undergoing radical prostatectomy for high-risk, localised prostate cancer. METHODS AND ANALYSIS The multicentre randomised, controlled 4:1 two-arm, phase II, open label pharmacodynamic study will recruit 47 men with high risk, localised prostate cancer who are planned to undergo radical prostatectomy. Participants who are randomised to receive the study treatment will be treated with LEE011 400 mg daily for 21 days for one cycle. The primary endpoint is the frequency of a 50% reduction in Ki-67 proliferation index from the pretreatment prostate biopsy compared to that present in prostate cancer tissue from radical prostatectomy. Secondary and tertiary endpoints include pharmacodynamic assessment of CDK4/6 cell cycle progression via E2F levels, apoptotic cell death by cleaved caspase-3, changes in serum and tumour levels of Prostate Specific Antigen (PSA), pathological regression, safety via incidence of adverse events and exploratory biomarker analysis. ETHICS AND DISSEMINATION The protocol was approved by a central ethics review committee (St Vincent's Hospital HREC) for all participating sites (HREC/17/SVH/294). Results will be disseminated in peer-reviewed journals and at scientific conferences. DRUG SUPPLY Novartis. PROTOCOL VERSION 2.0, 30 May 2019 TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12618000354280).
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Affiliation(s)
- Tahlia Scheinberg
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Cancer Research, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - James Kench
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Cancer Research, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Martin Stockler
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Kate L Mahon
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Cancer Research, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Lucille Sebastian
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Phillip Stricker
- Cancer Research, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Urology, St Vincent's Clinic, Darlinghurst, NSW, Australia
| | - Anthony M Joshua
- Cancer Research, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Medical Oncology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - H Woo
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Urology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Ruban Thanigasalam
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Urology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- Urology, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Nariman Ahmadi
- Urology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Margaret M Centenera
- Prostate Cancer Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa M Butler
- Prostate Cancer Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa G Horvath
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Cancer Research, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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12
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Mahon KL, Qu W, Lin HM, Spielman C, Cain D, Jacobs C, Stockler MR, Higano CS, de Bono JS, Chi KN, Clark SJ, Horvath LG. Serum Free Methylated Glutathione S-transferase 1 DNA Levels, Survival, and Response to Docetaxel in Metastatic, Castration-resistant Prostate Cancer: Post Hoc Analyses of Data from a Phase 3 Trial. Eur Urol 2019; 76:306-312. [DOI: 10.1016/j.eururo.2018.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 11/01/2018] [Indexed: 11/25/2022]
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13
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Zhang AY, Chiam K, Haupt Y, Fox S, Birch S, Tilley W, Butler LM, Knudsen K, Comstock C, Rasiah K, Grogan J, Mahon KL, Bianco-Miotto T, Ricciardelli C, Böhm M, Henshall S, Delprado W, Stricker P, Horvath LG, Kench JG. An analysis of a multiple biomarker panel to better predict prostate cancer metastasis after radical prostatectomy. Int J Cancer 2018; 144:1151-1159. [PMID: 30288742 DOI: 10.1002/ijc.31906] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 08/22/2018] [Indexed: 12/23/2022]
Abstract
A plethora of individual candidate biomarkers for predicting biochemical relapse in localized prostate cancer (PCa) have been proposed. Combined biomarkers may improve prognostication, and ensuring validation against more clinically relevant endpoints are required. The Australian PCa Research Centre NSW has contributed to numerous studies of molecular biomarkers associated with biochemical relapse. In the current study, these biomarkers were re-analyzed for biochemical relapse, metastatic relapse and PCa death with extended follow-up. Biomarkers of significance were then used to develop a combined prognostic model for clinical outcomes and validated in a large independent cohort. The discovery cohort (n = 324) was based on 12 biomarkers with a median follow-up of 16 years. Seven biomarkers were significantly associated with biochemical relapse. Three biomarkers were associated with metastases: AZGP1, Ki67 and PML. Only AZGP1 was associated with PCa death. In their individual and combinational forms, AZGP1 and Ki67 as a dual BM signature was the most robust predictor of metastatic relapse (AUC 0.762). The AZPG1 and Ki67 signature was validated in an independent cohort of 347 PCa patients. The dual BM signature of AZGP1 and Ki67 predicted metastasis in the univariable (HR 7.2, 95% CI, 1.6-32; p = 0.01) and multivariable analysis (HR 5.4, 95% CI, 1.2-25; p = 0.03). The dual biomarker signature marginally improved risk prediction compared to AZGP1 alone (AUC 0.758 versus 0.738, p < 0.001). Our findings indicate that biochemical relapse is not an adequate surrogate for metastasis or PCa death. The dual biomarker signature of AZGP1 and Ki67 offers a small benefit in predicting metastasis over AZGP1 alone.
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Affiliation(s)
- Alison Y Zhang
- Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,University of Sydney, Camperdown, NSW, Australia
| | - Karen Chiam
- Cancer Research Division, Cancer Council New South Wales, Woolloomooloo, NSW, Australia
| | - Ygal Haupt
- Peter MacCallum Cancer Centre, Parkville, VIC, Australia
| | - Stephen Fox
- Peter MacCallum Cancer Centre, Parkville, VIC, Australia.,University of Melbourne, Parkville, VIC, Australia
| | - Simone Birch
- Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Wayne Tilley
- Freemason's Foundation Centre for Men's Health, University of Adelaide, Adelaide, SA, Australia.,South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Lisa M Butler
- Freemason's Foundation Centre for Men's Health, University of Adelaide, Adelaide, SA, Australia.,South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Karen Knudsen
- Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, US
| | - Clay Comstock
- Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, US
| | | | - Judith Grogan
- Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Kate L Mahon
- Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Tina Bianco-Miotto
- School of Agriculture, Food and Wine, University of Adelaide, Adelaide, SA, Australia
| | - Carmela Ricciardelli
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Maret Böhm
- Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Susan Henshall
- Union for International Cancer Control, Geneva, Switzerland
| | - Warick Delprado
- Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia
| | - Phillip Stricker
- Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,Department of Urology, St Vincent's Clinic, Darlinghurst, NSW, Australia
| | - Lisa G Horvath
- Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,University of Sydney, Camperdown, NSW, Australia.,Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - James G Kench
- Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,University of Sydney, Camperdown, NSW, Australia.,Royal Prince Alfred Hospital, Camperdown, NSW, Australia
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14
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Zhang AY, Grogan JS, Mahon KL, Rasiah K, Sved P, Eisinger DR, Boulas J, Vasilaris A, Henshall SM, Stricker PD, Kench JG, Horvath LG. A prospective multicentre phase III validation study of AZGP1 as a biomarker in localized prostate cancer. Ann Oncol 2018; 28:1903-1909. [PMID: 28486686 DOI: 10.1093/annonc/mdx247] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Prostate cancers (PCs) with similar characteristics at the time of diagnosis can have very different disease outcomes. Conventional biomarkers of PC still lack precision in identifying individuals at high risk of PC recurrence. While many candidate biomarkers are proposed in the literature, few are in clinical practice as they lack rigorous validation. This study prospectively enrolled an independent phase III cohort to evaluate the clinical utility of zinc-alpha 2-glycoprotein (AZGP1) as a prognostic biomarker in localized PC. Patients and methods In our multicentre, prospective phase III study, AZGP1 status in 347 radical prostatectomy specimens was assayed by immunohistochemistry in a NATA-accredited laboratory. The AZGP1 score was assessed in a multivariable model incorporating established prognostic factors. We also report extended outcomes from our previous phase II study. The primary endpoint was biochemical relapse-free survival (BRFS). Secondary endpoints were metastasis-free survival (MFS) and PC-specific survival (PCSS). Results In the phase II cohort, with a median follow-up of 15.8 years, low/absent AZGP1 expression was an independent predictor of poor BRFS (HR, 1.4; 95% CI, 1.1-1.9; P = 0.03), MFS (HR, 2.8; 95% CI, 1.2-6.6; P = 0.02) and PCSS (HR, 3.8; 95% CI, 1.5-9.5; P = 0.005). These results were validated in our prospective phase III cohort. Low/absent AZGP1 expression independently predicted for BRFS (HR, 1.9; 95% CI, 1.1-3.3; P = 0.02), with shorter MFS (HR, 2.0; 95% CI, 1.1-3.4; P = 0.02). AZGP1 improved the discriminatory value when incorporated into existing prognostic risk models. Conclusion Our study provides prospective phase III validation that absent/low AZGP1 expression provides independent prognostic value in PC. This study provides robust evidence for the incorporation of this biomarker into clinical practice.
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Affiliation(s)
- A Y Zhang
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown.,Cancer Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst.,Sydney Medical School, University of Sydney, Camperdown
| | - J S Grogan
- Cancer Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst
| | - K L Mahon
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown.,Cancer Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst
| | - K Rasiah
- Cancer Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst.,Sydney Medical School, University of Sydney, Camperdown.,Department of Urology, Royal North Shore Hospital, Crows Nest
| | - P Sved
- Sydney Medical School, University of Sydney, Camperdown.,Department of Urology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - D R Eisinger
- Department of Urology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - J Boulas
- Department of Urology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - A Vasilaris
- Department of Urology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - S M Henshall
- Three Stories Consulting - Global Health Advocacy, USA
| | - P D Stricker
- Cancer Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst.,Sydney Medical School, University of Sydney, Camperdown.,Department of Urology, St Vincent's Clinic, Darlinghurst.,Discipline of Medicine, University of New South Wales
| | - J G Kench
- Cancer Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst.,Sydney Medical School, University of Sydney, Camperdown.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - L G Horvath
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown.,Cancer Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst.,Sydney Medical School, University of Sydney, Camperdown.,Discipline of Medicine, University of New South Wales.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Australia
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15
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Lin HM, Mahon KL, Weir JM, Mundra PA, Spielman C, Briscoe K, Gurney H, Mallesara G, Marx G, Stockler MR, PRIMe Consortium, Parton RG, Hoy AJ, Daly RJ, Meikle PJ, Horvath LG. A distinct plasma lipid signature associated with poor prognosis in castration-resistant prostate cancer. Int J Cancer 2017; 141:2112-2120. [PMID: 28741687 DOI: 10.1002/ijc.30903] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 04/21/2017] [Revised: 06/19/2017] [Accepted: 07/06/2017] [Indexed: 12/29/2022]
Abstract
Lipids are known to influence tumour growth, inflammation and chemoresistance. However, the association of circulating lipids with the clinical outcome of metastatic castration-resistant prostate cancer (CRPC) is unknown. We investigated associations between the plasma lipidome and clinical outcome in CRPC. Lipidomic profiling by liquid chromatography-tandem mass spectrometry was performed on plasma samples from a Phase 1 discovery cohort of 96 CRPC patients. Results were validated in an independent Phase 2 cohort of 63 CRPC patients. Unsupervised analysis of lipidomic profiles (323 lipid species) classified the Phase 1 cohort into two patient subgroups with significant survival differences (HR 2.31, 95% CI 1.44-3.68, p = 0.0005). The levels of 46 lipids were individually prognostic and were predominantly sphingolipids with higher levels associated with poor prognosis. A prognostic three-lipid signature was derived (ceramide d18:1/24:1, sphingomyelin d18:2/16:0, phosphatidylcholine 16:0/16:0) and was also associated with shorter survival in the Phase 2 cohort (HR 4.8, 95% CI 2.06-11.1, p = 0.0003). The signature was an independent prognostic factor when modelled with clinicopathological factors or metabolic characteristics. The association of plasma lipids with CRPC prognosis suggests a possible role of these lipids in disease progression. Further research is required to determine if therapeutic modulation of the levels of these lipids by targeting their metabolic pathways may improve patient outcome.
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Affiliation(s)
- Hui-Ming Lin
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St Vincent's Clinical School, UNSW Sydney, NSW, Australia
| | - Kate L Mahon
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St Vincent's Clinical School, UNSW Sydney, NSW, Australia.,Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Jacquelyn M Weir
- Metabolomics Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Piyushkumar A Mundra
- Metabolomics Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Calan Spielman
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Karen Briscoe
- Medical Oncology, Mid North Coast Cancer Institute, Coffs Harbour Health Campus, Coffs Harbour, NSW, Australia
| | - Howard Gurney
- Medical Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - Girish Mallesara
- Medical Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia
| | - Gavin Marx
- Medical Oncology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - Martin R Stockler
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,Medical Oncology, Concord Repatriation General Hospital, Concord, NSW, Australia.,Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
| | - PRIMe Consortium
- Pharmacogenomics Research for Individualised Medicine Consortium, NSW, Australia
| | - Robert G Parton
- Cell Biology and Molecular Medicine Division, Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Andrew J Hoy
- Discipline of Physiology, School of Medical Sciences & Bosch Institute, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Roger J Daly
- Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC, Australia
| | - Peter J Meikle
- Metabolomics Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Lisa G Horvath
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St Vincent's Clinical School, UNSW Sydney, NSW, Australia.,Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
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16
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Khoo TK, Yu B, Smith JA, Clarke AJ, Luk PP, Selinger CI, Mahon KL, Kraitsek S, Palme C, Boyer MJ, Dinger ME, Cowley MJ, O'Toole SA, Clark JR, Gupta R. Somatic mutations in salivary duct carcinoma and potential therapeutic targets. Oncotarget 2017; 8:75893-75903. [PMID: 29100278 PMCID: PMC5652672 DOI: 10.18632/oncotarget.18173] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 01/10/2017] [Accepted: 03/20/2017] [Indexed: 02/01/2023] Open
Abstract
Background Salivary duct carcinomas (SDCa) are rare highly aggressive malignancies. Most patients die from distant metastatic disease within three years of diagnosis. There are limited therapeutic options for disseminated disease. Results 11 cases showed androgen receptor expression and 6 cases showed HER2 amplification. 6 Somatic mutations with additional available targeted therapies were identified: EGFR (p.G721A: Gefitinib), PDGFRA (p.H845Y: Imatinib and Crenolanib), PIK3CA (p.H1047R: Everolimus), ERBB2 (p.V842I: Lapatinib), HRAS (p.Q61R: Selumetinib) and KIT (p.T670I: Sorafenib). Furthermore, alterations in PTEN, PIK3CA and HRAS that alter response to androgen deprivation therapy and HER2 inhibition were also seen. Materials and Methods Somatic mutation analysis was performed on DNA extracted from 15 archival cases of SDCa using the targeted Illumina TruSeq Amplicon Cancer Panel. Potential targetable genetic alterations were identified using extensive literature and international somatic mutation database (COSMIC, KEGG) search. Immunohistochemistry for androgen receptor and immunohistochemistry and fluorescent in situ hybridization for HER2 were also performed. Conclusions SDCa show multiple somatic mutations, some that are amenable to pharmacologic manipulation and others that confer resistance to treatments currently under investigation. These findings emphasize the need to develop testing and treatment strategies for SDCa.
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Affiliation(s)
- Timothy K Khoo
- Central Clinical School, The University of Sydney, Australia
| | - Bing Yu
- Central Clinical School, The University of Sydney, Australia.,Department of Medical Genomics, Royal Prince Alfred Hospital, Sydney, Australia
| | - Joel A Smith
- The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia
| | - Angus J Clarke
- Central Clinical School, The University of Sydney, Australia
| | - Peter P Luk
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Christina I Selinger
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Kate L Mahon
- Central Clinical School, The University of Sydney, Australia.,The Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia
| | - Spiridoula Kraitsek
- Department of Medical Genomics, Royal Prince Alfred Hospital, Sydney, Australia
| | - Carsten Palme
- Central Clinical School, The University of Sydney, Australia.,The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia
| | - Michael J Boyer
- Central Clinical School, The University of Sydney, Australia.,The Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia
| | - Marcel E Dinger
- Kinghorn Cancer Centre and Garvan Institute of Medical Research, Darlinghurst, Sydney, Australia
| | - Mark J Cowley
- Kinghorn Cancer Centre and Garvan Institute of Medical Research, Darlinghurst, Sydney, Australia
| | - Sandra A O'Toole
- Central Clinical School, The University of Sydney, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Jonathan R Clark
- Central Clinical School, The University of Sydney, Australia.,The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,South West Clinical School, University of New South Wales, Sydney, Australia
| | - Ruta Gupta
- Central Clinical School, The University of Sydney, Australia.,The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
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17
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Grogan J, Gupta R, Mahon KL, Stricker PD, Haynes AM, Delprado W, Turner J, Horvath LG, Kench JG. Predictive value of the 2014 International Society of Urological Pathology grading system for prostate cancer in patients undergoing radical prostatectomy with long-term follow-up. BJU Int 2017; 120:651-658. [DOI: 10.1111/bju.13857] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Judith Grogan
- Cancer Research Program; Kinghorn Cancer Centre/Garvan Institute of Medical Research; Darlinghurst NSW Australia
| | - Ruta Gupta
- Cancer Research Program; Kinghorn Cancer Centre/Garvan Institute of Medical Research; Darlinghurst NSW Australia
- Department of Tissue Pathology and Diagnostic Oncology; Royal Prince Alfred Hospital; Sydney NSW Australia
- Sydney Medical School; University of Sydney; Sydney NSW Australia
| | - Kate L. Mahon
- Cancer Research Program; Kinghorn Cancer Centre/Garvan Institute of Medical Research; Darlinghurst NSW Australia
- Department of Medical Oncology; Chris O'Brien Lifehouse; Camperdown NSW Australia
| | | | - Anne-Maree Haynes
- Cancer Research Program; Kinghorn Cancer Centre/Garvan Institute of Medical Research; Darlinghurst NSW Australia
| | - Warick Delprado
- Douglass Hanly Moir Pathology; Sydney NSW Australia
- Australian School of Advanced Medicine; Macquarie University; Sydney NSW Australia
| | - Jennifer Turner
- Douglass Hanly Moir Pathology; Sydney NSW Australia
- Australian School of Advanced Medicine; Macquarie University; Sydney NSW Australia
| | - Lisa G. Horvath
- Cancer Research Program; Kinghorn Cancer Centre/Garvan Institute of Medical Research; Darlinghurst NSW Australia
- Sydney Medical School; University of Sydney; Sydney NSW Australia
- Department of Medical Oncology; Chris O'Brien Lifehouse; Camperdown NSW Australia
| | - James G. Kench
- Cancer Research Program; Kinghorn Cancer Centre/Garvan Institute of Medical Research; Darlinghurst NSW Australia
- Department of Tissue Pathology and Diagnostic Oncology; Royal Prince Alfred Hospital; Sydney NSW Australia
- Sydney Medical School; University of Sydney; Sydney NSW Australia
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18
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Lin HM, Mahon KL, Spielman C, Gurney H, Mallesara G, Stockler MR, Bastick P, Briscoe K, Marx G, Swarbrick A, Horvath LG. Phase 2 study of circulating microRNA biomarkers in castration-resistant prostate cancer. Br J Cancer 2017; 116:1002-1011. [PMID: 28278515 PMCID: PMC5396108 DOI: 10.1038/bjc.2017.50] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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: 12/05/2016] [Revised: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 12/19/2022] Open
Abstract
Background: Biomarkers of therapeutic response and prognosis are needed to assist in the sequencing of treatments for metastatic castration-resistant prostate cancer (CRPC). Previously in a Phase 1 discovery study, we identified 14 circulating microRNAs that were associated with response to docetaxel chemotherapy or overall survival. We performed a Phase 2 validation study to verify these findings. Methods: Using real-time PCR, the levels of the 14 microRNAs were measured in plasma collected before and after the first cycle of docetaxel from a Phase 2 cohort of 89 patients. Results: The microRNAs were not associated with docetaxel response in the Phase 2 cohort. Higher baseline levels of six microRNAs, predominantly of the miR-200 family, were confirmed to be associated with shorter overall survival. A microRNA signature comprising these six microRNAs predicted high-risk patients in the Phase 2 cohort with a hazard ratio of 4.12 (95% CI 2.20–7.70, P=0.000001). The signature was an independent predictor in multivariable analysis with clinicopathological factors. Conclusions: The association of circulating microRNAs with overall survival suggests their involvement in CRPC progression.
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Affiliation(s)
- Hui-Ming Lin
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia.,St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Darlinghurst, New South Wales 2010, Australia
| | - Kate L Mahon
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia.,St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Darlinghurst, New South Wales 2010, Australia.,Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales 2050, Australia.,Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia
| | - Calan Spielman
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
| | - Howard Gurney
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales 2145, Australia.,Pharmacogenomics Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia
| | - Girish Mallesara
- Pharmacogenomics Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia.,Calvary Mater Newcastle Hospital, Waratah, New South Wales 2298, Australia
| | - Martin R Stockler
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales 2050, Australia.,Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia.,Pharmacogenomics Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia.,Sydney Medical School, University of Sydney, Camperdown, New South Wales 2050, Australia.,Concord Repatriation General Hospital, Concord, New South Wales 2139, Australia
| | - Patricia Bastick
- Pharmacogenomics Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia.,St George Hospital, Kogarah, New South Wales 2217, Australia
| | - Karen Briscoe
- Pharmacogenomics Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia.,Mid North Coast Cancer Institute, Coffs Harbour Health Campus, Coffs Harbour, New South Wales 2450, Australia
| | - Gavin Marx
- Pharmacogenomics Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia.,Sydney Adventist Hospital, Wahroonga, New South Wales 2076, Australia
| | - Alexander Swarbrick
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia.,St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Darlinghurst, New South Wales 2010, Australia
| | - Lisa G Horvath
- Cancer Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia.,St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Darlinghurst, New South Wales 2010, Australia.,Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales 2050, Australia.,Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia.,Pharmacogenomics Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia.,Sydney Medical School, University of Sydney, Camperdown, New South Wales 2050, Australia
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19
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Bruce HM, Stricker PD, Gupta R, Savdie RR, Haynes AM, Mahon KL, Lin HM, Kench JG, Horvath LG. Loss of AZGP1 as a Superior Predictor of Relapse in Margin-Positive Localized Prostate Cancer. Prostate 2016; 76:1491-1500. [PMID: 27473574 DOI: 10.1002/pros.23233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/21/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Positive surgical margins (PSMs) in localized prostate cancer (PC) confer a two- to three-fold increased risk of biochemical relapse (BR). Absent/weak AZGP1 expression and Gleason grade ≥4 at the margin are each independent predictors of BR in patients with PSMs. Our study aimed to determine whether the biomarkers AZGP1 expression and Gleason grade at the site of a PSM are significant independent markers of biochemical and clinical relapse (CR) when modeled together and whether one of these biomarkers may be superior in its capacity to predict outcome. METHODS A cohort of 275 consecutive patients with margin-positive localized PC following surgery were assessed for Gleason grade and AZGP1 expression at the PSM. BR-free survival was the primary end-point, while CR-free survival and PC-specific death were secondary endpoints. Kaplan-Meier Analysis and Cox Proportional Hazards Modeling were performed. RESULTS Absent AZGP1 expression was significantly associated with increased risk of BR (P = 0.001) and PC-specific death (P = 0.02). Gleason grade ≥4 at PSM was associated with BR (P = 0.02), CR (P = 0.003), and PC-specific death (P = 0.004). On multivariable analysis, absent AZGP1 expression remained an independent predictor of BR (HR 2.4, 95%CI 1.5-3.9, P < 0.001) when modeled with Gleason grade at margin (HR 1.3, 95%CI 0.9-1.9, P = 0.16), preoperative PSA (P = 0.002), seminal vesicle involvement (P = 0.002), extraprostatic extension (P = 0.001), Gleason score (P = 0.01), adjuvant treatment (P = 0.75), linear length of the involved margin (P = 0.001) and margin number (P = 0.09). CONCLUSION Absent AZGP1 expression is an independent predictor of BR in margin-positive localized PC and is associated with increased PC-specific mortality in a Phase II study. Absent AZGP1 expression was superior to Gleason grade at PSM in predicting relapse and should be incorporated into subsequent clinical trials of post-operative radiotherapy in men with margin-positive PC. Prostate 76:1491-1500, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Hannah M Bruce
- Division of Cancer Research, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia
- University of New South Wales, Kensington, New South Wales, Australia
| | - Phillip D Stricker
- Division of Cancer Research, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia
- University of New South Wales, Kensington, New South Wales, Australia
- Department of Urology, St Vincent's Clinic, Darlinghurst, New South Wales, Australia
| | - Ruta Gupta
- Division of Cancer Research, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- University of Sydney, Camperdown, New South Wales, Australia
| | - Richard R Savdie
- Department of Urology, St Vincent's Clinic, Darlinghurst, New South Wales, Australia
| | - Anne-Maree Haynes
- Division of Cancer Research, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia
| | - Kate L Mahon
- Division of Cancer Research, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia
- University of Sydney, Camperdown, New South Wales, Australia
- Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Hui-Ming Lin
- Division of Cancer Research, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia
| | - James G Kench
- Division of Cancer Research, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- University of Sydney, Camperdown, New South Wales, Australia
| | - Lisa G Horvath
- Division of Cancer Research, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia.
- University of Sydney, Camperdown, New South Wales, Australia.
- Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
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20
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Abstract
Circulating tumor DNA (ctDNA) in the plasma or serum of cancer patients provides an opportunity for non-invasive sampling of tumor DNA. This 'liquid biopsy' allows for interrogations of DNA such as quantity, chromosomal alterations, sequence mutations and epigenetic changes, and can be used to guide and improve treatment throughout the course of the disease. This tremendous potential for real-time 'tracking' in a cancer patient has led to substantial research efforts in the ctDNA field. ctDNA can be distinguished from non-tumor DNA by the presence of tumor-specific mutations and copy number variations, and also by aberrant DNA methylation, with both DNA sequence and methylation changes corresponding to those found in the tumor. Aberrant methylation of specific promoter regions can be a very consistent feature of cancer, in contrast to mutations, which typically occur at a wide range of sites. This consistency makes ctDNA methylation amenable to the design of widely applicable clinical assays. In this review, we examine ctDNA methylation in the context of monitoring disease status, treatment response and determining the prognosis of cancer patients.
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Affiliation(s)
- Kristina Warton
- Garvan Institute of Medical ResearchThe Kinghorn Cancer Centre and St Vincent's Clinical School, 370 Victoria Street, Darlinghurst, Sydeny, New South Wales, AustraliaChris O'Brien LifehouseCamperdown, New South Wales, Australia
| | - Kate L Mahon
- Garvan Institute of Medical ResearchThe Kinghorn Cancer Centre and St Vincent's Clinical School, 370 Victoria Street, Darlinghurst, Sydeny, New South Wales, AustraliaChris O'Brien LifehouseCamperdown, New South Wales, Australia Garvan Institute of Medical ResearchThe Kinghorn Cancer Centre and St Vincent's Clinical School, 370 Victoria Street, Darlinghurst, Sydeny, New South Wales, AustraliaChris O'Brien LifehouseCamperdown, New South Wales, Australia
| | - Goli Samimi
- Garvan Institute of Medical ResearchThe Kinghorn Cancer Centre and St Vincent's Clinical School, 370 Victoria Street, Darlinghurst, Sydeny, New South Wales, AustraliaChris O'Brien LifehouseCamperdown, New South Wales, Australia
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21
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Mahon KL, Lin HM, Castillo L, Lee BY, Lee-Ng M, Chatfield MD, Chiam K, Breit SN, Brown DA, Molloy MP, Marx GM, Pavlakis N, Boyer MJ, Stockler MR, Daly RJ, Henshall SM, Horvath LG. Cytokine profiling of docetaxel-resistant castration-resistant prostate cancer. Br J Cancer 2015; 112:1340-8. [PMID: 25867259 PMCID: PMC4402456 DOI: 10.1038/bjc.2015.74] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [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: 09/04/2014] [Revised: 01/28/2015] [Accepted: 01/30/2015] [Indexed: 11/25/2022] Open
Abstract
Background: Docetaxel improves symptoms and survival in metastatic castration-resistant prostate cancer (CRPC). However, ∼50% of patients are chemoresistant. This study examined whether changes in cytokine levels predict for docetaxel resistance in vitro and in a clinical cohort. Methods: PC3 cells or their docetaxel-resistant subline (PC3Rx) were co-cultured with U937 monocytes, with and without docetaxel treatment, and cytokine levels were measured. The circulating levels of 28 cytokines were measured pre-/post cycle 1 of docetaxel from 55 men with CRPC, and compared with prostate-specific antigen (PSA) response. Results: PC3Rx-U937 co-culture expressed more cytokines, chiefly markers of alternative macrophage differentiation, compared with PC3-U937 co-culture. Docetaxel treatment enhanced cytokine production by PC3Rx-U937 co-culture, while reducing cytokine levels in PC3-U937. In patients, changes in the levels of seven circulating cytokines (macrophage inhibitory cytokine 1 (MIC1), interleukin (IL)-1ra, IL-1β, IL-4, IL-6, IL-12 and IFNγ) after cycle 1 of docetaxel were associated with progressive disease (all P<0.05). The combination of changes in MIC1, IL-4 and IL-6 most strongly predicted PSA response (P=0.002). Conclusions: In vitro studies suggest docetaxel resistance is mediated, at least in part, by cytokines induced by the interaction between the docetaxel-resistant tumour cells and macrophages. Early changes in circulating cytokine levels were associated with docetaxel resistance in CRPC patients. When considered together, these data suggest a significant role for the inflammatory response and macrophages in the development of docetaxel resistance in CRPC.
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Affiliation(s)
- K L Mahon
- 1] Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia [2] Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, NSW 2010, Australia [3] University of Sydney, Sydney, New South Wales 2050, Australia
| | - H-M Lin
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, NSW 2010, Australia
| | - L Castillo
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, NSW 2010, Australia
| | - B Y Lee
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, NSW 2010, Australia
| | - M Lee-Ng
- St Vincent's Centre for Applied Medical Research, Liverpool Street, Darlinghurst, NSW 2010, Australia
| | - M D Chatfield
- Menzies School of Health Research, Darwin, NT, Australia
| | - K Chiam
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, NSW 2010, Australia
| | - S N Breit
- St Vincent's Centre for Applied Medical Research, Liverpool Street, Darlinghurst, NSW 2010, Australia
| | - D A Brown
- St Vincent's Centre for Applied Medical Research, Liverpool Street, Darlinghurst, NSW 2010, Australia
| | - M P Molloy
- Australian Proteome Analysis Facility, Macquarie University, NSW 2105, Australia
| | - G M Marx
- Northern Haematology and Oncology Group, SAN Clinic, Wahroonga, NSW 2076, Australia
| | - N Pavlakis
- Royal North Shore Hospital, Pacific Highway, Sydney, NSW 2065, Australia
| | - M J Boyer
- 1] Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia [2] University of Sydney, Sydney, New South Wales 2050, Australia
| | - M R Stockler
- 1] Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia [2] University of Sydney, Sydney, New South Wales 2050, Australia
| | - R J Daly
- Signalling Network Laboratory, Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, Monash University, Clayton, VIC 3800, Australia
| | - S M Henshall
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, NSW 2010, Australia
| | - L G Horvath
- 1] Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia [2] Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, NSW 2010, Australia [3] University of Sydney, Sydney, New South Wales 2050, Australia
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22
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Mahon KL, Qu W, Devaney J, Paul C, Castillo L, Wykes RJ, Chatfield MD, Boyer MJ, Stockler MR, Marx G, Gurney H, Mallesara G, Molloy PL, Horvath LG, Clark SJ. Methylated Glutathione S-transferase 1 (mGSTP1) is a potential plasma free DNA epigenetic marker of prognosis and response to chemotherapy in castrate-resistant prostate cancer. Br J Cancer 2014; 111:1802-9. [PMID: 25144624 PMCID: PMC4453725 DOI: 10.1038/bjc.2014.463] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [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: 04/17/2014] [Revised: 07/16/2014] [Accepted: 07/24/2014] [Indexed: 12/25/2022] Open
Abstract
Background: Glutathione S-transferase 1 (GSTP1) inactivation is associated with CpG island promoter hypermethylation in the majority of prostate cancers (PCs). This study assessed whether the level of circulating methylated GSTP1 (mGSTP1) in plasma DNA is associated with chemotherapy response and overall survival (OS). Methods: Plasma samples were collected prospectively from a Phase I exploratory cohort of 75 men with castrate-resistant PC (CRPC) and a Phase II independent validation cohort (n=51). mGSTP1 levels in free DNA were measured using a sensitive methylation-specific PCR assay. Results: The Phase I cohort identified that detectable baseline mGSTP1 DNA was associated with poorer OS (HR, 4.2 95% CI 2.1–8.2; P<0.0001). A decrease in mGSTP1 DNA levels after cycle 1 was associated with a PSA response (P=0.008). In the Phase II cohort, baseline mGSTP1 DNA was a stronger predictor of OS than PSA change after 3 months (P=0.02). Undetectable plasma mGSTP1 after one cycle of chemotherapy was associated with PSA response (P=0.007). Conclusions: We identified plasma mGSTP1 DNA as a potential prognostic marker in men with CRPC as well as a potential surrogate therapeutic efficacy marker for chemotherapy and corroborated these findings in an independent Phase II cohort. Prospective Phase III assessment of mGSTP1 levels in plasma DNA is now warranted.
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Affiliation(s)
- K L Mahon
- 1] Chris O'Brien Lifehouse, Missenden Rd, Camperdown, New South Wales, 2050, Australia [2] Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, 2010, Australia [3] Sydney Medical School, University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - W Qu
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, 2010, Australia
| | - J Devaney
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, 2010, Australia
| | - C Paul
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, 2010, Australia
| | - L Castillo
- Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, 2010, Australia
| | - R J Wykes
- Royal Prince Alfred Hospital, Missenden Rd, Camperdown, New South Wales, 2050, Australia
| | - M D Chatfield
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - M J Boyer
- 1] Chris O'Brien Lifehouse, Missenden Rd, Camperdown, New South Wales, 2050, Australia [2] Sydney Medical School, University of Sydney, Camperdown, New South Wales, 2050, Australia [3] Royal Prince Alfred Hospital, Missenden Rd, Camperdown, New South Wales, 2050, Australia
| | - M R Stockler
- 1] Chris O'Brien Lifehouse, Missenden Rd, Camperdown, New South Wales, 2050, Australia [2] Sydney Medical School, University of Sydney, Camperdown, New South Wales, 2050, Australia [3] NHMRC Clinical Trials Centre, University of Sydney, New South Wales, 2050, Australia
| | - G Marx
- 1] Sydney Medical School, University of Sydney, Camperdown, New South Wales, 2050, Australia [2] Northern Haematology and Oncology Group, SAN Clinic, Wahroonga, New South Wales, 2076, Australia
| | - H Gurney
- 1] Sydney Medical School, University of Sydney, Camperdown, New South Wales, 2050, Australia [2] Westmead Hospital, Sydney, New South Wales, Australia
| | - G Mallesara
- Calvary Mater Newcastle, New South Wales, Australia
| | - P L Molloy
- CSIRO Animal, Food and Health Sciences, North Ryde, New South Wales, 2113, Australia
| | - L G Horvath
- 1] Chris O'Brien Lifehouse, Missenden Rd, Camperdown, New South Wales, 2050, Australia [2] Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, 2010, Australia [3] Sydney Medical School, University of Sydney, Camperdown, New South Wales, 2050, Australia [4] Royal Prince Alfred Hospital, Missenden Rd, Camperdown, New South Wales, 2050, Australia
| | - S J Clark
- 1] Cancer Research Division, Garvan Institute of Medical Research/The Kinghorn Cancer Centre, Darlinghurst, New South Wales, 2010, Australia [2] St Vincent's Clinical School, University of NSW, Sydney, 2010, New South Wales, Australia
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23
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Lin HM, Castillo L, Mahon KL, Chiam K, Lee BY, Nguyen Q, Boyer MJ, Stockler MR, Pavlakis N, Marx G, Mallesara G, Gurney H, Clark SJ, Swarbrick A, Daly RJ, Horvath LG. Circulating microRNAs are associated with docetaxel chemotherapy outcome in castration-resistant prostate cancer. Br J Cancer 2014; 110:2462-71. [PMID: 24714754 PMCID: PMC4021524 DOI: 10.1038/bjc.2014.181] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [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] [Revised: 02/03/2014] [Accepted: 03/13/2014] [Indexed: 12/18/2022] Open
Abstract
Background: Docetaxel is the first-line chemotherapy for castration-resistant prostate cancer (CRPC). However, response rates are ∼50% and determined quite late in the treatment schedule, thus non-responders are subjected to unnecessary toxicity. The potential of circulating microRNAs as early biomarkers of docetaxel response in CRPC patients was investigated in this study. Methods: Global microRNA profiling was performed on docetaxel-resistant and sensitive cell lines to identify candidate circulating microRNA biomarkers. Custom Taqman Array MicroRNA cards were used to measure the levels of 46 candidate microRNAs in plasma/serum samples, collected before and after docetaxel treatment, from 97 CRPC patients. Results: Fourteen microRNAs were associated with serum prostate-specific antigen (PSA) response or overall survival, according to Mann–Whitney U or log-rank tests. Non-responders to docetaxel and patients with shorter survival generally had high pre-docetaxel levels of miR-200 family members or decreased/unchanged post-docetaxel levels of miR-17 family members. Multivariate Cox regression with bootstrapping validation showed that pre-docetaxel miR-200b levels, post-docetaxel change in miR-20a levels, pre-docetaxel haemoglobin levels and visceral metastasis were independent predictors of overall survival when modelled together. Conclusions: Our study suggests that circulating microRNAs are potential early predictors of docetaxel chemotherapy outcome, and warrant further investigation in clinical trials.
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Affiliation(s)
- H-M Lin
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
| | - L Castillo
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
| | - K L Mahon
- 1] Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia [2] Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia
| | - K Chiam
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
| | - B Y Lee
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
| | - Q Nguyen
- 1] Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia [2] Pharmacogenomic Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia
| | - M J Boyer
- 1] Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia [2] Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales 2050, Australia [3] Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia
| | - M R Stockler
- 1] Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia [2] Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales 2050, Australia [3] Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia [4] Medical Oncology, Concord Repatriation General Hospital, Concord, New South Wales 2139, Australia
| | - N Pavlakis
- 1] Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia [2] Medical Oncology, Royal North Shore Hospital, St Leonards, New South Wales 2065, Australia
| | - G Marx
- 1] Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia [2] Northern Haematology and Oncology Group, Sydney Adventist Hospital, Wahroonga, New South Wales 2076, Australia
| | - G Mallesara
- 1] Pharmacogenomic Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia [2] Calvary Mater Newcastle Hospital, Waratah, New South Wales 2298, Australia
| | - H Gurney
- 1] Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia [2] Pharmacogenomic Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia [3] Westmead Hospital, Westmead, New South Wales 2145, Australia
| | - S J Clark
- 1] Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia [2] St Vincent's Clinical School, Faculty of Medicine, UNSW Australia, Sydney, New South Wales, Australia
| | - A Swarbrick
- 1] Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia [2] St Vincent's Clinical School, Faculty of Medicine, UNSW Australia, Sydney, New South Wales, Australia
| | - R J Daly
- Signalling Network Laboratory, School of Biomedical Sciences, Monash University, Clayton, Victoria 3800, Australia
| | - L G Horvath
- 1] Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia [2] Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia [3] Pharmacogenomic Research for Individualised Medicine (PRIMe) consortium, New South Wales, Australia [4] Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales 2050, Australia [5] Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia
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24
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Abstract
Chemotherapy remains the major treatment option for castration-resistant prostate cancer (CRPC) and limited cytotoxic options are available. Inherent chemotherapy resistance occurs in half of all patients and inevitably develops even in those who initially respond. Docetaxel has been the mainstay of therapy for 6 years, providing a small survival benefit at the cost of significant toxicity. Cabazitaxel is a promising second-line agent; however, it is no less toxic, whereas mitoxantrone provides only symptomatic benefit. Multiple cellular pathways involving apoptosis, inflammation, angiogenesis, signalling intermediaries, drug efflux pumps and tubulin are implicated in the development of chemoresistance. A thorough understanding of these pathways is needed to identify biomarkers that predict chemotherapy resistance with the aim to avoid unwarranted toxicities in patients who will not benefit from treatment. Until recently, the search for predictive biomarkers has been disappointing; however, the recent discovery of macrophage inhibitory cytokine 1 as a marker of chemoresistance may herald a new era of biomarker discovery in CRPC. Understanding the interface between this complex array of chemoresistance pathways rather than their study in isolation will be required to effectively predict response and target the late stages of advanced disease. The pre-clinical evidence for these resistance pathways and their progress through clinical trials as therapeutic targets is reviewed in this study.
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Affiliation(s)
- Kate L Mahon
- Department of Medical Oncology, Sydney Cancer Centre, Missenden Road, Camperdown, New South Wales 2050, Australia.
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