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Lachance G, Robitaille K, Laaraj J, Gevariya N, Varin TV, Feldiorean A, Gaignier F, Julien IB, Xu HW, Hallal T, Pelletier JF, Bouslama S, Boufaied N, Derome N, Bergeron A, Ellis L, Piccirillo CA, Raymond F, Fradet Y, Labbé DP, Marette A, Fradet V. The gut microbiome-prostate cancer crosstalk is modulated by dietary polyunsaturated long-chain fatty acids. Nat Commun 2024; 15:3431. [PMID: 38654015 DOI: 10.1038/s41467-024-45332-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 01/17/2024] [Indexed: 04/25/2024] Open
Abstract
The gut microbiota modulates response to hormonal treatments in prostate cancer (PCa) patients, but whether it influences PCa progression remains unknown. Here, we show a reduction in fecal microbiota alpha-diversity correlating with increase tumour burden in two distinct groups of hormonotherapy naïve PCa patients and three murine PCa models. Fecal microbiota transplantation (FMT) from patients with high PCa volume is sufficient to stimulate the growth of mouse PCa revealing the existence of a gut microbiome-cancer crosstalk. Analysis of gut microbial-related pathways in mice with aggressive PCa identifies three enzymes responsible for the metabolism of long-chain fatty acids (LCFA). Supplementation with LCFA omega-3 MAG-EPA is sufficient to reduce PCa growth in mice and cancer up-grading in pre-prostatectomy PCa patients correlating with a reduction of gut Ruminococcaceae in both and fecal butyrate levels in PCa patients. This suggests that the beneficial effect of omega-3 rich diet is mediated in part by modulating the crosstalk between gut microbes and their metabolites in men with PCa.
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Affiliation(s)
- Gabriel Lachance
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
- Centre de recherche de l'IUCPQ, Québec, QC, Canada
| | - Karine Robitaille
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Jalal Laaraj
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Nikunj Gevariya
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | | | - Andrei Feldiorean
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Division of Urology, Department of Surgery, McGill University, Montréal, QC, Canada
| | - Fanny Gaignier
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Isabelle Bourdeau Julien
- Institute of nutrition and functional foods (INAF) and NUTRISS Center - Nutrition, health and society of Université Laval, Québec, QC, Canada
| | - Hui Wen Xu
- Department of Mathematics and Statistics, Université Laval, Québec, QC, Canada
| | - Tarek Hallal
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Department of Anatomy and Cell Biology, McGill University, Montréal, QC, Canada
| | - Jean-François Pelletier
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Sidki Bouslama
- Institut de Biologie Intégrative et des Systèmes (IBIS), Université Laval, Québec, QC, Canada
| | - Nadia Boufaied
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Nicolas Derome
- Institut de Biologie Intégrative et des Systèmes (IBIS), Université Laval, Québec, QC, Canada
- Department of Biology, Université Laval, Québec, QC, Canada
| | - Alain Bergeron
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Leigh Ellis
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Ciriaco A Piccirillo
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
| | - Frédéric Raymond
- Institute of nutrition and functional foods (INAF) and NUTRISS Center - Nutrition, health and society of Université Laval, Québec, QC, Canada
| | - Yves Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - David P Labbé
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Division of Urology, Department of Surgery, McGill University, Montréal, QC, Canada
- Department of Anatomy and Cell Biology, McGill University, Montréal, QC, Canada
| | | | - Vincent Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada.
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada.
- Institute of nutrition and functional foods (INAF) and NUTRISS Center - Nutrition, health and society of Université Laval, Québec, QC, Canada.
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Lafront C, Germain L, Campolina-Silva GH, Weidmann C, Berthiaume L, Hovington H, Brisson H, Jobin C, Frégeau-Proulx L, Cotau R, Gonthier K, Lacouture A, Caron P, Ménard C, Atallah C, Riopel J, Latulippe É, Bergeron A, Toren P, Guillemette C, Pelletier M, Fradet Y, Belleannée C, Pouliot F, Lacombe L, Lévesque É, Audet-Walsh É. The estrogen signaling pathway reprograms prostate cancer cell metabolism and supports proliferation and disease progression. J Clin Invest 2024:e170809. [PMID: 38625747 DOI: 10.1172/jci170809] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Just as the androgen receptor (AR), the estrogen receptor α (ERα) is expressed in the prostate and is thought to influence prostate cancer (PCa) biology. Yet, the incomplete understanding of ERα functions in PCa hinders our ability to fully comprehend its clinical relevance and restricts the repurposing of estrogen-targeted therapies for the treatment of this disease. Using two human PCa tissue microarray cohorts, we first demonstrated that nuclear ERα expression was heterogeneous among patients, being only detected in half of tumors. Positive nuclear ERα levels were correlated with disease recurrence, progression to metastatic PCa, and patient survival. Using in vitro and in vivo models of the normal prostate and PCa, bulk and single-cell RNA-Seq analyses revealed that estrogens partially mimic the androgen transcriptional response and induce specific biological pathways linked to proliferation and metabolism. Bioenergetic flux assays and metabolomics confirmed the regulation of cancer metabolism by estrogens, supporting proliferation. Using cancer cell lines and patient-derived organoids, selective estrogen receptor modulators, a pure anti-estrogen, and genetic approaches impaired cancer cell proliferation and growth in an ERα-dependent manner. Overall, our study revealed that, when expressed, ERα functionally reprograms PCa metabolism, is associated with disease progression, and could be targeted for therapeutic purposes.
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Affiliation(s)
- Camille Lafront
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | - Lucas Germain
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | | | - Cindy Weidmann
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Line Berthiaume
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Hélène Hovington
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Hervé Brisson
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Cynthia Jobin
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | | | - Raul Cotau
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Kevin Gonthier
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | - Aurélie Lacouture
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | - Patrick Caron
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Claire Ménard
- Department of Medicine, Université Laval, Québec City, Canada
| | - Chantal Atallah
- Department of Medicine, Université Laval, Québec City, Canada
| | - Julie Riopel
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Éva Latulippe
- Department of Pathology, CHU de Québec-Université Laval, Québec City, Canada
| | - Alain Bergeron
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Paul Toren
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Chantal Guillemette
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Martin Pelletier
- Department of Microbiology-Infectious Diseases and Immunology, Université Laval, Québec City, Canada
| | - Yves Fradet
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Clémence Belleannée
- Department of Obstetrics, Gynecology, and Reproduction, Université Laval, Québec City, Canada
| | - Frédéric Pouliot
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Louis Lacombe
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Éric Lévesque
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
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Robitaille K, Guertin MH, Jamshidi A, Xu HW, Hovington H, Pelletier JF, Beaudoin L, Gevariya N, Lacombe L, Tiguert R, Caumartin Y, Dujardin T, Toren P, Lodde M, Racine É, Trudel D, Perigny M, Duchesne T, Savard J, Julien P, Fradet Y, Fradet V. A phase IIb randomized placebo-controlled trial testing the effect of MAG-EPA long-chain omega-3 fatty acid dietary supplement on prostate cancer proliferation. Commun Med (Lond) 2024; 4:56. [PMID: 38519581 PMCID: PMC10960033 DOI: 10.1038/s43856-024-00456-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 02/07/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND High prostate eicosapentaenoic fatty acid (EPA) levels were associated with a significant reduction of upgrading to grade group (GG) ≥ 2 prostate cancer in men under active surveillance. We aimed to evaluate the effect of MAG-EPA long-chain omega-3 fatty acid dietary supplement on prostate cancer proliferation. METHODS A phase II double-blind randomized placebo-controlled trial was conducted in 130 men diagnosed with GG ≥ 2 prostate cancer and undergoing radical prostatectomy between 2015-2017 (Clinicaltrials.gov: NCT02333435). Participants were randomized to receive 3 g daily of either MAG-EPA (n = 65) or placebo (n = 65) for 7 weeks (range 4-10) prior to radical prostatectomy. The primary outcome was the cancer proliferation index quantified by automated image analysis of tumor nuclear Ki-67 expression using standardized prostatectomy tissue microarrays. Additional planned outcomes at surgery are reported including plasma levels of 27 inflammatory cytokines and fatty acid profiles in circulating red blood cells membranes and prostate tissue. RESULTS Cancer proliferation index measured by Ki-67 expression was not statistically different between the intervention (3.10%) and placebo (2.85%) groups (p = 0.64). In the per protocol analyses, the adjusted estimated effect of MAG-EPA was greater but remained non-significant. Secondary outcome was the changes in plasma levels of 27 cytokines, of which only IL-7 was higher in MAG-EPA group compared to placebo (p = 0.026). Men randomized to MAG-EPA prior to surgery had four-fold higher EPA levels in prostate tissue compared to those on placebo. CONCLUSIONS This MAG-EPA intervention did not affect the primary outcome of prostate cancer proliferation according to nuclear Ki-67 expression. More studies are needed to decipher the effects of long-chain omega-3 fatty acid dietary supplementation in men with prostate cancer.
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Affiliation(s)
- Karine Robitaille
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- Institute of nutrition and functional foods (INAF) and NUTRISS Center - Nutrition, health and society of Université Laval, Québec, G1V 0A6, Canada
| | - Marie-Hélène Guertin
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Afshin Jamshidi
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
| | - Hui Wen Xu
- Department of Mathematics and Statistics, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Hélène Hovington
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
| | | | - Lisanne Beaudoin
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
| | - Nikunj Gevariya
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
| | - Louis Lacombe
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Rabi Tiguert
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
| | - Yves Caumartin
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
| | - Thierry Dujardin
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
| | - Paul Toren
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Michele Lodde
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
| | - Étienne Racine
- Department of Pathology, CHU de Québec-Université Laval, Québec, QC, G1R 2J6, Canada
| | - Dominique Trudel
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) et Institut du cancer de Montréal, and Department of Pathology and Cellular Biology, Université de Montréal, Montréal, H3C 3J7, Canada
| | - Martine Perigny
- Department of Pathology, CHU de Québec-Université Laval, Québec, QC, G1R 2J6, Canada
| | - Thierry Duchesne
- Department of Mathematics and Statistics, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Josée Savard
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- School of psychology, Université Laval, Montréal, QC, G1R 2J6, Canada
| | - Pierre Julien
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Yves Fradet
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Vincent Fradet
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada.
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada.
- Institute of nutrition and functional foods (INAF) and NUTRISS Center - Nutrition, health and society of Université Laval, Québec, G1V 0A6, Canada.
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada.
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Garneau CA, Marcotte N, Lacombe L, Fradet Y, Fradet V, Pouliot F, Toren P, Lodde M. Salvage therapy for BCG failure with intravesical sequential gemcitabine and docetaxel in patients with recurrent NMIBC. Can Urol Assoc J 2024; 18:33-40. [PMID: 37931285 PMCID: PMC10841565 DOI: 10.5489/cuaj.8341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Bacillus Calmette-Guérin (BCG) failure occurs in approximately 40% of patients with non-muscle-invasive bladder cancer (NMIBC) within two years. We describe our institutional experience with sequential intravesical gemcitabine and docetaxel (gem/doce) as salvage therapy post-BCG failure in patients who were not candidates for or declined radical cystectomy (RC). METHODS We retrospectively reviewed NMIBC patients with BCG failure who received gem/doce from April 2019 through October 2022 at the CHU de Québec-Université Laval. Patients received at least five weekly intravesical instillations according to published protocols. Patients who responded to gem/doce had maintenance instillations monthly for up to two years. Primary outcome was progression-free survival (PFS). Secondary outcomes included recurrence-free survival (RFS), cystectomy-free survival (CFS), cancer-specific survival (CSS), overall survival (OS), and treatment adverse events. Survival probabilities were estimated using the Kaplan-Meier method from the first gem/doce instillation. RESULTS Thirty-five patients with a median age of 78 years old were included in the study. The median followup time was 21 months (interquartile range 10-29). More than 25% of patients received two or more prior BCG induction treatments. Overall and MIBC PFS estimates at one year were 85% and 88%, and at two years, 60% and 70%, respectively. Adverse events occurred in 37% of the patients, but only two patients didn't complete the treatment due to intolerance. Three patients underwent RC due to cancer progression. OS was 94% at two years. CONCLUSIONS With 60% of PFS at two years, gem/doce appears to be a safe and well-tolerated option for BCG failure patients. Further studies are needed to justify widespread use.
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Affiliation(s)
- Charles-Antoine Garneau
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec City, QC, Canada
| | - Nathalie Marcotte
- Department of Pharmacy, Unité pour l’usage optimal du médicament et la recherche (UGMR), CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Louis Lacombe
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec City, QC, Canada
| | - Yves Fradet
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec City, QC, Canada
| | - Vincent Fradet
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec City, QC, Canada
| | - Frédéric Pouliot
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec City, QC, Canada
| | - Paul Toren
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec City, QC, Canada
| | - Michele Lodde
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec City, QC, Canada
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5
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Savard J, Moussa H, Pelletier J, Julien P, Lacombe L, Tiguert R, Caumartin Y, Dujardin T, Toren P, Pouliot F, Lodde M, Fradet Y, Robitaille K, Fradet V. Effects of omega-3 supplementation on psychological symptoms in men with prostate cancer: Secondary analysis of a double-blind placebo-controlled randomized trial. Cancer Med 2023; 12:20163-20176. [PMID: 37787025 PMCID: PMC10587967 DOI: 10.1002/cam4.6598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND In the general population, a higher omega-3 polyunsaturated fatty acids intake is associated with lower levels of several psychological symptoms, especially depression. However, the existing evidence in cancer is equivocal. METHODS This phase IIB double-blind, placebo-controlled trial was aimed at comparing the effects of eicosapentaenoic acid monoacylglyceride (MAG-EPA) supplementation and high oleic acid sunflower oil (HOSO; placebo) on depression levels (primary outcome) and other symptoms (anxiety, fear of cancer recurrence, fatigue, insomnia, perceived cognitive impairments; secondary outcomes). Participants, recruited in a prostate cancer clinic, were randomized to MAG-EPA (3.75 g daily; n = 65) or HOSO (3.75 g daily; n = 65) for 1 year post-radical prostatectomy (RP), starting 4-10 weeks before surgery. Patients completed self-report scales at baseline (before RP) and 3, 6, 9, and 12 months after: Hospital Anxiety and Depression Scale (HADS), Fear of Cancer Recurrence Inventory (FCRI), Insomnia Severity Index (ISI), Fatigue Symptom Inventory (FSI), and Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). RESULTS Analyses showed significant reductions in HADS-depression, HADS-anxiety, FCRI, ISI, FSI-number of days, and FACT-Cog-impact scores over time. A significant group-by-time interaction was obtained on FACT-Cog-Impact scores only; yet, the temporal change was significant in HOSO patients only. CONCLUSIONS Several symptoms significantly decreased over time, mainly within the first months of the study. However, MAG-EPA did not produce greater reductions than HOSO. Omega-3 supplementation does not seem to improve psychological symptoms of men treated with RP.
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Affiliation(s)
- Josée Savard
- School of PsychologyUniversité LavalQuébecCanada
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
| | - Hanane Moussa
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
- Faculty of MedicineUniversité LavalQuébecCanada
| | - Jean‐François Pelletier
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
| | | | - Louis Lacombe
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
- Faculty of MedicineUniversité LavalQuébecCanada
| | - Rabi Tiguert
- CHU de Québec‐Université Laval Research CenterQuébecCanada
| | - Yves Caumartin
- CHU de Québec‐Université Laval Research CenterQuébecCanada
| | | | - Paul Toren
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
- Faculty of MedicineUniversité LavalQuébecCanada
| | - Frédéric Pouliot
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
- Faculty of MedicineUniversité LavalQuébecCanada
| | - Michele Lodde
- CHU de Québec‐Université Laval Research CenterQuébecCanada
| | - Yves Fradet
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
- Faculty of MedicineUniversité LavalQuébecCanada
| | - Karine Robitaille
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
| | - Vincent Fradet
- CHU de Québec‐Université Laval Research CenterQuébecCanada
- Université Laval Cancer Research CenterQuébecCanada
- Faculty of MedicineUniversité LavalQuébecCanada
- Institute of Nutrition and Functional Foods (INAF) and NutritionHealth and Society (NUTRISS) center of Université LavalQuébecCanada
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6
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Gonthier K, Weidmann C, Berthiaume L, Jobin C, Lacouture A, Lafront C, Harvey M, Neveu B, Loehr J, Bergeron A, Fradet Y, Lacombe L, Riopel J, Latulippe É, Atallah C, Shum M, Lambert J, Pouliot F, Pelletier M, Audet‐Walsh É. Isocitrate dehydrogenase 1 sustains a hybrid cytoplasmic-mitochondrial tricarboxylic acid cycle that can be targeted for therapeutic purposes in prostate cancer. Mol Oncol 2023; 17:2109-2125. [PMID: 37086156 PMCID: PMC10552900 DOI: 10.1002/1878-0261.13441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/07/2023] [Accepted: 04/21/2023] [Indexed: 04/23/2023] Open
Abstract
The androgen receptor (AR) is an established orchestrator of cell metabolism in prostate cancer (PCa), notably by inducing an oxidative mitochondrial program. Intriguingly, AR regulates cytoplasmic isocitrate dehydrogenase 1 (IDH1), but not its mitochondrial counterparts IDH2 and IDH3. Here, we aimed to understand the functional role of IDH1 in PCa. Mouse models, in vitro human PCa cell lines, and human patient-derived organoids (PDOs) were used to study the expression and activity of IDH enzymes in the normal prostate and PCa. Genetic and pharmacological inhibition of IDH1 was then combined with extracellular flux analyses and gas chromatography-mass spectrometry for metabolomic analyses and cancer cell proliferation in vitro and in vivo. In PCa cells, more than 90% of the total IDH activity is mediated through IDH1 rather than its mitochondrial counterparts. This profile seems to originate from the specialized prostate metabolic program, as observed using mouse prostate and PDOs. Pharmacological and genetic inhibition of IDH1 impaired mitochondrial respiration, suggesting that this cytoplasmic enzyme contributes to the mitochondrial tricarboxylic acid cycle (TCA) in PCa. Mass spectrometry-based metabolomics confirmed this hypothesis, showing that inhibition of IDH1 impairs carbon flux into the TCA cycle. Consequently, inhibition of IDH1 decreased PCa cell proliferation in vitro and in vivo. These results demonstrate that PCa cells have a hybrid cytoplasmic-mitochondrial TCA cycle that depends on IDH1. This metabolic enzyme represents a metabolic vulnerability of PCa cells and a potential new therapeutic target.
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Affiliation(s)
- Kevin Gonthier
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Department of Molecular Medicine, Faculty of MedicineUniversité LavalQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Cindy Weidmann
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Line Berthiaume
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Cynthia Jobin
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Department of Molecular Medicine, Faculty of MedicineUniversité LavalQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Aurélie Lacouture
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Department of Molecular Medicine, Faculty of MedicineUniversité LavalQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Camille Lafront
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Department of Molecular Medicine, Faculty of MedicineUniversité LavalQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Mario Harvey
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Bertrand Neveu
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Oncology AxisCentre de recherche du CHU de Québec – Université LavalCanada
| | - Jérémy Loehr
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Alain Bergeron
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Oncology AxisCentre de recherche du CHU de Québec – Université LavalCanada
- Department of Surgery, Faculty of MedicineUniversité LavalQuébecCanada
| | - Yves Fradet
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Oncology AxisCentre de recherche du CHU de Québec – Université LavalCanada
- Department of Surgery, Faculty of MedicineUniversité LavalQuébecCanada
| | - Louis Lacombe
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Oncology AxisCentre de recherche du CHU de Québec – Université LavalCanada
- Department of Surgery, Faculty of MedicineUniversité LavalQuébecCanada
| | - Julie Riopel
- Anatomopathology Service, Department of Laboratory MedicineCHU de Québec – Université LavalCanada
| | - Éva Latulippe
- Department of PathologyCHU de Québec – Université LavalCanada
| | - Chantal Atallah
- Department of PathologyCHU de Québec – Université LavalCanada
| | - Michael Shum
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Department of Molecular Medicine, Faculty of MedicineUniversité LavalQuébecCanada
| | - Jean‐Philippe Lambert
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Department of Molecular Medicine, Faculty of MedicineUniversité LavalQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Big Data Research CenterUniversité LavalQuébecQCCanada
| | - Frédéric Pouliot
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Oncology AxisCentre de recherche du CHU de Québec – Université LavalCanada
- Department of Surgery, Faculty of MedicineUniversité LavalQuébecCanada
| | - Martin Pelletier
- Infectious and Immune Disease AxisCHU de Québec‐Université Laval Research CenterCanada
- ARThrite Research CenterUniversité LavalQuébecQCCanada
- Department of Microbiology‐Infectious Diseases and Immunology, Faculty of MedicineUniversité LavalQuébecQCCanada
| | - Étienne Audet‐Walsh
- Endocrinology – Nephrology Research AxisCHU de Québec‐Université Laval Research CenterCanada
- Department of Molecular Medicine, Faculty of MedicineUniversité LavalQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
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7
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Molina OE, LaRue H, Simonyan D, Hovington H, Têtu B, Fradet V, Lacombe L, Toren P, Bergeron A, Fradet Y. High infiltration of CD209 + dendritic cells and CD163 + macrophages in the peritumor area of prostate cancer is predictive of late adverse outcomes. Front Immunol 2023; 14:1205266. [PMID: 37435060 PMCID: PMC10331466 DOI: 10.3389/fimmu.2023.1205266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/09/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction Prostate cancer (PCa) shows considerable variation in clinical outcomes between individuals with similar diseases. The initial host-tumor interaction as assessed by detailed analysis of tumor infiltrating immune cells within the primary tumor may dictate tumor evolution and late clinical outcomes. In this study, we assessed the association between clinical outcomes and dendritic cell (DC) or macrophage (MΦ) tumor infiltration as well as with expression of genes related to their functions. Methods Infiltration and localization of immature DC, mature DC, total MΦ and M2-type MΦ was analyzed by immunohistochemistry in 99 radical prostatectomy specimens from patients with 15.5 years median clinical follow-up using antibodies against CD209, CD83, CD68 and CD163, respectively. The density of positive cells for each marker in various tumor areas was determined. In addition, expression of immune genes associated with DC and MΦ was tested in a series of 50 radical prostatectomy specimens by Taqman Low-Density Array with similarly long follow-up. Gene expression was classified as low and high after unsupervised hierarchical clustering. Numbers and ratio of positive cells and levels of gene expression were correlated with endpoints such as biochemical recurrence (BCR), need for definitive androgen deprivation therapy (ADT) or lethal PCa using Cox regression analyses and/or Kaplan-Meier curves. Results Positive immune cells were observed in tumor, tumor margin, and normal-like adjacent epithelium areas. CD209+ and CD163+ cells were more abundant at the tumor margin. Higher CD209+/CD83+ cell density ratio at the tumor margin was associated with higher risk of ADT and lethal PCa while higher density of CD163+ cells in the normal-like adjacent epithelium was associated with a higher risk of lethal PCa. A combination of 5 genes expressed at high levels correlated with a shorter survival without ADT and lethal PCa. Among these five genes, expression of IL12A and CD163 was correlated to each other and was associated with shorter survival without BCR and ADT/lethal PCa, respectively. Conclusion A higher level of infiltration of CD209+ immature DC and CD163+ M2-type MΦ in the peritumor area was associated with late adverse clinical outcomes.
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Affiliation(s)
- Oscar Eduardo Molina
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
| | - Hélène LaRue
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
| | - David Simonyan
- Plateforme de Recherche Clinique et Évaluative, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Hélène Hovington
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
| | - Bernard Têtu
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
| | - Vincent Fradet
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
- Département de Chirurgie de l’Université Laval, Québec, QC, Canada
| | - Louis Lacombe
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
- Département de Chirurgie de l’Université Laval, Québec, QC, Canada
| | - Paul Toren
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
- Département de Chirurgie de l’Université Laval, Québec, QC, Canada
| | - Alain Bergeron
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
- Département de Chirurgie de l’Université Laval, Québec, QC, Canada
| | - Yves Fradet
- Axe Oncologie, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC, Canada
- Département de Chirurgie de l’Université Laval, Québec, QC, Canada
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Diop MK, Molina OE, Birlea M, LaRue H, Hovington H, Têtu B, Lacombe L, Bergeron A, Fradet Y, Trudel D. Leukocytic Infiltration of Intraductal Carcinoma of the Prostate: An Exploratory Study. Cancers (Basel) 2023; 15:cancers15082217. [PMID: 37190147 DOI: 10.3390/cancers15082217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
Intraductal carcinoma of the prostate (IDC-P) is an aggressive histological subtype of prostate cancer (PCa) detected in approximately 20% of radical prostatectomy (RP) specimens. As IDC-P has been associated with PCa-related death and poor responses to standard treatment, the purpose of this study was to explore the immune infiltrate of IDC-P. Hematoxylin- and eosin-stained slides from 96 patients with locally advanced PCa who underwent RP were reviewed to identify IDC-P. Immunohistochemical staining of CD3, CD8, CD45RO, FoxP3, CD68, CD163, CD209 and CD83 was performed. For each slide, the number of positive cells per mm2 in the benign tissues, tumor margins, cancer and IDC-P was calculated. Consequently, IDC-P was found in a total of 33 patients (34%). Overall, the immune infiltrate was similar in the IDC-P-positive and the IDC-P-negative patients. However, FoxP3+ regulatory T cells (p < 0.001), CD68+ and CD163+ macrophages (p < 0.001 for both) and CD209+ and CD83+ dendritic cells (p = 0.002 and p = 0.013, respectively) were less abundant in the IDC-P tissues compared to the adjacent PCa. Moreover, the patients were classified as having immunologically "cold" or "hot" IDC-P, according to the immune-cell densities averaged in the total IDC-P or in the immune hotspots. The CD68/CD163/CD209-immune hotspots predicted metastatic dissemination (p = 0.014) and PCa-related death (p = 0.009) in a Kaplan-Meier survival analysis. Further studies on larger cohorts are necessary to evaluate the clinical utility of assessing the immune infiltrate of IDC-P with regards to patient prognosis and the use of immunotherapy for lethal PCa.
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Affiliation(s)
- Mame-Kany Diop
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (axe Cancer) and Institut du Cancer de Montréal, 900 Saint-Denis, Montréal, QC H2X 0A9, Canada
- Department of Pathology and Cellular Biology, Université de Montréal, 2900 Boulevard Édouard-Montpetit, Montréal, QC H3T 1J4, Canada
| | - Oscar Eduardo Molina
- Centre de Recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L'Hôtel-Dieu de Québec, 9 McMahon, Québec, QC G1R 3S3, Canada
| | - Mirela Birlea
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (axe Cancer) and Institut du Cancer de Montréal, 900 Saint-Denis, Montréal, QC H2X 0A9, Canada
| | - Hélène LaRue
- Centre de Recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L'Hôtel-Dieu de Québec, 9 McMahon, Québec, QC G1R 3S3, Canada
| | - Hélène Hovington
- Centre de Recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L'Hôtel-Dieu de Québec, 9 McMahon, Québec, QC G1R 3S3, Canada
| | - Bernard Têtu
- Centre de Recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L'Hôtel-Dieu de Québec, 9 McMahon, Québec, QC G1R 3S3, Canada
- Department of Pathology, CHU de Québec-Université Laval, 11 Côte du Palais, Québec, QC G1R 2J6, Canada
| | - Louis Lacombe
- Centre de Recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L'Hôtel-Dieu de Québec, 9 McMahon, Québec, QC G1R 3S3, Canada
- Department of Surgery, Université Laval, 2325 rue de l'Université, Québec, QC G1V 0A6, Canada
| | - Alain Bergeron
- Centre de Recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L'Hôtel-Dieu de Québec, 9 McMahon, Québec, QC G1R 3S3, Canada
- Department of Surgery, Université Laval, 2325 rue de l'Université, Québec, QC G1V 0A6, Canada
| | - Yves Fradet
- Centre de Recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L'Hôtel-Dieu de Québec, 9 McMahon, Québec, QC G1R 3S3, Canada
- Department of Surgery, Université Laval, 2325 rue de l'Université, Québec, QC G1V 0A6, Canada
| | - Dominique Trudel
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (axe Cancer) and Institut du Cancer de Montréal, 900 Saint-Denis, Montréal, QC H2X 0A9, Canada
- Department of Pathology and Cellular Biology, Université de Montréal, 2900 Boulevard Édouard-Montpetit, Montréal, QC H3T 1J4, Canada
- Department of Pathology, Centre Hospitalier de l'Université de Montréal, 1051 Sanguinet, Montréal, QC H2X 0C1, Canada
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9
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Gonthier K, Weidmann C, Berthiaume L, Jobin C, Lacouture A, Lafront C, Harvey M, Neveu B, Loehr J, Bergeron A, Fradet Y, Lacombe L, Riopel J, Latulippe É, Atallah C, Shum M, Lambert JP, Pouliot F, Pelletier M, Audet-Walsh É. Abstract 3700: Isocitrate dehydrogenase 1 sustains a hybrid cytoplasmic-mitochondrial tricarboxylic acid cycle in prostate cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Background: The androgen receptor (AR) is an established orchestrator of cell metabolism in prostate cancer (PCa), notably by inducing an oxidative mitochondrial program. Intriguingly, AR regulates cytoplasmic isocitrate dehydrogenase 1 (IDH1) but not its mitochondrial counterparts IDH2 and IDH3. Here, we aimed to understand the functional role of IDH1 in PCa.
Methods: Mouse models, in vitro human PCa cell lines, and human prostate organoids were used to study the expression and activity of IDH enzymes in the normal prostate and PCa. Genetic and pharmacological inhibition of IDH1 was then combined with extracellular flux analysis and gas chromatography-mass spectrometry for metabolomic analyses and cancer cell proliferation in vitro and in vivo.
Results: In PCa cells, more than 90% of the total IDH activity is mediated through IDH1 rather than its mitochondrial counterparts. This profile seems to originate from the specialized prostate metabolic program, as observed using mouse prostate and human patient-derived organoids. Pharmacological and genetic inhibition of IDH1 impaired mitochondrial respiration, suggesting that this cytoplasmic enzyme contributes to the mitochondrial tricarboxylic acid cycle (TCA) in PCa. Mass spectrometry-based metabolomics confirmed this hypothesis, showing that inhibition of IDH1 impairs carbon flux into the TCA cycle. Consequently, inhibition of IDH1 decreased PCa cell proliferation in vitro and in vivo.
Conclusions: These results demonstrate that PCa cells have a hybrid cytoplasmic-mitochondrial TCA cycle that depends on IDH1. This metabolic enzyme represents a metabolic vulnerability of PCa cells and a potential new therapeutic target.
Citation Format: Kevin Gonthier, Cindy Weidmann, Line Berthiaume, Cynthia Jobin, Aurélie Lacouture, Camille Lafront, Mario Harvey, Bertrand Neveu, Jérémy Loehr, Alain Bergeron, Yves Fradet, Louis Lacombe, Julie Riopel, Éva Latulippe, Chantal Atallah, Michael Shum, Jean-Philippe Lambert, Frédéric Pouliot, Martin Pelletier, Étienne Audet-Walsh. Isocitrate dehydrogenase 1 sustains a hybrid cytoplasmic-mitochondrial tricarboxylic acid cycle in prostate cancer. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3700.
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Affiliation(s)
| | - Cindy Weidmann
- 2CRCHU de Québec-Université Laval, Québec, Quebec, Canada
| | | | | | | | | | - Mario Harvey
- 2CRCHU de Québec-Université Laval, Québec, Quebec, Canada
| | | | - Jérémy Loehr
- 2CRCHU de Québec-Université Laval, Québec, Quebec, Canada
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10
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Moussa H, Robitaille K, Pelletier JF, Tourigny R, Fradet Y, Lacombe L, Toren P, Lodde M, Tiguert R, Dujardin T, Caumartin Y, Duchesne T, Julien P, Savard J, Diorio C, Fradet V. Effects of Concentrated Long-Chain Omega-3 Polyunsaturated Fatty Acid Supplementation on Quality of Life after Radical Prostatectomy: A Phase II Randomized Placebo-Controlled Trial (RCT-EPA). Nutrients 2023; 15:nu15061369. [PMID: 36986098 PMCID: PMC10052536 DOI: 10.3390/nu15061369] [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: 02/10/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/16/2023] Open
Abstract
Prostate cancer (PCa) and associated treatments incur symptoms that may impact patients’ quality of life. Studies have shown beneficial relationships between diet, especially omega-3 fatty acids, and these symptoms. Unfortunately, only few data describing the relationship between long-chain omega-3 fatty acids (LCn3) and PCa-related symptoms in patients are available. The purpose of this study was to evaluate the effects of LCn3 supplementation on PCa-specific quality of life in 130 men treated by radical prostatectomy. Men were randomized to receive a daily dose of either 3.75 g of fish oil or a placebo starting 7 weeks before surgery and for up to one-year post-surgery. Quality of life was assessed using the validated EPIC-26 and IPSS questionnaires at randomization, at surgery, and every 3 months following surgery. Between-group differences were assessed using linear mixed models. Intention-to-treat analyses showed no significant difference between the two groups. However, at 12-month follow-up, per-protocol analyses showed a significantly greater increase in the urinary irritation function score (better urinary function) (MD = 5.5, p = 0.03) for the LCn3 group compared to placebo. These results suggest that LCn3 supplementation may improve the urinary irritation function in men with PCa treated by radical prostatectomy and support to conduct of larger-scale studies.
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Affiliation(s)
- Hanane Moussa
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
- Institute of Nutrition and Functional Foods (INAF) and NUTRISS Center—Nutrition, Health and Society of Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC G1R 3S3, Canada
| | - Karine Robitaille
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
- Institute of Nutrition and Functional Foods (INAF) and NUTRISS Center—Nutrition, Health and Society of Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC G1R 3S3, Canada
| | | | - Roxane Tourigny
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
- Institute of Nutrition and Functional Foods (INAF) and NUTRISS Center—Nutrition, Health and Society of Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC G1R 3S3, Canada
| | - Yves Fradet
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC G1R 3S3, Canada
- Centre Intégré de Cancérologie du CHU de Québec-Université Laval, Québec, QC G1J 5B3, Canada
| | - Louis Lacombe
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC G1R 3S3, Canada
- Centre Intégré de Cancérologie du CHU de Québec-Université Laval, Québec, QC G1J 5B3, Canada
| | - Paul Toren
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC G1R 3S3, Canada
- Centre Intégré de Cancérologie du CHU de Québec-Université Laval, Québec, QC G1J 5B3, Canada
| | - Michele Lodde
- Centre Intégré de Cancérologie du CHU de Québec-Université Laval, Québec, QC G1J 5B3, Canada
| | - Rabi Tiguert
- Centre Intégré de Cancérologie du CHU de Québec-Université Laval, Québec, QC G1J 5B3, Canada
| | - Thierry Dujardin
- Centre Intégré de Cancérologie du CHU de Québec-Université Laval, Québec, QC G1J 5B3, Canada
| | - Yves Caumartin
- Centre Intégré de Cancérologie du CHU de Québec-Université Laval, Québec, QC G1J 5B3, Canada
| | - Thierry Duchesne
- Department of Mathematics and Statistics, Université Laval, Québec, QC G1V 0A6, Canada
| | - Pierre Julien
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
| | - Josée Savard
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC G1R 3S3, Canada
- School of Psychology, Université Laval, Québec, QC G1V 0A6, Canada
| | - Caroline Diorio
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
| | - Vincent Fradet
- CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S1, Canada
- Institute of Nutrition and Functional Foods (INAF) and NUTRISS Center—Nutrition, Health and Society of Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche sur le Cancer de l’Université Laval, Québec, QC G1R 3S3, Canada
- Centre Intégré de Cancérologie du CHU de Québec-Université Laval, Québec, QC G1J 5B3, Canada
- Correspondence:
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11
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Balar AV, Castellano DE, Grivas P, Vaughn DJ, Powles T, Vuky J, Fradet Y, Lee JL, Fong L, Vogelzang NJ, Climent MA, Necchi A, Petrylak DP, Plimack ER, Xu JZ, Imai K, Moreno BH, Bellmunt J, de Wit R, O'Donnell PH. Efficacy and safety of pembrolizumab in metastatic urothelial carcinoma: results from KEYNOTE-045 and KEYNOTE-052 after up to 5 years of follow-up. Ann Oncol 2023; 34:289-299. [PMID: 36494006 DOI: 10.1016/j.annonc.2022.11.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors are a standard therapy in metastatic urothelial carcinoma (UC). Long-term follow-up is necessary to confirm durability of response and identify further safety concerns. PATIENTS AND METHODS In KEYNOTE-045, patients with metastatic UC that progressed on platinum-containing chemotherapy were randomly assigned 1:1 to receive pembrolizumab or investigator's choice of paclitaxel, docetaxel, or vinflunine. Primary endpoints were progression-free survival per RECIST version 1.1 by blinded independent central review (BICR) and overall survival. In KEYNOTE-052, cisplatin-ineligible patients with metastatic UC received first-line pembrolizumab. The primary endpoint was objective response rate per RECIST version 1.1 by BICR. RESULTS A total of 542 patients (pembrolizumab, n = 270; chemotherapy, n = 272) were randomly assigned in KEYNOTE-045. The median follow-up was 62.9 months (range 58.6-70.9 months; data cut-off 1 October 2020). At 48 months, overall survival rates were 16.7% for pembrolizumab and 10.1% for chemotherapy; progression-free survival rates were 9.5% and 2.7%, respectively. The median duration of response (DOR) was 29.7 months (range 1.6+ to 60.5+ months) for pembrolizumab and 4.4 months (range 1.4+ to 63.1+ months) for chemotherapy; 36-month DOR rates were 44.4% and 28.3%, respectively. A total of 370 patients were enrolled in KEYNOTE-052. The median follow-up was 56.3 months (range 51.2-65.3 months; data cut-off 26 September 2020). The confirmed objective response rate was 28.9% (95% confidence interval 24.3-33.8), and the median DOR was 33.4 months (range 1.4+ to 60.7+ months); the 36-month DOR rate was 44.8%. Most treatment-related adverse events for pembrolizumab in either study were grade 1 or 2 and manageable, which is consistent with prior reports. CONCLUSION With ∼5 years of follow-up, pembrolizumab monotherapy continued to demonstrate durable efficacy with no new safety signals in patients with platinum-resistant metastatic UC and as first-line therapy in cisplatin-ineligible patients. CLINICAL TRIAL REGISTRY AND ID With ClinicalTrials.gov NCT02256436 (KEYNOTE-045); https://clinicaltrials.gov/ct2/show/NCT02256436 and NCT02335424 (KEYNOTE-052); https://clinicaltrials.gov/ct2/show/NCT02335424.
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Affiliation(s)
- A V Balar
- Perlmutter Cancer Center, New York University Langone Health, New York, USA
| | - D E Castellano
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Grivas
- Department of Medicine, Division of Oncology, University of Washington, Fred Hutchinson Cancer Center, Seattle
| | - D J Vaughn
- Division of Hematology/Oncology, Abramson Cancer Center, Penn Medicine, Philadelphia, USA
| | - T Powles
- Department of Genitourinary Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - J Vuky
- Department of Medicine/Oncology, Oregon Health and Science University, Knight Cancer Institute, Portland, USA
| | - Y Fradet
- Department of Surgery/Urology, CHU de Québec-Université Laval, Québec City, Canada
| | - J-L Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - L Fong
- Department of Medicine, University of California San Francisco, San Francisco
| | - N J Vogelzang
- Department of Medical Oncology, Comprehensive Cancer Centers of Nevada, Las Vegas, USA
| | - M A Climent
- Department of Medical Oncology, Fundación Instituto Valenciano de Oncología, València, Spain
| | - A Necchi
- Department of Medical Oncology, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy
| | - D P Petrylak
- Department of Internal Medicine/Medical Oncology, Smilow Cancer Hospital, Yale New Haven Health, New Haven, USA
| | - E R Plimack
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, USA
| | - J Z Xu
- Department of Medical Oncology, Merck & Co., Inc., Rahway, USA
| | - K Imai
- Department of Medical Oncology, Merck & Co., Inc., Rahway, USA
| | - B H Moreno
- Department of Medical Oncology, Merck & Co., Inc., Rahway, USA
| | - J Bellmunt
- Department of Hematology and Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - R de Wit
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
| | - P H O'Donnell
- Department of Medicine, Section of Hematology/Oncology, The University of Chicago, Chicago, USA.
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12
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Lacombe L, Hovington H, Brisson H, Mehdi S, Beillevaire D, Émond JP, Wagner A, Villeneuve L, Simonyan D, Ouellet V, Barrès V, Latour M, Aprikian A, Bergeron A, Castonguay V, Couture F, Chevalier S, Brimo F, Fazli L, Fleshner N, Gleave M, Karakiewicz PI, Lattouf JB, Trudel D, van der Kwast T, Mes-Masson AM, Pouliot F, Fradet Y, Audet-Walsh E, Saad F, Guillemette C, Lévesque E. UGT2B28 accelerates prostate cancer progression through stabilization of the endocytic adaptor protein HIP1 regulating AR and EGFR pathways. Cancer Lett 2023; 553:215994. [PMID: 36343786 DOI: 10.1016/j.canlet.2022.215994] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/28/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Abstract
The androgen inactivating UGT2B28 pathway emerges as a predictor of progression in prostate cancer (PCa). However, the clinical significance of UGT2B28 tumoral expression and its contribution to PCa progression remain unclear. Using the Canadian Prostate Cancer Biomarker Network biobank (CPCBN; n = 1512), we analyzed UGT2B28 tumor expression in relation to clinical outcomes in men with localized PCa. UGT2B28 was overexpressed in tumors compared to paired normal adjacent prostatic tissue and was associated with inferior outcomes. Functional analyses indicated that UGT2B28 promoted cell proliferation, and its expression was regulated by the androgen receptor (AR)/ARv7. Mechanistically, UGT2B28 was shown to be a protein partner of the endocytic adaptor protein huntingtin-interacting protein 1 (HIP1), increasing its stability and priming AR/epidermal growth factor receptor (EGFR) pathways, leading to ERK1/2 activation triggering cell proliferation and epithelial-to-mesenchymal transition (EMT). HIP1 knockdown in UGT2B28 positive cells, and dual pharmacological targeting of AR and EGFR pathways, abolished cell proliferative advantages conferred by UGT2B28. In conclusion, UGT2B28 is a prognosticator of progression in localized PCa, regulates both AR and EGFR oncogenic signaling pathways via HIP1, and therefore can be therapeutically targeted by using combination of existing AR/EGFR inhibitors.
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Affiliation(s)
- Louis Lacombe
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada.
| | - Hélène Hovington
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Hervé Brisson
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Sadia Mehdi
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Déborah Beillevaire
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Jean-Philippe Émond
- Pharmacogenomics Laboratory, CRCHUQc-UL, Centre de recherche sur le cancer (CRC) de l'Université Laval and Faculty of Pharmacy, Université Laval, Québec, Québec, Canada
| | - Antoine Wagner
- Pharmacogenomics Laboratory, CRCHUQc-UL, Centre de recherche sur le cancer (CRC) de l'Université Laval and Faculty of Pharmacy, Université Laval, Québec, Québec, Canada
| | - Lyne Villeneuve
- Pharmacogenomics Laboratory, CRCHUQc-UL, Centre de recherche sur le cancer (CRC) de l'Université Laval and Faculty of Pharmacy, Université Laval, Québec, Québec, Canada
| | - David Simonyan
- Clinical and Evaluative Research Platform, CRCHUQc-UL, Québec, Québec, Canada
| | - Véronique Ouellet
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Véronique Barrès
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Mathieu Latour
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Armen Aprikian
- Research Institute of the McGill University Health Centre and Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Alain Bergeron
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Vincent Castonguay
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Félix Couture
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Simone Chevalier
- Research Institute of the McGill University Health Centre and Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Fadi Brimo
- Research Institute of the McGill University Health Centre and Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Ladan Fazli
- Vancouver Prostate Cancer Centre, Vancouver, British Columbia, Canada
| | | | - Martin Gleave
- Vancouver Prostate Cancer Centre, Vancouver, British Columbia, Canada
| | - Pierre I Karakiewicz
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Jean-Baptiste Lattouf
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Dominique Trudel
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | | | - Anne-Marie Mes-Masson
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Frédéric Pouliot
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Yves Fradet
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Etienne Audet-Walsh
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Fred Saad
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Chantal Guillemette
- Pharmacogenomics Laboratory, CRCHUQc-UL, Centre de recherche sur le cancer (CRC) de l'Université Laval and Faculty of Pharmacy, Université Laval, Québec, Québec, Canada.
| | - Eric Lévesque
- Centre de recherche du Centre Hospitalier Universitaire de Québec - Université Laval (CRCHUQc-UL), Centre de recherche sur le cancer (CRC) de l'Université Laval, Faculty of Medicine, Université Laval, Québec, Québec, Canada.
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13
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Fadel J, Simonyan D, Fradet V, Lodde M, Lacombe L, Fradet Y, Toren P. Analysis of sex-based differences to Bacillus Calmette-Guérin for non-muscle invasive bladder cancer. Urol Oncol 2022; 40:539.e1-539.e8. [PMID: 36272848 DOI: 10.1016/j.urolonc.2022.09.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate whether differences exist between men and women in response to intravesical BCG treatments. The incidence of urothelial carcinoma of the bladder is lower in women but they tend to present with more aggressive and advanced disease. Some prior studies also suggest there are sex-based differences in response to treatment for non-muscle invasive bladder tumors. METHODS In this retrospective study, we reviewed all consecutive patients who received BCG at the CHU de Québec - Laval University from 2009-2019. Men and women were treated with intravesical BCG therapy following pathologic confirmation of urothelial carcinoma. Outcomes evaluated include recurrence, progression, and treatment tolerability. Recurrence was defined as a pathology confirmed cancer whereas progression was the new development of high-grade (recurrence) pathology or an increase of stage. Tolerability was defined according to the proportion of prescribed BCG received. All clinical details were obtained through review of the medical records, collaborated by pharmacy records for BCG administration. Competing-risk analysis was used to compare outcomes. RESULTS Among 613 patients who received BCG at our institution between 2009-2019, 472 (77.0%) were men and 141 (23.0%) were women. The recurrence rate was not different between sexes, with a 5-year recurrence risk of 52% (95% CI: 36.93-65.4) among women compared to 57.5% (CI 95%: 51.9-62.6) among men. The overall non-progression rate at 1,3 and 5 years was 97.3% (95% CI: 95.6%-98.3%), 93.6% (95% CI: 91.2%-95.4%), and 91.7% (95% CI: 88.4%-94.1%), respectively. The completion of ≥5 induction BCG instillations and maintenance BCG use was similar in both genders. CONCLUSIONS We report a contemporary NMIBC cohort treated with BCG and find no clear evidence for sex-based differences in response to BCG treatment in regard of progression, recurrence, and tolerability.
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Affiliation(s)
- Jonathan Fadel
- Faculty of Medicine, Department of Surgery, Université Laval, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Oncology Division
| | - David Simonyan
- Clinical and Evaluative Research Platform, CHU de Québec-Université Laval Research Centre, Québec, QC, Canada
| | - Vincent Fradet
- Faculty of Medicine, Department of Surgery, Université Laval, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Oncology Division
| | - Michele Lodde
- Faculty of Medicine, Department of Surgery, Université Laval, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Oncology Division
| | - Louis Lacombe
- Faculty of Medicine, Department of Surgery, Université Laval, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Oncology Division
| | - Yves Fradet
- Faculty of Medicine, Department of Surgery, Université Laval, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Oncology Division
| | - Paul Toren
- Faculty of Medicine, Department of Surgery, Université Laval, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Oncology Division.
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14
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Turcotte B, Bélanger L, Blais AS, Blouin AC, Bolduc S, Bolduc-Mokhtar A, Bureau M, Caumartin Y, Cloutier J, Deschênes-Rompré MP, Dujardin T, Fradet Y, Gaudreau N, Lacombe L, Moore K, Morin F, Nadeau G, Paquet S, Simard F, Simonyan D, Soucy F, Tiguert R, Toren P, Lodde M, Pouliot F. Perception and satisfaction of patients after telemedicine urology consultations: A matched analysis with physicians' perspective. Can Urol Assoc J 2022; 16:334-339. [PMID: 35621285 PMCID: PMC9565072 DOI: 10.5489/cuaj.7819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
INTRODUCTION During the first regional COVID-19 lockdown in March 2020, we conducted a study aimed at evaluating completeness of telemedicine consultation in urology. Of 1679 consultations, 67% were considered completely managed by phone. The aim of the present study was to assess patients' experience and satisfaction with telemedicine and to compare them with urologists' perceptions about quality and completeness of the telemedicine consultation. METHODS We contacted a randomly selected sample of patients (n=356) from our previous study to enquire about their experience. We used a home patient experience questionnaire, inspired by the Patient Experiences Questionnaire for Out-of-Hours Care (PEQOHC) and the Consumer Assessment Health Profile Survey (CAHPS). RESULTS Of 356 patients contacted, 315 agreed to complete the questionnaire. Urological consultations were for non-oncological (104), oncological (121), cancer suspicion (41), and pediatric (49) indications. Mean patient satisfaction score after telemedicine consultation was 8.8/10 (median 9/10) and 86.3% of patients rated the quality of the consultation as either excellent (54.6%) or very good (31.7%). Consultations regarding cancer suspicion had the lowest score (8.3/10). Overall, 46.7% of all patients would have preferred an in-person visit outside of the pandemic situation. Among patients whose consultations were rated suboptimal by urologists, almost a third more (31.2%) would have preferred an in-person visit (p=0.03). CONCLUSIONS Despite high reported patient satisfaction rates with telemedicine, it is noteworthy that nearly half of the patients would have preferred an in-person visit. Post-pandemic, it will be important to incorporate telemedicine as an alternative, while retaining and offering in-person visits.
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Affiliation(s)
- Bruno Turcotte
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Lynda Bélanger
- Office of Patient Experience Expertise, CHU de Québec-Université Laval, Quebec, QC, Canada
- Department of Nursing Sciences and School of Design (Public Services), Université Laval, Quebec, QC, Canada
| | - Anne-Sophie Blais
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Annie-Claude Blouin
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Stéphane Bolduc
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Amélie Bolduc-Mokhtar
- Office of Patient Experience Expertise, CHU de Québec-Université Laval, Quebec, QC, Canada
| | - Michel Bureau
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Yves Caumartin
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Jonathan Cloutier
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | | | - Thierry Dujardin
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Yves Fradet
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Noémie Gaudreau
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Louis Lacombe
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Katherine Moore
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Fannie Morin
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Geneviève Nadeau
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Sophie Paquet
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Francis Simard
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - David Simonyan
- Clinical and Evaluative Research Platform, Research Center, CHU de Québec-Université Laval, Quebec, QC, Canada
| | - Frédéric Soucy
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Rabi Tiguert
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Paul Toren
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Michele Lodde
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
| | - Frédéric Pouliot
- Division of Urology, Department of Surgery, CHU de Québec–Université Laval, Quebec, QC, Canada
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De Wit R, Vaughn D, Fradet Y, Fong L, Vogelzang N, Climent Duran M, Necchi A, Petrylak D, Gerritsen W, Gurney H, Quinn D, Culine S, Sternberg C, Bajorin D, Choueiri T, Xu J, Imai K, Homet Moreno B, Bellmunt J, Lee JL. 1747P Impact of prior chemotherapy (Chemo) on pembrolizumab (Pembro) response in urothelial cancer (UC): Exploratory analysis of the phase III KEYNOTE-045 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Mapepe P, Lachance G, Jamshidi A, Castonguay-Paradis S, Veilleux A, Marette A, Bergeron A, Fradet Y, Raymond F, Robitaille K, Fradet V. Relations entre habitudes de vie, microbiote intestinal et risque de cancer de la prostate. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Tourigny R, Moussa H, Robitaille K, Bussières V, Saad F, Carmel M, Aprikian A, Fradet Y, Network BIOCGR, Fradet V. 271 - Analyse de la qualité de vie des hommes à risque de cancer de la prostate. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Bellmunt J, de Wit R, Fradet Y, Climent MA, Petrylak DP, Lee JL, Fong L, Necchi A, Sternberg CN, O'Donnell PH, Powles T, Plimack ER, Bajorin DF, Balar AV, Castellano D, Choueiri TK, Culine S, Gerritsen W, Gurney H, Quinn DI, Vuky J, Vogelzang NJ, Cristescu R, Lunceford J, Saadatpour A, Loboda A, Ma J, Rajasagi M, Godwin JL, Homet Moreno B, Grivas P. Putative Biomarkers of Clinical Benefit With Pembrolizumab in Advanced Urothelial Cancer: Results from the KEYNOTE-045 and KEYNOTE-052 Landmark Trials. Clin Cancer Res 2022; 28:2050-2060. [PMID: 35247908 DOI: 10.1158/1078-0432.ccr-21-3089] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE In an exploratory analysis, we investigated the association between programmed death ligand 1 (PD-L1), tumor mutational burden (TMB), T-cell-inflamed gene expression profile (TcellinfGEP), and stromal signature with outcomes of pembrolizumab in urothelial carcinoma (UC). PATIENTS AND METHODS Patients with advanced UC received first-line pembrolizumab 200 mg every 3 weeks in the single-arm phase II KEYNOTE-052 trial (NCT02335424) and salvage pembrolizumab 200 mg every 3 weeks or chemotherapy (paclitaxel/docetaxel/vinflunine) in the randomized phase III KEYNOTE-045 trial (NCT02256436). The association of each biomarker (continuous variable) with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) was evaluated using logistic regression (ORR) and Cox PH (PFS, OS), adjusted for ECOG PS; nominal P values were calculated without multiplicity adjustment (one-sided, pembrolizumab; two-sided, chemotherapy). Significance was prespecified at α = 0.05. RESULTS In KEYNOTE-052, PD-L1, TMB, and TcellinfGEP were significantly associated with improved outcomes; stromal signature was significantly associated with worse outcomes. In KEYNOTE-045, although findings for TMB and TcellinfGEP with pembrolizumab were consistent with those of KEYNOTE-052, PD-L1 was not significantly associated with improved outcomes, nor was stromal signature associated with worse outcomes with pembrolizumab; chemotherapy was not associated with outcomes in a consistent manner for any of the biomarkers. Hazard ratio (HR) estimates at prespecified cutoffs showed an advantage for pembrolizumab versus chemotherapy regardless of PD-L1 or TMB, with a trend toward lower HRs in the combined positive score ≥10 and the TMB ≥175 mutation/exome subgroup. For TcellinfGEP, PFS and OS HRs were lower in the TcellinfGEP-nonlow subgroup regardless of treatment. CONCLUSIONS Multiple biomarkers characterizing the tumor microenvironment may help predict response to pembrolizumab monotherapy in UC, and potential clinical utility of these biomarkers may be context-dependent.
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Affiliation(s)
- Joaquim Bellmunt
- Department of Hematology and Oncology, Beth Israel Deaconess Medical Center, and IMIM-PSMAR Lab Harvard Medical School, Boston, Massachusetts
| | - Ronald de Wit
- Department of MedOnc, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Yves Fradet
- Department of Surgery/Urology, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec City, QC, Canada
| | - Miguel A Climent
- Department of Medical Oncology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Daniel P Petrylak
- Department of Internal Medicine/Medical Oncology, Yale New Haven Health, Smilow Cancer Hospital, New Haven, Connecticut
| | - Jae-Lyun Lee
- Department of Oncology, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Lawrence Fong
- Department of Medicine, UCLA, Los Angeles, California
| | - Andrea Necchi
- Department of Medical Oncology, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Cora N Sternberg
- Englander Institute for Precision Medicine, Department of Hematology and Oncology, Weill Cornell Medicine, Meyer Cancer Center, New York, New York
| | - Peter H O'Donnell
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, Illinois
| | - Thomas Powles
- Department of Genitourinary Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Elizabeth R Plimack
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Dean F Bajorin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Arjun V Balar
- Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York
| | - Daniel Castellano
- Department of Medical Oncology, Hospital Universitario 12 de Octubre (CiberOnc), Madrid, Spain
| | | | - Stephane Culine
- Department of Medical Oncology, Hôpital Saint-Louis, Paris, France
| | - Winald Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Howard Gurney
- Department of Medical Oncology, Westmead Hospital and Macquarie University, Sydney, NSW, Australia
| | - David I Quinn
- Department of Medicine, USC Norris Comprehensive Cancer Center, Los Angeles, California
| | - Jacqueline Vuky
- Department of Medicine/Oncology, Oregon Health & Science University, Portland, Oregon
| | - Nicholas J Vogelzang
- Department of Medical Oncology, Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada
| | - Razvan Cristescu
- Department of Translational Medicine, Merck & Co., Inc., Kenilworth, New Jersey
| | - Jared Lunceford
- Department of Translational Oncology Statistics, Merck & Co., Inc., Kenilworth, New Jersey
| | - Assieh Saadatpour
- Department of Genome and Biomarker Sciences, Merck & Co., Inc., Kenilworth, New Jersey
| | - Andrey Loboda
- Department of Translational Medicine, Merck & Co., Inc., Kenilworth, New Jersey
| | - Junshui Ma
- Department of Translational Oncology Statistics, Merck & Co., Inc., Kenilworth, New Jersey
| | - Mohini Rajasagi
- Department of Oncology Early Development, Merck & Co., Inc., Kenilworth, New Jersey
| | | | | | - Petros Grivas
- Department of Medicine, Division of Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, Washington
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19
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Frégeau-Proulx L, Lacouture A, Berthiaume L, Weidmann C, Harvey M, Gonthier K, Pelletier JF, Neveu B, Jobin C, Bastien D, Bergeron A, Fradet Y, Lacombe L, Laverdière I, Atallah C, Pouliot F, Audet-Walsh É. Multiple metabolic pathways fuel the truncated tricarboxylic acid cycle of the prostate to sustain constant citrate production and secretion. Mol Metab 2022; 62:101516. [PMID: 35598879 PMCID: PMC9168698 DOI: 10.1016/j.molmet.2022.101516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 11/15/2022] Open
Abstract
Objective The prostate is metabolically unique: it produces high levels of citrate for secretion via a truncated tricarboxylic acid (TCA) cycle to maintain male fertility. In prostate cancer (PCa), this phenotype is reprogrammed, making it an interesting therapeutic target. However, how the truncated prostate TCA cycle works is still not completely understood. Methods We optimized targeted metabolomics in mouse and human organoid models in ex vivo primary culture. We then used stable isotope tracer analyses to identify the pathways that fuel citrate synthesis. Results First, mouse and human organoids were shown to recapitulate the unique citrate-secretory program of the prostate, thus representing a novel model that reproduces this unusual metabolic profile. Using stable isotope tracer analysis, several key nutrients were shown to allow the completion of the prostate TCA cycle, revealing a much more complex metabolic profile than originally anticipated. Indeed, along with the known pathway of aspartate replenishing oxaloacetate, glutamine was shown to fuel citrate synthesis through both glutaminolysis and reductive carboxylation in a GLS1-dependent manner. In human organoids, aspartate entered the TCA cycle at the malate entry point, upstream of oxaloacetate. Our results demonstrate that the citrate-secretory phenotype of prostate organoids is supported by the known aspartate–oxaloacetate–citrate pathway, but also by at least three additional pathways: glutaminolysis, reductive carboxylation, and aspartate–malate conversion. Conclusions Our results add a significant new dimension to the prostate citrate-secretory phenotype, with at least four distinct pathways being involved in citrate synthesis. Better understanding this distinctive citrate metabolic program will have applications in both male fertility as well as in the development of novel targeted anti-metabolic therapies for PCa. Targeted metabolomics and stable isotope tracer analysis were optimized in mouse and human prostate organoids. Organoids recapitulate the unique citrate-secretory phenotype of the prostate. Glutamine fuels citrate synthesis for secretion by glutaminolysis and reductive carboxylation. Aspartate enters the TCA cycle at different entry points in mouse and human prostate organoids for citrate production. We revealed a much more complex TCA cycle in the prostate than originally anticipated.
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Affiliation(s)
- Lilianne Frégeau-Proulx
- Endocrinology - Nephrology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Aurélie Lacouture
- Endocrinology - Nephrology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Line Berthiaume
- Endocrinology - Nephrology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Cindy Weidmann
- Endocrinology - Nephrology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Mario Harvey
- Endocrinology - Nephrology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Kevin Gonthier
- Endocrinology - Nephrology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Jean-François Pelletier
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada; Oncology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada
| | - Bertrand Neveu
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada; Oncology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada
| | - Cynthia Jobin
- Endocrinology - Nephrology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada
| | - Dominic Bastien
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada; Oncology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada
| | - Alain Bergeron
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada; Oncology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Yves Fradet
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada; Oncology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Louis Lacombe
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada; Oncology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Isabelle Laverdière
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada; Oncology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Department of Pharmacy, CHU de Québec - Université Laval, Québec, QC, Canada
| | - Chantal Atallah
- Department of Pathology, CHU de Québec - Université Laval, Québec, QC, Canada
| | - Frédéric Pouliot
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada; Oncology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Étienne Audet-Walsh
- Endocrinology - Nephrology Research Axis, CHU de Québec - Université Laval Research Center, Québec, QC, Canada; Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le Cancer de l'Université Laval, Québec, QC, Canada.
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20
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Berrehail Z, Boibessot C, Gris T, Joncas FH, Gaignier F, Guillemette C, Lacombe L, Fradet Y, Toren P. Sex steroid modulation of macrophages within the prostate tumor microenvironment. Am J Clin Exp Urol 2022; 10:98-110. [PMID: 35528461 PMCID: PMC9077148] [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] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The role of androgens and other sex steroids is known to influence the prognosis and progression of prostate cancer through different disease states. While androgens are generally regarded as immunosuppressive and estrogens as inflammatory, the specific influence of sex steroids on the immune microenvironment of prostate tumors remains incompletely understood. MATERIAL AND METHODS In this study, we evaluate the link between sex steroids and prostate cancer immune cells, particularly macrophages. Using in vitro and in vivo models, as well as ex vivo culture of patient prostate tissue, we evaluated the influence of androgen, estrogen, and progesterone on immune cells of the prostate microenvironment. RESULTS In vitro, we observed sex steroids induced indirect changes on prostate cancer cell proliferation via THP-1 derived macrophages, but no clear changes were induced using human monocyte derived macrophages. Comparing immunohistochemistry for immunosuppressive macrophage marker CD163 with concomitant circulating sex steroids from the same patients, we observed a correlation with higher dehydroepiandrosterone (DHEA)-sulfate and estrone-sulfate levels associated with higher prostate CD163 expression. Similar relationships between DHEA and CD163 levels were observed in ex vivo cultured prostate biopsies. Finally, in a murine prostate cancer model of long-term sex steroids we observed significant differences in tumor growth in mice implanted with estrogen and DHEA diffusion tubes. CONCLUSIONS Our results highlight the complex influence of sex steroids on the immune cell composition of prostate tumors. Understanding this biology may help to further personalized therapy and improve patient outcomes.
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Affiliation(s)
- Zohra Berrehail
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
| | - Clovis Boibessot
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
| | - Typhaine Gris
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
| | - France-Hélène Joncas
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
| | - Fanny Gaignier
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
| | - Chantal Guillemette
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
- Faculty of Pharmacy, Université Laval, CHU de Québec Research CenterQuebec City, Quebec, Canada
| | - Louis Lacombe
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
- Department of Surgery, Université LavalQuebec City, Quebec, Canada
| | - Yves Fradet
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
- Department of Surgery, Université LavalQuebec City, Quebec, Canada
| | - Paul Toren
- CHU de Québec-Université Laval Research CenterQuebec City, Quebec, Canada
- Cancer Research Center, Université LavalQuebec City, Quebec, Canada
- Department of Surgery, Université LavalQuebec City, Quebec, Canada
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21
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Messaoudene M, Pidgeon R, Richard C, Ponce M, Diop K, Benlaifaoui M, Nolin-Lapalme A, Cauchois F, Malo J, Belkaid W, Isnard S, Fradet Y, Dridi L, Velin D, Oster P, Raoult D, Ghiringhelli F, Boidot R, Chevrier S, Kysela DT, Brun YV, Falcone EL, Pilon G, Oñate FP, Gitton-Quent O, Le Chatelier E, Durand S, Kroemer G, Elkrief A, Marette A, Castagner B, Routy B. A Natural Polyphenol Exerts Antitumor Activity and Circumvents Anti-PD-1 Resistance through Effects on the Gut Microbiota. Cancer Discov 2022; 12:1070-1087. [PMID: 35031549 PMCID: PMC9394387 DOI: 10.1158/2159-8290.cd-21-0808] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/26/2021] [Accepted: 01/11/2022] [Indexed: 01/07/2023]
Abstract
Several approaches to manipulate the gut microbiome for improving the activity of cancer immune-checkpoint inhibitors (ICI) are currently under evaluation. Here, we show that oral supplementation with the polyphenol-rich berry camu-camu (CC; Myrciaria dubia) in mice shifted gut microbial composition, which translated into antitumor activity and a stronger anti-PD-1 response. We identified castalagin, an ellagitannin, as the active compound in CC. Oral administration of castalagin enriched for bacteria associated with efficient immunotherapeutic responses (Ruminococcaceae and Alistipes) and improved the CD8+/FOXP3+CD4+ ratio within the tumor microenvironment. Moreover, castalagin induced metabolic changes, resulting in an increase in taurine-conjugated bile acids. Oral supplementation of castalagin following fecal microbiota transplantation from ICI-refractory patients into mice supported anti-PD-1 activity. Finally, we found that castalagin binds to Ruminococcus bromii and promoted an anticancer response. Altogether, our results identify castalagin as a polyphenol that acts as a prebiotic to circumvent anti-PD-1 resistance. SIGNIFICANCE The polyphenol castalagin isolated from a berry has an antitumor effect through direct interactions with commensal bacteria, thus reprogramming the tumor microenvironment. In addition, in preclinical ICI-resistant models, castalagin reestablishes the efficacy of anti-PD-1. Together, these results provide a strong biological rationale to test castalagin as part of a clinical trial. This article is highlighted in the In This Issue feature, p. 873.
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Affiliation(s)
- Meriem Messaoudene
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Reilly Pidgeon
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Corentin Richard
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Mayra Ponce
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Khoudia Diop
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Myriam Benlaifaoui
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Alexis Nolin-Lapalme
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Florent Cauchois
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Julie Malo
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Wiam Belkaid
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Stephane Isnard
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Yves Fradet
- Centre de recherche du CHU de Québec, Oncology Division, CHU de Québec, Université Laval, Québec City, Quebec, Canada
| | - Lharbi Dridi
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Dominique Velin
- Service of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Paul Oster
- Service of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Didier Raoult
- Aix Marseille Université, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | | | - Romain Boidot
- Unit of Molecular Biology, Department of Biology and Pathology of Tumors, Georges-François Leclerc Cancer Center, UNICANCER, Dijon, France
- UMR CNRS 6302, Dijon, France
| | - Sandy Chevrier
- Unit of Molecular Biology, Department of Biology and Pathology of Tumors, Georges-François Leclerc Cancer Center, UNICANCER, Dijon, France
| | - David T. Kysela
- Faculté de Médecine, Département de Microbiologie, Infectiologie et Immunologie, University of Montreal, Montreal, Quebec, Canada
| | - Yves V. Brun
- Faculté de Médecine, Département de Microbiologie, Infectiologie et Immunologie, University of Montreal, Montreal, Quebec, Canada
| | - Emilia Liana Falcone
- Department of Immunity and Viral Infections, Montreal Clinical Research Institute (IRCM), Montreal, Quebec, Canada
- Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Geneviève Pilon
- Department of Medicine, Faculty of Medicine, Cardiology Axis of the Québec Heart and Lung Institute and Institute of Nutrition and Functional Foods, Laval University, Québec City, Quebec, Canada
| | | | | | | | - Sylvere Durand
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
- Centre de Recherche des Cordeliers, Équipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Institut Universitaire de France, Paris, France
| | - Guido Kroemer
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
- Centre de Recherche des Cordeliers, Équipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Institut Universitaire de France, Paris, France
- Pôle de Biologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Arielle Elkrief
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - André Marette
- Department of Medicine, Faculty of Medicine, Cardiology Axis of the Québec Heart and Lung Institute and Institute of Nutrition and Functional Foods, Laval University, Québec City, Quebec, Canada
| | - Bastien Castagner
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Bertrand Routy
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Hematology-Oncology Division, Department of Medicine, University of Montreal Healthcare Centre (CHUM), Montreal, Quebec, Canada
- Corresponding Author: Bertrand Routy, Hemato-Oncology, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec H2X 3H8, Canada. Phone: 514-890-8000; E-mail:
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22
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Morales-Barrera R, Powles T, Ozguroglu M, Csoszi T, Loriot Y, Flechon A, Matsubara N, Rodriguez-Vida A, Geczi L, Cheng SY, Fradet Y, Oudard S, Gunduz S, Ma J, Rajasagi M, Vajdi A, Cristescu R, Imai K, Homet Moreno B, Alva AS. Association of TMB and PD-L1 with efficacy of first-line pembrolizumab (pembro) or pembro + chemotherapy (chemo) versus chemo in patients (pts) with advanced urothelial carcinoma (UC) from KEYNOTE-361. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
540 Background: The 3-arm, open-label, phase 3 KEYNOTE-361 study (NCT02853305) evaluated first-line pembro ± chemo vs chemo in advanced UC regardless of PD-L1 status. The trial did not meet its primary end points of superior PFS and OS with pembro + chemo vs chemo and thus analysis of pembro monotherapy (mono) vs chemo was exploratory. We explored the association of TMB status and PD-L1 combined positive score (CPS) with clinical outcomes in KEYNOTE-361. Methods: In pts with TMB and/or PD-L1 data, the association between TMB (via whole exome sequencing) and PD-L1 (via PD-L1 IHC 22C3 pharmDx) and clinical outcomes (ORR, PFS, and OS) was evaluated. In each treatment arm, the hypotheses regarding the associations were evaluated using logistic regression (ORR) and Cox proportional hazards regression (PFS; OS), and 1-sided (pembro; pembro + chemo) and 2-sided (chemo) P values were calculated; significance was prespecified at α = 0.05 without multiplicity adjustment. Clinical utility was assessed using prespecified cutoffs of 175 mut/exome (TMB) and CPS 10 (PD-L1). Clinical data cutoff was April 29, 2020. Results: 820/993 pts (82.6%) had evaluable TMB data (pembro, 252; pembro + chemo, 282; chemo, 286). TMB (log10) was significantly positively associated with ORR, PFS, and OS for pembro ( P < 0.001, < 0.001, and 0.007, respectively) and PFS and OS for pembro + chemo ( P= 0.007 and 0.010, respectively). The area under the receiver operating characteristics (AUROC) curve (95% CI) for discriminating response was 0.64 (0.56-0.71) for pembro, 0.53 (0.46-0.60) for pembro + chemo, and 0.52 (0.45-0.59) for chemo. Efficacy by TMB cutoff is reported in the Table. All 993 pts had PD-L1 data (pembro, 302; pembro + chemo, 349; chemo, 342). PD-L1 was significantly positively associated with PFS for pembro ( P= 0.006) and ORR for pembro + chemo ( P= 0.042) but not chemo. Efficacy by PD-L1 CPS is reported in the Table. Conclusions: Strong associations were observed between TMB and all 3 clinical outcomes (ORR, PFS, and OS) with pembro mono in the first-line setting and a reduced association was observed between TMB and clinical outcomes with pembro + chemo. No consistent associations were observed between PD-L1 and clinical outcomes with pembro mono or pembro + chemo. Clinical trial information: NCT02853305. [Table: see text]
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Affiliation(s)
- Rafael Morales-Barrera
- Vall d’Hebron Institute of Oncology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas Powles
- Barts Cancer Centre, St Bartholomew’s Hospital, Barts Cancer Institute, Barts Health NHS Trust, Queen Mary University of London, London, United Kingdom
| | - Mustafa Ozguroglu
- Cerrahpaşa School of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Tibor Csoszi
- County Oncology Centre, Hetényi Géza Hospital, Szolnok, Hungary
| | - Yohann Loriot
- Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | | | - Lajos Geczi
- National Institute of Oncology, Budapest, Hungary
| | | | - Yves Fradet
- CHU de Québec - Université Laval, Québec City, QC, Canada
| | - Stephane Oudard
- Georges Pompidou European Hospital, University of Paris, Paris, France
| | - Seyda Gunduz
- Memorial Antalya Hospital and Minimally Invasive Therapeutics Laboratory, Mayo Clinic, Antalya, Turkey
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23
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Powles T, Alva AS, Ozguroglu M, O'Donnell PH, Loriot Y, Csoszi T, Vuky J, Morales-Barrera R, Plimack ER, Matsubara N, Fradet Y, Geczi L, Gunduz S, Mamtani R, Bajorin DF, Liu CC, Imai K, Homet Moreno B, Bellmunt J, Balar AV. Post hoc pooled analysis of first-line (1L) pembrolizumab (pembro) for advanced urothelial carcinoma (UC): Outcomes by response at week nine in KEYNOTE-052 and KEYNOTE-361. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
519 Background: Pembro is a 1L treatment for cisplatin-ineligible pts with UC. This post hoc landmark analysis evaluated clinical outcomes by response at 9 wk to 1L pembro monotherapy in pts with advanced/unresectable or metastatic UC from the single-arm phase 2 KEYNOTE-052 (NCT02335424) and the randomized phase 3 KEYNOTE-361 (NCT02853305) trials. Methods: Cisplatin-ineligible pts with advanced UC were enrolled in KEYNOTE-052 and received pembro (200 mg Q3W for ≤2 y). Platinum-eligible pts with advanced UC who had not previously received systemic chemotherapy (chemo) were enrolled in KEYNOTE-361 and randomly assigned 1:1:1 to receive pembro (200 mg Q3W for ≤2 y), pembro + chemo (1000 mg/m2 gemcitabine on d1 and d8 + cisplatin [70 mg/m2] or carboplatin [AUC 5] on d1 of each 3-wk cycle), or chemo. The primary analysis group included pembro monotherapy–treated pts; the sensitivity analysis group included pembro monotherapy–treated pts from KEYNOTE-052 and the choice of carboplatin subpopulation of pembro monotherapy–treated pts from KEYNOTE-361. Landmark analyses of OS by pts with CR, PR, SD, or PD per RECIST v1.1 by BICR at first imaging assessment (wk 9) were pooled for the ITT populations. Duration of CR/PR/SD and OS were estimated using the Kaplan-Meier method. Data cutoffs were Sep 26, 2020 (KEYNOTE-052) and Apr 29, 2020 (KEYNOTE-361). Results: The primary analysis group included 681 pembro-treated pts (KEYNOTE-052, N = 374; KEYNOTE-361, N = 307); the sensitivity analysis group included 544 pembro-treated pts (KEYNOTE-052, N = 374; KEYNOTE-361, N = 170). Median time from randomization to cutoff was 51.9 mo (range, 22.0-65.3) and 53.7 mo (range, 22.0-65.3) for the primary and sensitivity analysis groups, respectively. Twenty-five pts (4.6%) had CR and 135 (24.6%) had PR (primary group); 17 pts (3.9%) had CR and 105 (24.1%) had PR (sensitivity group). Median DOR was 25.9 mo for pts with CR/PR at wk 9; pts with CR/PR or SD at wk 9 had longer OS than pts with PD at wk 9 (Table). Conclusions: In this post hoc analysis, pts with advanced UC in KEYNOTE-052 and KEYNOTE-361 with CR/PR at wk 9 had better clinical outcomes with pembro monotherapy than pts with SD or PD; 1L pembro monotherapy continues to show efficacy in advanced UC. Clinical trial information: NCT02335424 and NCT02853305. [Table: see text]
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Affiliation(s)
- Thomas Powles
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | | | - Mustafa Ozguroglu
- Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | | | - Yohann Loriot
- Gustave Roussy, Cancer Campus, and University of Paris-Saclay, Villejuif, France
| | - Tibor Csoszi
- County Oncology Centre, Hetényi Géza Hospital, Szolnok, Hungary
| | | | - Rafael Morales-Barrera
- Vall d’Hebron Institute of Oncology, Vall d’ Hebron University Hospital, and Autonomous University of Barcelona, Barcelona, Spain
| | | | | | - Yves Fradet
- CHU de Quebec-University of Laval, Quebec City, QC, Canada
| | - Lajos Geczi
- National Institute of Oncology, Budapest, Hungary
| | | | - Ronac Mamtani
- Abramson Cancer Center, Penn Medicine, Philadelphia, PA
| | | | | | | | | | - Joaquim Bellmunt
- Beth Israel Deaconess Medical Center/IMIM Research Institute, Harvard Medical School, Boston, MA
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O'Donnell PH, Balar AV, Castellano DE, De Wit R, Vaughn DJ, Powles T, Vuky J, Lee JL, Fradet Y, Bellmunt J, Fong L, Petrylak DP, Gerritsen WR, Quinn DI, Culine S, Bajorin DF, Xu JZ, Imai K, Homet Moreno B, Grivas P. Impact of primary tumor location on efficacy and safety of pembrolizumab (pembro) in patients (pts) with locally advanced or metastatic urothelial carcinoma (UC) enrolled in the phase 2 KEYNOTE-052 and phase 3 KEYNOTE-045 trials. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
516 Background: Pembro showed antitumor activity in 1L and 2L for pts with UC in the single-arm, phase 2 KEYNOTE-052 study (NCT02335424) and the randomized phase 3 KEYNOTE-045 (NCT02256436) study, respectively. This post hoc exploratory analysis evaluated whether primary tumor location affected efficacy and safety of pembro (KEYNOTE-052; KEYNOTE-045) and chemotherapy (chemo; KEYNOTE-045). Methods: KEYNOTE-052 enrolled cisplatin-ineligible pts with advanced/metastatic UC who had not previously received systemic therapy; they received pembro (200 mg IV Q3W). KEYNOTE-045 enrolled pts with advanced/metastatic UC who had received platinum-containing chemo; pts were randomly assigned 1:1 to receive pembro (200 mg IV Q3W) or investigator’s choice of chemo (paclitaxel, docetaxel, or vinflunine). Both studies required pts to have measurable disease per RECIST v1.1. Upper tract (UT) UC included primary tumors in the renal pelvis or ureter; lower tract (LT) UC included primary tumors in the bladder or urethra. Pts with UT and LT disease (UT/LT) were classified as LT. Pts receiving pembro were treated until disease progression, unacceptable toxicity, or withdrawal of consent, for up to 2y. End points were PFS, ORR, and DOR per RECIST v1.1 by central radiology assessment and OS. Results: A total of 369 pembro-treated pts (68 UT; 301 LT [79 UT/LT]) from KEYNOTE-052 plus 270 pembro-treated pts (93 UT; 177 LT [33 UT/LT]) and 272 chemo-treated pts (94 UT; 178 LT) from KEYNOTE-045 were evaluated. Median follow-up from randomization to data cutoff (09/26/20 and 10/1/20, respectively) was ≥56 mo. Both studies enrolled a similar percentage of pts with PD-L1–positive tumors (25%-30%). PFS, ORR, DOR, and OS for pembro were consistent regardless of tumor location, although ORR for KEYNOTE-045 was lower for the UT group (Table). In the chemo arm of KEYNOTE-045, similar efficacy was observed regardless of tumor location or regimen. Grade 3-5 TRAEs occurred at similar rates in KEYNOTE-052 (19.1% UT; 21.6% LT) and KEYNOTE-045 (17.2% UT; 16.8% LT). Conclusions: In this exploratory analysis, pembro showed similar clinical activity and manageable safety regardless of primary UC tumor location. Clinical trial information: NCT02256436 and NCT02335424. [Table: see text]
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Affiliation(s)
| | | | | | | | | | - Thomas Powles
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | | | - Jae-Lyun Lee
- Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Yves Fradet
- CHU de Québec-Laval University, Quebec City, QC, Canada
| | - Joaquim Bellmunt
- Beth Israel Deaconess Medical Center/IMIM Research Institute, Harvard Medical School, Boston, MA, Boston, MA
| | - Lawrence Fong
- University of California San Francisco, San Francisco, CA
| | | | - Winald R. Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands
| | - David I. Quinn
- USC Norris Comprehensive Cancer Center, Keck Medicine of USC, Los Angeles, CA
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Castellano DE, Balar AV, O'Donnell PH, Grivas P, Vaughn DJ, Powles T, Vuky J, Lee JL, Fradet Y, Bellmunt J, Climent MÁ, Vogelzang NJ, Plimack ER, Gurney H, Hahn NM, Sternberg CN, Xu JZ, Imai K, Homet Moreno B, De Wit R. Post hoc analysis of the efficacy of pembrolizumab retreatment after progression of advanced urothelial carcinoma (UC) in KEYNOTE-045 and KEYNOTE-052. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
512 Background: Pembrolizumab (pembro) has shown efficacy in advanced/unresectable and metastatic UC (mUC). There is interest in determining whether pts should be treated subsequently with checkpoint inhibitors such as anti–PD-1 therapy if mUC responds then later progresses. Pembro retreatment after disease progression has shown efficacy in melanoma and NSCLC. This post hoc exploratory analysis investigated the efficacy of pembro retreatment for pts with advanced UC or mUC enrolled in KEYNOTE-045 and KEYNOTE-052 with a best overall response (BOR) of SD or better and whose disease progressed after discontinuation or completion of 2 y of therapy. Methods: The phase 3 KEYNOTE-045 trial (NCT02256436) was designed to compare the efficacy and safety of pembro vs chemotherapy (chemo) in pts with mUC that recurred/progressed on platinum containing chemo; ≤2 prior lines of systemic chemo for mUC were permitted. The phase 2 KEYNOTE-052 trial (NCT02335424) was designed to evaluate the efficacy and safety of first-line pembro in cisplatin-ineligible pts with advanced UC. In both studies, pembro was administered for up to 2 y; pts were eligible for retreatment if they stopped pembro after CR or had a BOR of CR, PR, or SD and completed 2 y of treatment. Pts must have investigator-confirmed radiographic PD after therapy cessation, have ECOG PS score 0-1, and not have received anticancer treatment after the last pembro dose. BOR to retreatment is reported. Results: At data cutoff for KEYNOTE-045 (Oct 1, 2020), 11 pts were retreated: 5 (45%) achieved objective response to retreatment (3 CR; 2 PR; Table) and 6 had SD, for a disease control rate (DCR; CR+PR+SD) of 100%. Median treatment-free interval was 7.7 mo (IQR, 3.6-16.5); median duration of retreatment was 11.4 mo (IQR, 7.6-12.0). Seven pts (64%) were alive at cutoff. At data cutoff for KEYNOTE-052 (Sep 26, 2020), 10 pts were retreated; 5 (50%) had objective response to retreatment (1 CR; 4 PR) and 4 had SD, for a DCR of 90%. Retreatment BOR was PD for 1 pt (10%). Median treatment-free interval was 13.0 mo (9.2-16.6); median duration of retreatment was 6.0 mo (IQR, 4.9-9.2). Four pts (40%) were alive at cutoff. Conclusions: Although the number of pts who received retreatment was small, objective responses were observed. The findings are generally consistent with observations from retreatment in other tumor types (e.g., melanoma). Clinical trial information: NCT02256436 and NCT02335424. [Table: see text]
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Affiliation(s)
| | | | | | | | | | - Thomas Powles
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | | | - Jae-Lyun Lee
- Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Yves Fradet
- CHU de Quebec-University of Laval, Quebec City, QC, Canada
| | - Joaquim Bellmunt
- Beth Israel Deaconess Medical Center/IMIM Research Institute, Harvard Medical School, Boston, MA
| | | | | | | | - Howard Gurney
- Westmead Hospital and Macquarie University Hospital, Sydney, NSW, Australia
| | - Noah M. Hahn
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, Baltimore, MD
| | - Cora N. Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York-Presbyterian, New York, NY
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Fradet S, Pelletier JF, Singbo N, Lacombe L, Toren P, Lodde M, Dujardin T, Tiguert R, Fradet Y, Robitaille K, Fradet V. Effects of omega-3 fatty acids supplementation on perioperative blood loss and complications after radical prostatectomy. Clin Nutr ESPEN 2022; 47:221-226. [DOI: 10.1016/j.clnesp.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/03/2021] [Accepted: 12/12/2021] [Indexed: 11/29/2022]
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Gris T, Besançon M, Joncas FH, Picard V, Bergeron A, Fradet Y, Toren P. Targeting the androgen receptor axis to improve response to bladder cancer immunotherapy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00168-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Laaraj J, Lachance G, Gevariya N, Varin T, Feldiorean A, Gaignier F, Julien IB, Xu HW, Hallal T, Pelletier JF, Bouslama S, Boufaied N, Derome N, Fradet Y, Ellis L, Piccirillo CA, Raymond F, Labbé DP, Bergeron A, Marette A, Robitaille K, Fradet V. Abstract P001: The gut microbiome-prostate tumor crosstalk is modulated by dietary polyunsaturated fatty acids. Cancer Immunol Res 2022. [DOI: 10.1158/2326-6074.tumimm21-p001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction and Objective: Recently, gut microbiota emerged as an important factor for success of immunity-based cancer treatments. However, its steady-state interaction and contribution to developing tumors is largely unexplored in non-intestinal cancers. Our objective was to investigate the connection between prostate tumor and the gut microbiota independently of cancer therapies.
Methods: Human fecal samples were obtained from men participating into a phase IIb double-blind randomized controlled trial testing 3g/day of monoglyceride-eicosapentaenoic acid (MAG-EPA) versus placebo for a 4-10 week period before their radical prostatectomy (NCT02333435). A second set of samples were from men taking the same intervention of MAG-EPA or placebo after a PSA increase following their radical prostatectomy (NCT03753334). Short chain fatty acids (SCFA) analysis of patient stool samples between baseline and surgery was performed by gas chromatography coupled with flame ionization detection. 16srRNA libraries were amplified by targeting a fragment of the V3-V4 hypervariable region of the bacterial 16S rRNA gene. High-throughput sequencing of the bar-coded amplicons was performed on a MiSeq apparatus and the bioinformatics analysis was conducted using Mothur pipeline. In addition to human fecal samples, fully immunocompetent C57BL/6 mice were injected subcutaneously with TRAMP-C2 or PTEN−/− or PTEN−/− RB1−/− mouse prostate cancer cells to measure changes in the gut microbiota during tumor growth. We also recapitulated the MAG-EPA intervention in our TRAMP-C2 mice model and fed by gavage four different fatty acids (omega-9 (high oleic sunflower oil), omega-6 (MAG-arachidonic acid) and two omega-3 (MAG-docosahexaenoic and MAG-EPA).
Results: In human fecal samples from prostate cancer patients, we observed a reduced gut microbiota diversity correlating with tumor stage. We also found that tumor growth was sufficient to modulate the microbiota in three independent prostate cancer syngeneic mouse models. We showed that transplanted human gut flora was sufficient to modulate ectopic prostate tumor growth, supporting the causal impact of gut microbiota for prostate cancer. The analysis of SCFA in patient stool samples between baseline and surgery showed that MAG-EPA prebiotic intervention was associated with a decrease of fecal butyric acid levels in prostate cancer patients with downgrade at surgery. We finally investigated this gut-tumor connection using purified polyunsaturated fatty acids prebiotics in patients and mice. We observed a reduction in the levels of Ruminococcaceae following dietary omega-3 supplementation that correlated with prostate cancer downgrade in patients and reduced tumor growth in mice.
Conclusion: Overall our findings suggest that diet-actionable components of the gut microbiome can regulate prostate cancer growth.
Citation Format: Jalal Laaraj, Gabriel Lachance, Nikunj Gevariya, Thibaut Varin, Andrei Feldiorean, Fanny Gaignier, Isabelle Boudreau Julien, Hui Wen Xu, Tarek Hallal, Jean-François Pelletier, Sidki Bouslama, Nadia Boufaied, Nicolas Derome, Yves Fradet, Leigh Ellis, Ciriaco A. Piccirillo, Frédéric Raymond, David P. Labbé, Alain Bergeron, André Marette, Karine Robitaille, Vincent Fradet. The gut microbiome-prostate tumor crosstalk is modulated by dietary polyunsaturated fatty acids [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2021 Oct 5-6. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(1 Suppl):Abstract nr P001.
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Affiliation(s)
- Jalal Laaraj
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
| | - Gabriel Lachance
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
- 3Centre de recherche de l'IUCPQ, Québec, QC, Canada,
| | - Nikunj Gevariya
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
| | - Thibaut Varin
- 3Centre de recherche de l'IUCPQ, Québec, QC, Canada,
| | - Andrei Feldiorean
- 4Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada,
- 5Division of Urology, Department of Surgery, McGill University, Montréal, Québec, Canada, Montréal, QC, Canada,
| | - Fanny Gaignier
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
| | - Isabelle Boudreau Julien
- 6Institute of Nutrition and Functional Foods (INAF) and NUTRISS Center - Nutrition, Health and Society of Université Laval, Québec, QC, Canada,
| | - Hui Wen Xu
- 7Department of Mathematics and Statistics, Université Laval, Québec, QC, Canada,
| | - Tarek Hallal
- 4Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada,
- 8Department of Anatomy and Cell Biology, McGill University, Montréal, QC, Canada,
| | - Jean-François Pelletier
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
| | - Sidki Bouslama
- 9Institut de Biologie Intégrative et des Systèmes (IBIS), Université Laval, Québec, QC, Canada,
| | - Nadia Boufaied
- 4Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada,
| | - Nicolas Derome
- 9Institut de Biologie Intégrative et des Systèmes (IBIS), Université Laval, Québec, QC, Canada,
- 10Department of Biology, Université Laval, Québec, QC, Canada,
| | - Yves Fradet
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
| | - Leigh Ellis
- 11Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center and Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA,
| | - Ciriaco A. Piccirillo
- 12Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada,
- 13Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
| | - Frédéric Raymond
- 6Institute of Nutrition and Functional Foods (INAF) and NUTRISS Center - Nutrition, Health and Society of Université Laval, Québec, QC, Canada,
| | - David P. Labbé
- 4Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada,
- 5Division of Urology, Department of Surgery, McGill University, Montréal, Québec, Canada, Montréal, QC, Canada,
- 8Department of Anatomy and Cell Biology, McGill University, Montréal, QC, Canada,
| | - Alain Bergeron
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
| | - André Marette
- 3Centre de recherche de l'IUCPQ, Québec, QC, Canada,
| | - Karine Robitaille
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
| | - Vincent Fradet
- 1Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
- 2Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, Canada,
- 6Institute of Nutrition and Functional Foods (INAF) and NUTRISS Center - Nutrition, Health and Society of Université Laval, Québec, QC, Canada,
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Boibessot C, Molina O, Lachance G, Tav C, Champagne A, Neveu B, Pelletier J, Pouliot F, Fradet V, Bilodeau S, Fradet Y, Bergeron A, Toren P. Subversion of infiltrating prostate macrophages to a mixed immunosuppressive tumor-associated macrophage phenotype. Clin Transl Med 2022; 12:e581. [PMID: 35075795 PMCID: PMC8786699 DOI: 10.1002/ctm2.581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 12/21/2022] Open
Abstract
Tumor-associated macrophages (TAMs) support tumor progression within the tumor microenvironment (TME). Many questions remain as to the origin, development, and function of TAMs within the prostate TME. Evaluation of TAMs in prostate cancer (PCa) patients identified the immunosuppressive TAM marker CD163 in adjacent normal epithelium as an independent predictor of metastases or PCa death. Flow cytometry analyses identified prostate TAMs as frequently expressing both proinflammatory M1 (CCR7+) and immunosuppressive M2 (CD163+) markers. In vitro, we demonstrate PCa cells similarly subvert human M1 macrophages toward a mixed M1/M2 macrophage phenotype favoring tumor growth. Further the cytokine milieu-induced transition between immunosuppressive M2 to proinflammatory M1 (M2→M1) macrophages is abrogated by the presence of PCa cells. RNA sequencing suggests alterations in chemokine expression in prostate TAMs due to the presence of PCa cells. Together, our results suggest that prostate TAMs originate from inflammatory infiltrating macrophages, which are then reprogrammed mainly by PCa cells, but also the cytokine milieu. A better understanding of this subversion of macrophages within the prostate may lead to novel treatment strategies.
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Affiliation(s)
- Clovis Boibessot
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Oscar Molina
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Gabriel Lachance
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Christophe Tav
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Centre de Recherche en Données Massives de l'Université LavalQuébecCanada
| | - Audrey Champagne
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Bertrand Neveu
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Jean‐François Pelletier
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
| | - Frédéric Pouliot
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Département de chirurgieUniversité LavalQuébecCanada
| | - Vincent Fradet
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Département de chirurgieUniversité LavalQuébecCanada
| | - Steve Bilodeau
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Centre de Recherche en Données Massives de l'Université LavalQuébecCanada
- Département de biologie moléculairebiochimie médicale et pathologieFaculté de MédecineUniversité LavalQuébecCanada
| | - Yves Fradet
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Département de chirurgieUniversité LavalQuébecCanada
| | - Alain Bergeron
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Département de chirurgieUniversité LavalQuébecCanada
| | - Paul Toren
- Centre de recherche du CHU de Québec—Université LavalAxe OncologieQuébecCanada
- Centre de recherche sur le cancer de l'Université LavalQuébecCanada
- Département de chirurgieUniversité LavalQuébecCanada
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Diop MK, Albadine R, Kougioumoutzakis A, Delvoye N, Hovington H, Bergeron A, Fradet Y, Saad F, Trudel D. Identification of Morphologic Criteria Associated with Biochemical Recurrence in Intraductal Carcinoma of the Prostate. Cancers (Basel) 2021; 13:6243. [PMID: 34944863 PMCID: PMC8699439 DOI: 10.3390/cancers13246243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
Intraductal carcinoma of the prostate (IDC-P) is an aggressive subtype of prostate cancer strongly associated with an increased risk of biochemical recurrence (BCR). However, approximately 40% of men with IDC-P remain BCR-free five years after radical prostatectomy. In this retrospective multicenter study, we aimed to identify histologic criteria associated with BCR for IDC-P lesions. A total of 108 first-line radical prostatectomy specimens were reviewed. In our test cohort (n = 39), presence of larger duct size (>573 µm in diameter), cells with irregular nuclear contours (CINC) (≥5 CINC in two distinct high-power fields), high mitotic score (>1.81 mitoses/mm2), blood vessels, and comedonecrosis were associated with early BCR (<18 months) (p < 0.05). In our validation cohort (n = 69), the presence of CINC or blood vessels was independently associated with an increased risk of BCR (hazard ratio [HR] 2.32, 95% confidence interval [CI] 1.09-4.96, p = 0.029). When combining the criteria, the presence of any CINC, blood vessels, high mitotic score, or comedonecrosis showed a stronger association with BCR (HR 2.74, 95% CI 1.21-6.19, p = 0.015). Our results suggest that IDC-P can be classified as low versus high-risk of BCR. The defined morphologic criteria can be easily assessed and should be integrated for clinical application following validation in larger cohorts.
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Affiliation(s)
- Mame-Kany Diop
- Centre de recherche du Centre hospitalier de l’Université de Montréal (axe Cancer) and Institut du cancer de Montréal, 900 Saint-Denis, Montréal, QC H2X 0A9, Canada; (M.-K.D.); (N.D.); (F.S.)
- Department of Pathology and Cellular Biology, Université de Montréal, 2900 Boulevard Édouard-Montpetit, Montreal, QC H3T 1J4, Canada;
| | - Roula Albadine
- Department of Pathology and Cellular Biology, Université de Montréal, 2900 Boulevard Édouard-Montpetit, Montreal, QC H3T 1J4, Canada;
- Department of Pathology, Centre hospitalier de l’Université de Montréal, 1051 Sanguinet, Montréal, QC H2X 0C1, Canada;
| | - André Kougioumoutzakis
- Department of Pathology, Centre hospitalier de l’Université de Montréal, 1051 Sanguinet, Montréal, QC H2X 0C1, Canada;
| | - Nathalie Delvoye
- Centre de recherche du Centre hospitalier de l’Université de Montréal (axe Cancer) and Institut du cancer de Montréal, 900 Saint-Denis, Montréal, QC H2X 0A9, Canada; (M.-K.D.); (N.D.); (F.S.)
| | - Hélène Hovington
- Laboratoire d’Uro-Oncologie Expérimentale, Centre de recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L’Hôtel-Dieu de Québec, 10 McMahon, Québec City, QC G1R 3S1, Canada; (H.H.); (A.B.); (Y.F.)
| | - Alain Bergeron
- Laboratoire d’Uro-Oncologie Expérimentale, Centre de recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L’Hôtel-Dieu de Québec, 10 McMahon, Québec City, QC G1R 3S1, Canada; (H.H.); (A.B.); (Y.F.)
- Department of Surgery, Université Laval, 2325 rue de l’Université, Québec City, QC G1V 0A6, Canada
| | - Yves Fradet
- Laboratoire d’Uro-Oncologie Expérimentale, Centre de recherche du CHU de Québec-Université Laval (axe Oncologie), Hôpital L’Hôtel-Dieu de Québec, 10 McMahon, Québec City, QC G1R 3S1, Canada; (H.H.); (A.B.); (Y.F.)
- Department of Surgery, Université Laval, 2325 rue de l’Université, Québec City, QC G1V 0A6, Canada
| | - Fred Saad
- Centre de recherche du Centre hospitalier de l’Université de Montréal (axe Cancer) and Institut du cancer de Montréal, 900 Saint-Denis, Montréal, QC H2X 0A9, Canada; (M.-K.D.); (N.D.); (F.S.)
- Department of Urology, Centre hospitalier de l’Université de Montréal, 1051 Sanguinet, Montréal, QC H2X 0C1, Canada
| | - Dominique Trudel
- Centre de recherche du Centre hospitalier de l’Université de Montréal (axe Cancer) and Institut du cancer de Montréal, 900 Saint-Denis, Montréal, QC H2X 0A9, Canada; (M.-K.D.); (N.D.); (F.S.)
- Department of Pathology and Cellular Biology, Université de Montréal, 2900 Boulevard Édouard-Montpetit, Montreal, QC H3T 1J4, Canada;
- Department of Pathology, Centre hospitalier de l’Université de Montréal, 1051 Sanguinet, Montréal, QC H2X 0C1, Canada;
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Picard V, Kaliaperumal V, Gaignier F, Besançon M, Bramhecha Y, Hrytsenko O, McKay A, Fiset S, Bergeron A, Fradet Y. Abstract LBA030: DPX-SurMAGE, a novel dual-targeted immunotherapy for bladder cancer, induces target-specific T cells with a favorable safety profile in preclinical model. Mol Cancer Ther 2021. [DOI: 10.1158/1535-7163.targ-21-lba030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Thirty to forty percent of high-risk non-muscle invasive bladder cancer (NMIBC) fail standard of care, leaving radical cystectomy as the most recommended option for these patients. Therefore, new efficient and tolerable treatments are required to prevent or delay cystectomy. The DPX platform is a unique, water-free, lipid-based formulation that can deliver peptides, proteins, and small molecules specifically to antigen presenting cells (APCs), eliciting a targeted, robust, and sustained T cell-based immune response. Peptides that are packaged in DPX are specifically taken up by APCs. Maveropepimut-S (MVP-S, formerly known as DPX-Survivac) incorporates 5 HLA-restricted peptides derived from the anti-apoptotic protein survivin and is the first DPX-based immunotherapy. MVP-S demonstrated survivin-specific and sustained T cell response along with clinical activity and limited adverse events in patients with solid and hematologic tumors. Survivin and MAGE-A9 are well characterized tumor-associated antigens (TAAs) frequently overexpressed in bladder tumours. The DPX platform was leveraged to develop a new dual-targeted T cell activating immunotherapy, DPX-SurMAGE, incorporating HLA-A2 restricted peptides of both survivin and MAGE-A9. The feasibility of packaging peptides targeting two different TAAs into the DPX platform was assessed by performing comparative immunogenicity evaluation between 2 MVP-S peptides and DPX-SurMAGE in HLA-A2 transgenic mice. The magnitude of peptide-specific T cell responses against the shared HLA-A2 survivin peptide was similar in animals immunized with either DPX-SurMAGE or MVP-S indicating that the presence of MAGE-A9 peptides did not affect the immunogenicity of the MVP-S-based survivin peptide in the DPX-SurMAGE formulation. Immunogenicity and toxicity of DPX-SurMAGE with and without metronomic cyclophosphamide (mCPA) was further evaluated. IFN-γ ELISPOT assessment demonstrated robust induction of peptide-specific T cell responses to survivin and MAGE-A9 peptide pools. These strong responses were maintained at similar levels in the long-term chronic phase of the assessments both with and without mCPA. Preliminary safety observations including Detailed Clinical Examination (DCE), body weights and organ weights showed no sign of toxicity nor significant changes in mice treated with DPX-SurMAGE with or without mCPA. There were no significant differences in injection site reactions between DPX-SurMAGE groups (with and without mCPA). The local injection site reactions for DPX-SurMAGE groups were comparable to that of DPX-Empty control group. This study demonstrates the unique ability of the DPX delivery platform to deliver multiple antigenic TAA peptides without compromising the immunogenicity of each peptide. Furthermore, the DPX-SurMAGE treatment was well tolerated and was shown to induce robust and sustained target-specific T cell responses against both survivin and MAGE-A9 antigens, supporting the impending phase 1 clinical trial in high risk NMIBC patients.
Citation Format: Valérie Picard, Valarmathy Kaliaperumal, Fanny Gaignier, Marjorie Besançon, Yogesh Bramhecha, Olga Hrytsenko, Alecia McKay, Stephan Fiset, Alain Bergeron, Yves Fradet. DPX-SurMAGE, a novel dual-targeted immunotherapy for bladder cancer, induces target-specific T cells with a favorable safety profile in preclinical model [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr LBA030.
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Affiliation(s)
- Valérie Picard
- 1Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
| | | | - Fanny Gaignier
- 1Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
| | - Marjorie Besançon
- 1Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
| | | | | | | | | | - Alain Bergeron
- 1Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
| | - Yves Fradet
- 1Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada,
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Plante A, Dallaire F, Grosset AA, Nguyen T, Birlea M, Wong J, Daoust F, Roy N, Kougioumoutzakis A, Azzi F, Aubertin K, Kadoury S, Latour M, Albadine R, Prendeville S, Boutros P, Fraser M, Bristow RG, van der Kwast T, Orain M, Brisson H, Benzerdjeb N, Hovington H, Bergeron A, Fradet Y, Têtu B, Saad F, Trudel D, Leblond F. Dimensional reduction based on peak fitting of Raman micro spectroscopy data improves detection of prostate cancer in tissue specimens. J Biomed Opt 2021; 26:JBO-210212R. [PMID: 34743445 PMCID: PMC8571651 DOI: 10.1117/1.jbo.26.11.116501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE Prostate cancer is the most common cancer among men. An accurate diagnosis of its severity at detection plays a major role in improving their survival. Recently, machine learning models using biomarkers identified from Raman micro-spectroscopy discriminated intraductal carcinoma of the prostate (IDC-P) from cancer tissue with a ≥85 % detection accuracy and differentiated high-grade prostatic intraepithelial neoplasia (HGPIN) from IDC-P with a ≥97.8 % accuracy. AIM To improve the classification performance of machine learning models identifying different types of prostate cancer tissue using a new dimensional reduction technique. APPROACH A radial basis function (RBF) kernel support vector machine (SVM) model was trained on Raman spectra of prostate tissue from a 272-patient cohort (Centre hospitalier de l'Université de Montréal, CHUM) and tested on two independent cohorts of 76 patients [University Health Network (UHN)] and 135 patients (Centre hospitalier universitaire de Québec-Université Laval, CHUQc-UL). Two types of engineered features were used. Individual intensity features, i.e., Raman signal intensity measured at particular wavelengths and novel Raman spectra fitted peak features consisting of peak heights and widths. RESULTS Combining engineered features improved classification performance for the three aforementioned classification tasks. The improvements for IDC-P/cancer classification for the UHN and CHUQc-UL testing sets in accuracy, sensitivity, specificity, and area under the curve (AUC) are (numbers in parenthesis are associated with the CHUQc-UL testing set): +4 % (+8 % ), +7 % (+9 % ), +2 % (6%), +9 (+9) with respect to the current best models. Discrimination between HGPIN and IDC-P was also improved in both testing cohorts: +2.2 % (+1.7 % ), +4.5 % (+3.6 % ), +0 % (+0 % ), +2.3 (+0). While no global improvements were obtained for the normal versus cancer classification task [+0 % (-2 % ), +0 % (-3 % ), +2 % (-2 % ), +4 (+3)], the AUC was improved in both testing sets. CONCLUSIONS Combining individual intensity features and novel Raman fitted peak features, improved the classification performance on two independent and multicenter testing sets in comparison to using only individual intensity features.
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Affiliation(s)
- Arthur Plante
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Frédérick Dallaire
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Andrée-Anne Grosset
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
| | - Tien Nguyen
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Mirela Birlea
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Jahg Wong
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - François Daoust
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Noémi Roy
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - André Kougioumoutzakis
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Feryel Azzi
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Kelly Aubertin
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Samuel Kadoury
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Computer Engineering and Software Engineering, Montreal, Quebec, Canada
| | - Mathieu Latour
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
- Centre hospitalier de l’Université de Montréal, Department of Pathology, Montreal, Quebec, Canada
| | - Roula Albadine
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
- Centre hospitalier de l’Université de Montréal, Department of Pathology, Montreal, Quebec, Canada
| | - Susan Prendeville
- University Health Network, Laboratory Medicine Program, Toronto, Ontario, Canada
| | - Paul Boutros
- Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- University of California, Los Angeles, Department of Human Genetics, Los Angeles, California, United States
- University of California, Los Angeles, Department of Urology, Los Angeles, California, United States
- University of California, Los Angeles, Institute for Precision Health, Los Angeles, California, United States
- University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, California, United States
- University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Michael Fraser
- Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Rob G. Bristow
- University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | | | - Michèle Orain
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Hervé Brisson
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Nazim Benzerdjeb
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Hélène Hovington
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Alain Bergeron
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
- Université Laval, Department of Surgery, Quebec City, Quebec, Canada
| | - Yves Fradet
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
- Université Laval, Department of Surgery, Quebec City, Quebec, Canada
| | - Bernard Têtu
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Fred Saad
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Dominique Trudel
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Frédéric Leblond
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
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Lambert M, Benmoussa A, Diallo I, Ouellet-Boutin K, Dorval V, Majeau N, Joly-Beauparlant C, Droit A, Bergeron A, Têtu B, Fradet Y, Pouliot F, Provost P. Identification of Abundant and Functional dodecaRNAs (doRNAs) Derived from Ribosomal RNA. Int J Mol Sci 2021; 22:9757. [PMID: 34575920 PMCID: PMC8467515 DOI: 10.3390/ijms22189757] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/02/2021] [Accepted: 09/05/2021] [Indexed: 12/17/2022] Open
Abstract
Using a modified RNA-sequencing (RNA-seq) approach, we discovered a new family of unusually short RNAs mapping to ribosomal RNA 5.8S, which we named dodecaRNAs (doRNAs), according to the number of core nucleotides (12 nt) their members contain. Using a new quantitative detection method that we developed, we confirmed our RNA-seq data and determined that the minimal core doRNA sequence and its 13-nt variant C-doRNA (doRNA with a 5' Cytosine) are the two most abundant doRNAs, which, together, may outnumber microRNAs. The C-doRNA/doRNA ratio is stable within species but differed between species. doRNA and C-doRNA are mainly cytoplasmic and interact with heterogeneous nuclear ribonucleoproteins (hnRNP) A0, A1 and A2B1, but not Argonaute 2. Reporter gene activity assays suggest that C-doRNA may function as a regulator of Annexin II receptor (AXIIR) expression. doRNAs are differentially expressed in prostate cancer cells/tissues and may control cell migration. These findings suggest that unusually short RNAs may be more abundant and important than previously thought.
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Affiliation(s)
- Marine Lambert
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Department of Microbiology, Infectious Diseases and Immunology, Université Laval, Quebec City, QC G1V 4G2, Canada
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Abderrahim Benmoussa
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Department of Microbiology, Infectious Diseases and Immunology, Université Laval, Quebec City, QC G1V 4G2, Canada
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Idrissa Diallo
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Department of Microbiology, Infectious Diseases and Immunology, Université Laval, Quebec City, QC G1V 4G2, Canada
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Katheryn Ouellet-Boutin
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Department of Microbiology, Infectious Diseases and Immunology, Université Laval, Quebec City, QC G1V 4G2, Canada
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Véronique Dorval
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
| | - Nathalie Majeau
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
| | - Charles Joly-Beauparlant
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Department of Molecular Medicine, Université Laval, Quebec City, QC G1V 4G2, Canada
| | - Arnaud Droit
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Department of Molecular Medicine, Université Laval, Quebec City, QC G1V 4G2, Canada
| | - Alain Bergeron
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Department of Surgery, Université Laval, Quebec City, QC G1R 2J6, Canada
| | - Bernard Têtu
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Yves Fradet
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Department of Surgery, Université Laval, Quebec City, QC G1R 2J6, Canada
| | - Frédéric Pouliot
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Department of Surgery, Université Laval, Quebec City, QC G1R 2J6, Canada
| | - Patrick Provost
- CHU de Québec Research Center/CHUL Pavilion—Université Laval, 2705 boulevard Laurier, Quebec City, QC G1V 4G2, Canada; (M.L.); (A.B.); (I.D.); (K.O.-B.); (N.M.); (C.J.-B.); (A.D.); (A.B.); (B.T.); (Y.F.); (F.P.)
- Department of Microbiology, Infectious Diseases and Immunology, Université Laval, Quebec City, QC G1V 4G2, Canada
- Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
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Kourbanhoussen K, Joncas FH, D Wallis CJ, Hovington H, Dagenais F, Fradet Y, Guillemette C, Lacombe L, Toren P. Follicle-stimulating hormone (FSH) levels prior to prostatectomy are not related to long-term oncologic or cardiovascular outcomes for men with prostate cancer. Asian J Androl 2021; 24:21-25. [PMID: 34259197 PMCID: PMC8788605 DOI: 10.4103/aja.aja_58_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Prior research suggests a link between circulating levels of follicle-stimulating hormone (FSH) and prostate cancer outcomes. FSH levels may also explain some of the observed differences in cardiovascular events among men treated with gonadotropin-releasing hormone (GnRH) antagonists compared to GnRH agonists. This study evaluates the association between preoperative FSH and long-term cardiovascular and oncologic outcomes in a cohort of men with long follow-up after radical prostatectomy. We performed a cohort study utilizing an institutional biobank with annotated clinical data. FSH levels were measured from cryopreserved plasma and compared with sex steroids previously measured from the same samples. Differences in oncologic outcomes between tertiles of FSH levels were compared using adjusted cox regression models. Major adverse cardiovascular events (MACE) were similarly assessed using hospital admission diagnostic codes. A total of 492 patients were included, with a median follow-up of 13.1 (interquartile range: 8.9–15.9) years. Dehydroepiandrosterone sulfate (DHEA-S) levels, but not other androgens, negatively correlated with FSH levels on linear regression analysis (P = 0.03). There was no association between FSH tertile and outcomes of biochemical recurrence, time to castrate-resistant prostate cancer, or time to metastasis. MACEs were identified in 50 patients (10.2%), with a mean time to first event of 8.8 years. No association with FSH tertile and occurrence of MACE was identified. Our results do not suggest that preoperative FSH levels are significantly associated with oncologic outcomes among prostate cancer patients treated with radical prostatectomy, nor do these levels appear to be predictors of long-term cardiovascular risk.
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Affiliation(s)
- Kassim Kourbanhoussen
- Department of Surgery, Faculty of Medicine, Universitè Laval, CHU de Quèbec Research Center, Oncology Division, Quebec City G1R3S1, Canada
| | - France-Hélène Joncas
- Department of Surgery, Faculty of Medicine, Universitè Laval, CHU de Quèbec Research Center, Oncology Division, Quebec City G1R3S1, Canada
| | | | - Hélène Hovington
- Department of Surgery, Faculty of Medicine, Universitè Laval, CHU de Quèbec Research Center, Oncology Division, Quebec City G1R3S1, Canada
| | - François Dagenais
- Institut Universitaire Cardiologie et Pneumologie de Quèbec, Quebec City G1V 4G5, Canada
| | - Yves Fradet
- Department of Surgery, Faculty of Medicine, Universitè Laval, CHU de Quèbec Research Center, Oncology Division, Quebec City G1R3S1, Canada
| | - Chantal Guillemette
- Faculty of Pharmacy, Universitè Laval, CHU de Quèbec Research Center, Quebec City G1V 4G2, Canada
| | - Louis Lacombe
- Department of Surgery, Faculty of Medicine, Universitè Laval, CHU de Quèbec Research Center, Oncology Division, Quebec City G1R3S1, Canada
| | - Paul Toren
- Department of Surgery, Faculty of Medicine, Universitè Laval, CHU de Quèbec Research Center, Oncology Division, Quebec City G1R3S1, Canada
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Powles T, Csőszi T, Özgüroğlu M, Matsubara N, Géczi L, Cheng SYS, Fradet Y, Oudard S, Vulsteke C, Morales Barrera R, Fléchon A, Gunduz S, Loriot Y, Rodriguez-Vida A, Mamtani R, Yu EY, Nam K, Imai K, Homet Moreno B, Alva A. Pembrolizumab alone or combined with chemotherapy versus chemotherapy as first-line therapy for advanced urothelial carcinoma (KEYNOTE-361): a randomised, open-label, phase 3 trial. Lancet Oncol 2021; 22:931-945. [PMID: 34051178 DOI: 10.1016/s1470-2045(21)00152-2] [Citation(s) in RCA: 297] [Impact Index Per Article: 99.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND PD-1 and PD-L1 inhibitors are active in metastatic urothelial carcinoma, but positive randomised data supporting their use as a first-line treatment are lacking. In this study we assessed outcomes with first-line pembrolizumab alone or combined with chemotherapy versus chemotherapy for patients with previously untreated advanced urothelial carcinoma. METHODS KEYNOTE-361 is a randomised, open-label, phase 3 trial of patients aged at least 18 years, with untreated, locally advanced, unresectable, or metastatic urothelial carcinoma, with an Eastern Cooperative Oncology Group performance status of up to 2. Eligible patients were enrolled from 201 medical centres in 21 countries and randomly allocated (1:1:1) via an interactive voice-web response system to intravenous pembrolizumab 200 mg every 3 weeks for a maximum of 35 cycles plus intravenous chemotherapy (gemcitabine [1000 mg/m2] on days 1 and 8 and investigator's choice of cisplatin [70 mg/m2] or carboplatin [area under the curve 5] on day 1 of every 3-week cycle) for a maximum of six cycles, pembrolizumab alone, or chemotherapy alone, stratified by choice of platinum therapy and PD-L1 combined positive score (CPS). Neither patients nor investigators were masked to the treatment assignment or CPS. At protocol-specified final analysis, sequential hypothesis testing began with superiority of pembrolizumab plus chemotherapy versus chemotherapy alone in the total population (all patients randomly allocated to a treatment) for the dual primary endpoints of progression-free survival (p value boundary 0·0019), assessed by masked, independent central review, and overall survival (p value boundary 0·0142), followed by non-inferiority and superiority of overall survival for pembrolizumab versus chemotherapy in the patient population with CPS of at least 10 and in the total population (also a primary endpoint). Safety was assessed in the as-treated population (all patients who received at least one dose of study treatment). This study is completed and is no longer enrolling patients, and is registered at ClinicalTrials.gov, number NCT02853305. FINDINGS Between Oct 19, 2016 and June 29, 2018, 1010 patients were enrolled and allocated to receive pembrolizumab plus chemotherapy (n=351), pembrolizumab monotherapy (n=307), or chemotherapy alone (n=352). Median follow-up was 31·7 months (IQR 27·7-36·0). Pembrolizumab plus chemotherapy versus chemotherapy did not significantly improve progression-free survival, with a median progression-free survival of 8·3 months (95% CI 7·5-8·5) in the pembrolizumab plus chemotherapy group versus 7·1 months (6·4-7·9) in the chemotherapy group (hazard ratio [HR] 0·78, 95% CI 0·65-0·93; p=0·0033), or overall survival, with a median overall survival of 17·0 months (14·5-19·5) in the pembrolizumab plus chemotherapy group versus 14·3 months (12·3-16·7) in the chemotherapy group (0·86, 0·72-1·02; p=0·0407). No further formal statistical hypothesis testing was done. In analyses of overall survival with pembrolizumab versus chemotherapy (now exploratory based on hierarchical statistical testing), overall survival was similar between these treatment groups, both in the total population (15·6 months [95% CI 12·1-17·9] with pembrolizumab vs 14·3 months [12·3-16·7] with chemotherapy; HR 0·92, 95% CI 0·77-1·11) and the population with CPS of at least 10 (16·1 months [13·6-19·9] with pembrolizumab vs 15·2 months [11·6-23·3] with chemotherapy; 1·01, 0·77-1·32). The most common grade 3 or 4 adverse event attributed to study treatment was anaemia with pembrolizumab plus chemotherapy (104 [30%] of 349 patients) or chemotherapy alone (112 [33%] of 342 patients), and diarrhoea, fatigue, and hyponatraemia (each affecting four [1%] of 302 patients) with pembrolizumab alone. Six (1%) of 1010 patients died due to an adverse event attributed to study treatment; two patients in each treatment group. One each occurred due to cardiac arrest and device-related sepsis in the pembrolizumab plus chemotherapy group, one each due to cardiac failure and malignant neoplasm progression in the pembrolizumab group, and one each due to myocardial infarction and ischaemic colitis in the chemotherapy group. INTERPRETATION The addition of pembrolizumab to first-line platinum-based chemotherapy did not significantly improve efficacy and should not be widely adopted for treatment of advanced urothelial carcinoma. FUNDING Merck Sharp and Dohme, a subsidiary of Merck, Kenilworth, NJ, USA.
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Affiliation(s)
- Thomas Powles
- Barts Cancer Centre, St Bartholomew's Hospital, London, UK; Barts Cancer Institute, Barts Health NHS Trust, Queen Mary University of London, London, UK.
| | - Tibor Csőszi
- County Oncology Centre, Hetényi Géza Hospital, Szolnok, Hungary
| | - Mustafa Özgüroğlu
- Cerrahpaşa School of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | | | - Lajos Géczi
- National Institute of Oncology, Budapest, Hungary
| | | | - Yves Fradet
- CHU de Québec-Université Laval, Quebec, QC, Canada
| | - Stephane Oudard
- Georges Pompidou European Hospital, University of Paris, Paris, France
| | - Christof Vulsteke
- Center for Oncological Research (CORE), Antwerp University, Antwerp, Belgium; Integrated Cancer Center, Ghent, Belgium
| | - Rafael Morales Barrera
- Vall d'Hebron Institute of Oncology, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Seyda Gunduz
- Memorial Antalya Hospital, Antalya, Turkey; Minimally Invasive Therapeutics Laboratory, Mayo Clinic, AZ, USA
| | - Yohann Loriot
- Institut Gustave Roussy, Université Paris-Saclay, Villejuif, Val-de-Marne, France
| | | | - Ronac Mamtani
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Evan Y Yu
- University of Washington, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | | | - Ajjai Alva
- University of Michigan Health System, Ann Arbor, MI, USA
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Graff JN, Tagawa ST, Hoimes CJ, Gerritsen WR, Vaishampayan UN, Elliott T, Hwang C, Ten Tije AJ, Omlin A, McDermott RS, Fradet Y, Kilari D, Ferrario C, Uemura H, Niu C, Poehlein CH, De Wit R, Schloss C, De Bono JS, Antonarakis ES. Pembrolizumab plus enzalutamide for enzalutamide-resistant metastatic castration-resistant prostate cancer (mCRPC): Updated analyses after one additional year of follow-up from cohorts 4 and 5 of the KEYNOTE-199 study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.5042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5042 Background: KEYNOTE-199 (NCT02787005) is a multicohort phase 2 study to evaluate pembrolizumab (pembro) in mCRPC. A previous analysis of patients with RECIST-measurable (cohort 4 [C4]) or bone-predominant nonmeasurable (cohort 5 [C5]) disease who were chemotherapy-naive and had progression while on enzalutamide (enza) found that pembro + enza showed antitumor activity and manageable safety. Long-term outcomes are of interest with immunotherapy; hence, updated efficacy and safety data after an additional 1 year of follow-up are presented. Methods: Pts were eligible if they had resistance to enza after prior response. Prior treatment with abiraterone was allowed. Pts received pembro 200 mg Q3W for up to 35 cycles + enza QD until progression, unacceptable toxicity, or withdrawal. Primary end point was ORR per RECIST v1.1 by blinded independent central review (BICR) in C4. Secondary end points were DOR (C4), and DCR, rPFS, OS and safety (both cohorts). Results: 126 pts (C4, 81; C5, 45) were treated. Median age was 72 years (range 43-92), 32.5% had visceral disease and 87.3% previously received ≥6 mo of enzalutamide; 121 pts (96.0%) discontinued, most because of progressive disease. Median (range) time from enrollment to data cutoff was 31.7 mo (23.1-37.1) in C4 and 35.5 mo (22.9-37.3) in C5. In C4, confirmed ORR was 12.3% (95% CI 6.1-21.5) (2 CRs, 8 PRs); median (range) DOR was 8.1 mo (2.5+ to 15.2), and 62.5% had a response ≥6 mo (Kaplan-Meier estimate). Additional efficacy analyses are outlined in the table. A total of 27.2% and 28.9% of pts in C4 and C5, respectively, experienced grade ≥3 treatment-related adverse events. Two pts in C4 died of immune-related AEs (Miller Fisher syndrome and myasthenia gravis). Incidence of any-grade (34.1%) and grade 3 or 4 (5.6%) rash, regardless of relatedness to treatment, was higher than previously reported for individual agents but manageable with standard-of-care treatments; 2 pts discontinued because of rash. Conclusions: After an additional 1 year of follow-up, pembro + enza continued to show antitumor activity and a manageable safety profile in pts with mCRPC who became resistant to enza. The treatment combination is being further evaluated in the ongoing phase 3 KEYNOTE-641 trial (NCT03834493). Clinical trial information: NCT02787005. [Table: see text]
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Affiliation(s)
| | | | | | | | | | - Tony Elliott
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | | | | | - Yves Fradet
- CHU de Québec-Université Laval, Québec City, QC, Canada
| | | | | | - Hiroji Uemura
- Yokohama City University Medical Center, Yokohama, Japan
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37
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Bellmunt J, Necchi A, De Wit R, Lee JL, Fong L, Vogelzang NJ, Climent Durán MA, Petrylak DP, Choueiri TK, Gerritsen WR, Gurney H, Quinn DI, Culine S, Sternberg CN, Xu JZ, Homet Moreno B, Godwin JL, Bajorin DF, Vaughn DJ, Fradet Y. Pembrolizumab (pembro) versus investigator’s choice of paclitaxel, docetaxel, or vinflunine in recurrent, advanced urothelial cancer (UC): 5-year follow-up from the phase 3 KEYNOTE-045 trial. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.4532] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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
4532 Background: Pembro was approved for the treatment of locally advanced or metastatic UC that progressed during or after a platinum-containing regimen, based on the phase 3 KEYNOTE-045 (NCT02256436) trial that showed significantly improved OS with use of pembro. Updated results are presented from KEYNOTE-045 after >5 y of follow-up since the last patient (pt) was randomized. Methods: KEYNOTE-045 is a randomized, multisite, open-label, phase 3 trial. Pts with histologically or cytologically confirmed UC, progression after platinum-containing chemo, ECOG PS 0-2, measurable disease per RECIST v1.1, and ≤2 prior lines of systemic therapy were eligible. Pts were randomly assigned 1:1 to receive pembro 200 mg Q3W or investigator’s choice of paclitaxel 175 mg/m2 Q3W, docetaxel 75 mg/m2 Q3W, or vinflunine 320 mg/m2 Q3W. Primary end points are PFS (RECIST v1.1, blinded central review) and OS. ORR and duration of response (DOR) were key secondary end points. Results: As of Oct 1, 2020, among 542 enrolled pts, median time from randomization to data cutoff was 62.9 mo (range 58.6-70.9). 9.4% and 0% of pts in the pembro and chemo arms, respectively, completed 2 years of therapy. Median OS was longer for pembro vs chemo (10.1 vs 7.2 mo; HR, 0.71 [95% CI, 0.59-0.86]) overall and in pts with CPS ≥10 (8.0 vs 4.9 mo; HR, 0.59 [95% CI, 0.40-0.86]). For pts with CR or PR, median OS was not reached and 16.4 (95% CI, 11.3-25.1) mo in the pembro and chemo arms, respectively (Table). OS rates at 48 mo were 16.7% for pembro and 10.1% for chemo; 60-mo OS rates were 14.9% and 8.7%, respectively. OS benefit with pembro vs chemo continued regardless of age, ECOG PS, prior therapy, liver metastases, baseline hemoglobin, time from last chemo, histology, risk factors, and chemo choice. Median DOR for responders was longer for pembro vs chemo (29.7 mo [1.6+ to 60.5+] vs 4.4 mo [1.4+ to 63.1+]), and a greater proportion of responses lasted ≥48 mo (40.9% vs 28.3%, Kaplan-Meier) and ≥60 mo (32.8% vs 28.3%). ORR was higher for pembro vs chemo (21.9% vs 11.0%; difference 10.8% [95% CI, 4.6-17.0]). Fewer pts given pembro vs chemo experienced a treatment-related AE of any grade (62.0% vs 90.6%) or grade ≥3 (16.9% vs 50.2%). Conclusions: After 5 y, pembro maintained clinically meaningful OS benefit vs chemo in pts with locally advanced or metastatic UC that progressed during or after platinum-based chemo. Pts who responded to pembro experienced a durable response (median >2 y). Clinical trial information: NCT02256436 .[Table: see text]
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Affiliation(s)
- Joaquim Bellmunt
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Andrea Necchi
- Vita-Salute San Rafaele University and IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Jae-Lyun Lee
- Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Lawrence Fong
- University of California San Francisco, San Francisco, CA
| | | | | | | | | | | | - Howard Gurney
- Westmead Hospital and Macquarie University, Sydney, NSW, Australia
| | - David I. Quinn
- USC Norris Comprehensive Cancer Center, Keck Medicine of USC, Los Angeles, CA
| | | | | | | | | | | | | | | | - Yves Fradet
- CHU de Québec-Université Laval, Québec City, QC, Canada
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Otis-Chapados S, Goulet CR, Dubois G, Lavallée É, Dujardin T, Fradet Y, Lacombe L, Lodde M, Tiguert R, Toren P, Fradet V, Beauregard JM, Buteau FA, Pouliot F. 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is accurate for high-grade prostate cancer bone staging when compared to bone scintigraphy. Can Urol Assoc J 2021; 15:301-307. [PMID: 33750523 DOI: 10.5489/cuaj.7107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In this study, we compared 18F-FDG-postron emission tomography/computed tomography (PET/CT) and bone scintigraphy accuracies for the detection of bone metastases for primary staging in high-grade prostate cancer (PCa) patients to determine if 18F-FDG-PET/CT could be used alone as a staging modality. METHODS Men with localized high-grade PCa (n=256, Gleason 8-10, International Society of Urological Pathology [ISUP] grades 4 or 5) were imaged with bone scintigraphy and 18F-FDGPET/CT. We compared on a per-patient basis the accuracy of the two imaging modalities, taking intermodality agreement as the standard of truth (SOT). RESULTS 18F-FDG-PET/CT detected at least one bone metastasis in 33 patients compared to only 26 with bone scan. Of the seven false-negative bone scintigraphies, four (57.1%) were solitary metastases (monometastatic), three (42.9%) were oligometastatic (2-4 lesions), and none were plurimetastatic (>4 lesions). Compared to SOT, 18F-FDG-PET/CT showed higher sensitivity and accuracy than bone scintigraphy (100% vs. 78.8%, and 98.7% vs. 98.2%) for the detection of skeletal lesions. CONCLUSIONS 18F-FDG-PET/CT appears similar or better than conventional bone scans to assess for bone metastases in patients newly diagnosed with high-grade PCa. Since intraprostatic FDG-uptake is also a biomarker of failure to radical prostatectomy and that FDG-PET/CT has been shown to be accurate in detecting PCa lymph node metastasis, FDG-PET/CT has the potential to be used as the sole preoperative staging modality in high-grade PCa.
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Affiliation(s)
- Samuel Otis-Chapados
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Cassandra Ringuette Goulet
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Gabriel Dubois
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | | | - Thierry Dujardin
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Yves Fradet
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Louis Lacombe
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Michele Lodde
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Rabi Tiguert
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Paul Toren
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Vincent Fradet
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Jean-Mathieu Beauregard
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada.,Department of Medical Imaging, CHU de Québec, Quebec, QC, Canada
| | - François-Alexandre Buteau
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada.,Department of Medical Imaging, CHU de Québec, Quebec, QC, Canada
| | - Frédéric Pouliot
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada
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Alva AS, Csőszi T, Ozguroglu M, Matsubara N, Geczi L, Cheng SY, Fradet Y, Oudard S, Vulsteke C, Morales-Barrera R, Flechon A, Gunduz S, Loriot Y, Rodriguez-Vida A, Mamtani R, Yu EY, Nam K, Imai K, Homet Moreno B, Powles T. Impact of subsequent therapy on survival in KEYNOTE-361: Pembrolizumab (pembro) plus chemotherapy (chemo) or pembro alone versus chemo as first-line therapy for advanced urothelial carcinoma (UC). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.439] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
439 Background: The phase III KEYNOTE-361 study examined the efficacy and safety of 1L pembro + chemo or pembro alone vs chemo for pts with advanced UC. The PFS and OS benefit of pembro + chemo vs chemo did not reach statistical significance; no further formal tesing was done. We present an exploratory analysis of OS by subsequent therapy in KEYNOTE-361 (NCT02853305) to assess how 1L and 2L therapy selection affected survival outcomes; no formal comparisons were conducted. Methods: OS was estimated for pts by whether they received subsequent therapy, and by whether subsequent therapy included an anti–PD-(L)1 agent. Results: 351 pts were randomized to pembro + chemo, 307 pts to pembro, and 352 pts to chemo. As of Apr 29, 2020, the median (range) time from randomization to data cutoff was 31.7 (22.0-42.3) mo. 124/351 pts (35%) in the pembro + chemo arm, 126/307 pts (41%) in the pembro arm, and 215/352 pts (61%) in the chemo arm received any subsequent therapy. Similar rates of subsequent therapy (pembro + chemo: 32%; pembro: 43%; chemo: 59%) were observed for pts who experienced progressive disease (PD) by blinded independent central review (BICR). A higher rate of pts (169/352 [48%]) in the chemo arm received subsequent anti–PD-(L)1 therapy than in either the pembro + chemo arm (23/351 [7%]) or pembro arm (14/307 [5%]). Due to the small pt numbers, pts in the pembro + chemo or pembro arms who received subsequent anti−PD-(L)1 were not considered further. This analysis included all pts who received 2L therapy (465/1010 pts [46%]); the rate of 2L therapy was similar in pts with PD by BICR (274/615 [45%]). Chemo agents alone or in combination, specifically carboplatin, cisplatin, docetaxel, doxorubicin, gemcitabine, and paclitaxel, were the most commonly received subsequent therapies for pts who did not receive anti–PD-(L)1 in 2L. Pts who received 1L chemo followed by subsequent anti–PD-(L)1 had longer mOS (19.1 mo [95% CI 16.2-22.2]) than pts with 1L pembro followed by 2L therapy not including an anti−PD-(L)1 agent (16.0 mo [95% CI 11.8-19.2]) (Table). Conclusions: In this exploratory analysis, favorable survival outcomes were observed for pts who received 1L chemo followed by anti–PD-(L)1 compared with pts who received 1L pembro followed by 2L therapy not including an anti–PD-(L)1 agent. These data underline the continued importance of immunotherapy as 2L therapy for advanced UC. Clinical trial information: NCT02853305 . Research Sponsor: Merck & Co., Inc[Table: see text]
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Affiliation(s)
| | | | - Mustafa Ozguroglu
- Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Nobuaki Matsubara
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Lajos Geczi
- National Institute of Oncology, Budapest, Hungary
| | | | - Yves Fradet
- CHU de Québec - Université Laval, Québec City, QC, Canada
| | - Stephane Oudard
- Georges Pompidou Hospital, University of Paris, Paris, France
| | - Christof Vulsteke
- Center for Oncological Research (CORE), University of Antwerp, Integrated Cancer Center Ghent, Ghent, Belgium
| | | | - Aude Flechon
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Yohann Loriot
- Department of Cancer Medicine, Institute Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alejo Rodriguez-Vida
- Medical Oncology Department, Hospital del Mar Research Institute, Barcelona, Spain
| | | | - Evan Y. Yu
- Division of Oncology, Department of Medicine, University of Washington, Seattle, WA
| | | | | | | | - Thomas Powles
- Barts Cancer Centre, Queen Mary University of London, London, United Kingdom
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Ozguroglu M, Alva AS, Csőszi T, Matsubara N, Geczi L, Cheng SY, Fradet Y, Oudard S, Vulsteke C, Morales-Barrera R, Flechon A, Gunduz S, Loriot Y, Rodriguez-Vida A, Mamtani R, Yu EY, Nam K, Imai K, Homet Moreno B, Powles T. Analysis of PFS2 by subsequent therapy in KEYNOTE-361: Pembrolizumab (pembro) plus chemotherapy (chemo) or pembro alone versus chemo as 1L therapy for advanced urothelial carcinoma (UC). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.448] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
448 Background: 1L pembro + chemo did not show statistically superior PFS and OS vs chemo for pts with advanced UC in the phase III KEYNOTE-361 study; OS for pembro vs chemo was not formally tested. We analyzed PFS2 (time from randomization to progressive disease [PD] on first subsequent therapy, or death from any cause, whichever occurs first) by study treatment and subsequent therapy in KEYNOTE-361 (NCT02853305) to determine the effects, if any, of therapy sequence on PFS2. Methods: PFS2 was estimated for pts in each treatment arm, who received any subsequent therapy including any anti–PD-(L)1, any therapy other than anti–PD-(L)1, or no therapy. These were exploratory analyses; no formal comparisons were done. Results: 1010 pts were randomized: 351 pts to receive pembro + chemo, 307 to pembro, and 352 to chemo. As of Apr 29, 2020, the median (range) time from randomization to data cutoff was 31.7 (22.0-42.3) mo. Subsequent therapy was received by 124/351 (35%), 126/307 (41%), and 215/352 (61%) pts in the pembro + chemo, pembro, and chemo arms, respectively. Subsequent anti–PD-(L)1 therapy was received by 169/352 (48%) pts in the chemo arm vs 23/351 (7%) in the pembro + chemo arm and 14/307 (5%) in the pembro arm. Of pts in the pembro arm who received subsequent therapy, >90% received 2L cisplatin-based or carboplatin-based treatment. Median (m) PFS2 (95% CI) for all pts by treatment arm was 14.1 mo (12.6-16.2) with pembro + chemo, 10.9 mo (9.5-12.9) with pembro, and 10.4 mo (9.8-11.2) with chemo. Across treatment arms, pts in the pembro + chemo arm had the longest mPFS2 with any subsequent therapy (14.5 mo [95% CI 13.1-16.6]) (Table). Pts in the pembro arm who received no subsequent therapy had a longer mPFS2 (12.9 mo [95% CI 8.1-17.9]) vs pts in the chemo arm who received no subsequent therapy (9.4 mo [95% CI 7.6-10.6]). Finally, pts treated with 1L pembro in the trial followed by 2L therapy other than anti−PD-(L)1 had comparable mPFS2 (10.2 mo [95% CI 8.6-12.1]) to pts treated with 1L chemo in the trial followed by 2L anti−PD-(L)1 (11.1 mo [95% CI 10.2-12.9]). Conclusions: In this exploratory analysis, treatment sequence of chemo followed by anti−PD-(L)1 upon PD vs anti–PD-(L)1 followed by chemo upon PD did not appear to impact mPFS2. Among pts who did not receive 2L therapy, 1L pembro appeared to be associated with longer mPFS2 than chemo, potentially driven by long-term responders to pembro. Clinical trial information: NCT02853305 . [Table: see text]
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Affiliation(s)
- Mustafa Ozguroglu
- Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | | | | | - Nobuaki Matsubara
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Lajos Geczi
- National Institute of Oncology, Budapest, Hungary
| | | | - Yves Fradet
- CHU de Québec - Université Laval, Québec City, QC, Canada
| | - Stephane Oudard
- Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
| | - Christof Vulsteke
- Center for Oncological Research (CORE), University of Antwerp, Integrated Cancer Center Ghent, Ghent, Belgium
| | | | - Aude Flechon
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Yohann Loriot
- Department of Cancer Medicine, Institute Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alejo Rodriguez-Vida
- Medical Oncology Department, Hospital del Mar Research Institute, Barcelona, Spain
| | | | - Evan Y. Yu
- Division of Oncology, Department of Medicine, University of Washington, Seattle, WA
| | | | | | | | - Thomas Powles
- Barts Experimental Cancer Medicine Centre, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
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Powles T, Csőszi T, Ozguroglu M, Matsubara N, Geczi L, Cheng SY, Fradet Y, Oudard S, Vulsteke C, Morales-Barrera R, Flechon A, Gunduz S, Loriot Y, Rodriguez-Vida A, Mamtani R, Yu EY, Nam K, Imai K, Homet Moreno B, Alva AS. 1L pembrolizumab (pembro) versus chemotherapy (chemo) for choice-of-carboplatin patients with advanced urothelial carcinoma (UC) in KEYNOTE-361. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.450] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
450 Background: 1L pembro is approved in advanced UC for cisplatin-ineligible pts with PD-L1 combined positive score (CPS) ≥10 and any platinum-ineligible pts regardless of CPS in the United States based on single-arm trial data. In the phase III KEYNOTE-361 study, 1L pembro + chemo did not statistically significantly improve PFS or OS vs chemo for pts with advanced UC; formal testing of 1L pembro vs chemo was not performed. We present an exploratory analysis of outcomes with pembro vs chemo for choice-of-carboplatin (carbo) pts in KEYNOTE-361 (NCT02853305). Methods: At randomization, choice of platinum agent (cisplatin or carbo) plus gemcitabine for each pt was selected based on investigator’s assessment of cisplatin ineligibility. ORR/DOR per RECIST v1.1 by blinded independent central review and OS were determined for all pts selected for carbo (“choice-of-carbo”) and also choice-of-carbo pts with CPS ≥10. Risk difference assessment for select AEs for pembro vs chemo was conducted in choice-of-carbo pts who received ≥1 dose study treatment. Results: As of Apr 29, 2020, the median (range) time from randomization to data cutoff in the full study cohort was 31.7 (22.0-42.3) mo. At randomization, renal impairment was the most common reason for choice of carbo by investigators (36% of all pts). 170 choice-of-carbo pts were randomized to the pembro arm, and 196 choice-of-carbo pts to the chemo arm. Median OS in this subgroup was 14.6 mo with pembro vs 12.3 mo with chemo (HR 0.83 [95% CI 0.65-1.06]). 18-mo OS rate was 42% with pembro vs 40% with chemo. ORR to pembro vs chemo was 27.6% vs 41.8%. Median (range) DOR with pembro vs chemo was not reached (NR) (3.2+-36.1+ mo) vs 6.3 (1.8+-33.8+) mo. 84/170 (49%) and 89/196 (45%) choice-of-carbo pts in the pembro and chemo arms, respectively, had CPS ≥10. In this subgroup, median OS was 15.6 mo with pembro vs 13.5 mo with chemo (HR 0.82 [95% CI 0.57-1.17]). 18-mo OS rate was 44% with pembro vs 43% with chemo. ORR to pembro vs chemo was 29.8% vs 46.1%. Median (range) DOR with pembro vs chemo was NR (4.2-36.1+ mo) vs 8.3 (2.1+-33.8+) mo. Among treated pts (N=166 for pembro, N=190 for chemo), 112 pts (68%) in the pembro arm and 163 pts (86%) in the chemo arm had grade 3-5 AEs of any cause. Pembro was associated with a higher risk of pruritus, while chemo was associated with a higher risk of decreased white blood cell, neutrophil, and platelet counts, nausea, thrombocytopenia, neutropenia, and anemia. Conclusions: Due to the trial design, this subset was not statistically tested and is exploratory. Median OS and 18-mo OS rates did not appear markedly different in the two arms; some parameters such as DOR favored pembro, although longer follow-up is needed to determine median DOR for pembro. The PD-L1 CPS ≥10 did not clearly enrich for responders to pembro in choice-of-carbo pts. Pembro was associated with a lower rate of grade 3-5 AEs of any cause than chemo. Clinical trial information: NCT02853305.
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Affiliation(s)
- Thomas Powles
- Barts Cancer Centre, Queen Mary University of London, London, United Kingdom
| | | | - Mustafa Ozguroglu
- Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Nobuaki Matsubara
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Lajos Geczi
- National Institute of Oncology, Budapest, Hungary
| | | | - Yves Fradet
- CHU de Québec - Université Laval, Québec City, QC, Canada
| | - Stephane Oudard
- Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
| | - Christof Vulsteke
- Center for Oncological Research (CORE), University of Antwerp, Integrated Cancer Center Ghent, Ghent, Belgium
| | | | - Aude Flechon
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Yohann Loriot
- Department of Cancer Medicine, Institute Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alejo Rodriguez-Vida
- Medical Oncology Department, Hospital del Mar Research Institute, Barcelona, Spain
| | | | - Evan Y. Yu
- Division of Oncology, Department of Medicine, University of Washington, Seattle, WA
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Loriot Y, Alva AS, Csőszi T, Ozguroglu M, Matsubara N, Geczi L, Cheng SY, Fradet Y, Oudard S, Vulsteke C, Morales-Barrera R, Flechon A, Gunduz S, Rodriguez-Vida A, Mamtani R, Yu EY, Liu CC, Imai K, Homet Moreno B, Powles T. Post-hoc analysis of long-term outcomes in patients with CR, PR, or SD to pembrolizumab (pembro) or platinum-based chemotherapy (chemo) as 1L therapy for advanced urothelial carcinoma (UC) in KEYNOTE-361. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
435 Background: The phase III KEYNOTE-361 study compared efficacy and safety of 1L pembro + chemo or pembro vs chemo in pts with advanced UC. The trial did not meet its primary endpoints of PFS or OS superiority for pembro + chemo vs chemo; formal testing for OS for pembro vs chemo was not performed. We present a post hoc landmark analysis to examine the durability of CR/PR/SD and long-term survival in pts with CR, PR, or SD to pembro vs chemo at week 9 in KEYNOTE-361 (NCT02853305). Methods: Landmark analyses of OS by CR/PR/SD at 9 weeks after randomization in the ITT population were performed. Pts were included if they had a best response of CR/PR/SD per RECIST v1.1 by blinded independent central review at the landmark date of week 9 (first imaging assessment per study protocol). Duration of CR/PR/SD and OS were estimated by the Kaplan-Meier method. No formal comparisons were performed. Results: 307 pts were randomized to receive pembro and 352 pts to receive chemo in the KEYNOTE-361 study. As of Apr 29, 2020, the median (range) time from randomization to data cutoff was 32.5 (22.0-42.4) mo for the pembo arm and 31.4 (22.1-41.6) mo for the chemo arm. In the landmark analysis, fewer pts had CR/PR/SD at week 9 with pembro (n=137 [45%]) than with chemo (n=253 [72%]). Median (range) duration of response for pembro vs chemo was 18.7 (4.4+-35.4+) vs 12.3 (0.0+-29.7+) mo for pts with CR, and 35.0 (1.1-36.1+) vs 6.1 (0.0+-36.3+) mo for pts with PR. Median (range) duration of SD was 4.8 mo (0.0-38.2+) with pembro and 4.6 mo (0.0-16.1+) with chemo. Median OS (95% CI) for pembro vs chemo was not reached (NR) (25.5-NR) vs NR (19.1-NR) for pts with CR; NR (NR-NR) vs 14.8 mo (12.1-21.0) for pts with PR; and 18.5 mo (13.8-28.8) vs 11.1 mo (8.1-14.6) for pts with SD, respectively. Long-term OS rates were higher with pembro vs chemo across all groups (CR/PR/SD) at week 9 (Table). Conclusions: In this post hoc landmark analysis, chemo was associated with more initial responses than pembro, whereas pembro was associated with longer median duration of CR and PR, and generally longer median OS than chemo. Among pts who achieved CR/PR/SD at week 9, the relative OS benefit for pembro vs chemo increased over time. Clinical trial information: NCT02853305. [Table: see text]
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Affiliation(s)
- Yohann Loriot
- Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Tibor Csőszi
- Hetenyi G Korhaz, Onkologiai Kozpont, Szolnok, Hungary
| | - Mustafa Ozguroglu
- Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | | | - Lajos Geczi
- National Institute of Oncology, Budapest, Hungary
| | | | - Yves Fradet
- CHU de Québec - Université Laval, Québec City, QC, Canada
| | | | - Christof Vulsteke
- Center for Oncological Research (CORE), University of Antwerp, Integrated Cancer Center Ghent, Ghent, Belgium
| | | | | | | | - Alejo Rodriguez-Vida
- Medical Oncology Department, Hospital del Mar Research Institute, Barcelona, Spain
| | - Ronac Mamtani
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Evan Y. Yu
- Division of Oncology, Department of Medicine, University of Washington, Seattle, WA
| | | | | | | | - Thomas Powles
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
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Bilodeau JF, Gevariya N, Larose J, Robitaille K, Roy J, Oger C, Galano JM, Bergeron A, Durand T, Fradet Y, Julien P, Fradet V. Long chain omega-3 fatty acids and their oxidized metabolites are associated with reduced prostate tumor growth. Prostaglandins Leukot Essent Fatty Acids 2021; 164:102215. [PMID: 33276284 DOI: 10.1016/j.plefa.2020.102215] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 11/03/2020] [Accepted: 11/11/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Cancer has been associated with increased oxidative stress and deregulation of bioactive oxylipins derived from long-chain polyunsaturated fatty acids (LC-PUFA) like arachidonic acid (AA). There is a debate whether ω-3 LC-PUFA could promote or prevent prostate tumor growth through immune modulation and reduction of oxidative stress. Our aim was to study the association between enzymatically or non-enzymatically produced oxidized-LC-PUFA metabolites and tumor growth in an immune-competent eugonadal and castrated C57BL/6 male mice injected with TRAMP-C2 prostate tumor cells, fed with ω-3 or ω-6 LC-PUFA-rich diets. MATERIALS AND METHODS Tumor fatty acids were profiled by gas chromatography and 26 metabolites derived from either AA, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were assessed by liquid chromatography-mass spectrometry. RESULTS The enriched ω-3 diet did not reduce oxidative stress overall in tumors but favored the formation of ω-3 rather than ω-6 derived isoprostanoids. We discovered that EPA and its oxidized-derivatives like F3-isoprostanes and prostaglandin (PG)F3α, were inversely correlated with tumor volume (spearman correlations and T-test, p<0.05). In contrast, F2-isoprostanes, adrenic acid, docosapentaenoic acid (DPAω-6) and PGE2 were positively correlated with tumor volume. Interestingly, F4-neuroprostanes, PGD2, PGF2α, and thromboxane were specifically increased in TRAMP-C2 tumors of castrated mice compared to those of eugonadal mice. DISCUSSION Decreasing tumor growth under ω-3 diet could be attributed in part to increased levels of EPA and its oxidized-derivatives, a reduced level of pro-angiogenic PGE2 and increased levels of F4-neuroprostanes and resolvins content in tumors, suspected of having anti-proliferative and anti-inflammatory effects.
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Affiliation(s)
- Jean-François Bilodeau
- Axe endocrinologie et néphrologie, Centre de recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de Médecine, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Nikunj Gevariya
- Laboratoire d'Uro-Oncologie Expérimentale, Centre de Recherche du CHU de Québec - Université Laval, site L'Hôtel-Dieu de Québec, Québec, QC, Canada
| | - Jessica Larose
- Axe endocrinologie et néphrologie, Centre de recherche du CHU de Québec - Université Laval, Québec, QC, Canada
| | - Karine Robitaille
- Laboratoire d'Uro-Oncologie Expérimentale, Centre de Recherche du CHU de Québec - Université Laval, site L'Hôtel-Dieu de Québec, Québec, QC, Canada
| | - Jérôme Roy
- Montreal Diabetes Research Center, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Département de Nutrition, Université de Montréal, Montréal, QC, Canada
| | - Camille Oger
- Institut des Biomolécules Max Mousseron (IBMM), CNRS UMR 5247, Université de Montpellier, ENSCM, Montpellier, France
| | - Jean-Marie Galano
- Institut des Biomolécules Max Mousseron (IBMM), CNRS UMR 5247, Université de Montpellier, ENSCM, Montpellier, France
| | - Alain Bergeron
- Laboratoire d'Uro-Oncologie Expérimentale, Centre de Recherche du CHU de Québec - Université Laval, site L'Hôtel-Dieu de Québec, Québec, QC, Canada; Département de Chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le cancer de l'Université Laval, Québec, QC, Canada
| | - Thierry Durand
- Institut des Biomolécules Max Mousseron (IBMM), CNRS UMR 5247, Université de Montpellier, ENSCM, Montpellier, France
| | - Yves Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Centre de Recherche du CHU de Québec - Université Laval, site L'Hôtel-Dieu de Québec, Québec, QC, Canada; Département de Chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le cancer de l'Université Laval, Québec, QC, Canada
| | - Pierre Julien
- Axe endocrinologie et néphrologie, Centre de recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de Médecine, Faculté de Médecine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le cancer de l'Université Laval, Québec, QC, Canada
| | - Vincent Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Centre de Recherche du CHU de Québec - Université Laval, site L'Hôtel-Dieu de Québec, Québec, QC, Canada; Département de Chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada; Centre de Recherche sur le cancer de l'Université Laval, Québec, QC, Canada; Centre Nutrition, santé et société (NUTRISS) et Institut sur la nutrition et les aliments fonctionnels (INAF), Québec, Canada.
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Vittrant B, Leclercq M, Martin-Magniette ML, Collins C, Bergeron A, Fradet Y, Droit A. Identification of a Transcriptomic Prognostic Signature by Machine Learning Using a Combination of Small Cohorts of Prostate Cancer. Front Genet 2020; 11:550894. [PMID: 33324443 PMCID: PMC7723980 DOI: 10.3389/fgene.2020.550894] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/29/2020] [Indexed: 01/31/2023] Open
Abstract
Determining which treatment to provide to men with prostate cancer (PCa) is a major challenge for clinicians. Currently, the clinical risk-stratification for PCa is based on clinico-pathological variables such as Gleason grade, stage and prostate specific antigen (PSA) levels. But transcriptomic data have the potential to enable the development of more precise approaches to predict evolution of the disease. However, high quality RNA sequencing (RNA-seq) datasets along with clinical data with long follow-up allowing discovery of biochemical recurrence (BCR) biomarkers are small and rare. In this study, we propose a machine learning approach that is robust to batch effect and enables the discovery of highly predictive signatures despite using small datasets. Gene expression data were extracted from three RNA-Seq datasets cumulating a total of 171 PCa patients. Data were re-analyzed using a unique pipeline to ensure uniformity. Using a machine learning approach, a total of 14 classifiers were tested with various parameters to identify the best model and gene signature to predict BCR. Using a random forest model, we have identified a signature composed of only three genes (JUN, HES4, PPDPF) predicting BCR with better accuracy [74.2%, balanced error rate (BER) = 27%] than the clinico-pathological variables (69.2%, BER = 32%) currently in use to predict PCa evolution. This score is in the range of the studies that predicted BCR in single-cohort with a higher number of patients. We showed that it is possible to merge and analyze different small and heterogeneous datasets altogether to obtain a better signature than if they were analyzed individually, thus reducing the need for very large cohorts. This study demonstrates the feasibility to regroup different small datasets in one larger to identify a predictive genomic signature that would benefit PCa patients.
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Affiliation(s)
- Benjamin Vittrant
- Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada.,Département de Médecine Moléculaire, Université Laval, QC, Canada
| | - Mickael Leclercq
- Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada.,Département de Médecine Moléculaire, Université Laval, QC, Canada
| | - Marie-Laure Martin-Magniette
- Universities of Paris Saclay, Paris, Evry, CNRS, INRAE, Institute of Plant Sciences Paris Saclay (IPS2), 91192, GIf sur Yvette, France.,UMR MIA-Paris, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Colin Collins
- Vancouver Prostate Cancer Centre, Vancouver, BC, Canada.,Department of Urologic Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Alain Bergeron
- Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada.,Département de Chirurgie, Oncology Axis, Université Laval, Québec, QC, Canada
| | - Yves Fradet
- Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada.,Département de Chirurgie, Oncology Axis, Université Laval, Québec, QC, Canada
| | - Arnaud Droit
- Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada.,Département de Médecine Moléculaire, Université Laval, QC, Canada
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Gevariya N, Lachance G, Robitaille K, Joly Beauparlant C, Beaudoin L, Fournier É, Fradet Y, Droit A, Julien P, Marette A, Bergeron A, Fradet V. Omega-3 Eicosapentaenoic Acid Reduces Prostate Tumor Vascularity. Mol Cancer Res 2020; 19:516-527. [PMID: 33262291 DOI: 10.1158/1541-7786.mcr-20-0316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/31/2020] [Accepted: 11/25/2020] [Indexed: 11/16/2022]
Abstract
The impact of omega (ω)-3 fatty acids on prostate cancer is controversial in epidemiological studies but experimental studies suggest a protective effect. However, little is known about the mechanism of action. Here, we studied the effects of purified fatty acid molecules on prostate tumor progression using the TRAMP-C2 syngeneic immunocompetent mouse model. Compared with ω-6 or ω-9-supplemented animals, we observed that late-stage prostate tumor growth was reduced with a monoacylglyceride (MAG)-conjugated form of eicosapentaenoic acid (EPA) supplementation, whereas docosahexanenoic acid (DHA) caused an early reduction. MAG-EPA significantly decreased tumor blood vessel diameter (P < 0.001). RNA sequencing analysis revealed that MAG-EPA downregulated angiogenesis- and vascular-related pathways in tumors. We also observed this tissue vascular phenotype in a clinical trial testing MAG-EPA versus a high oleic sunflower oil placebo. Using anti-CD31 IHC, we observed that MAG-EPA reduced blood vessel diameter in prostate tumor tissue (P = 0.03) but not in normal adjacent tissue. Finally, testing autocrine and paracrine effects in an avascular tumor spheroid growth assay, both exogenous MAG-EPA and endogenous ω3 reduced VEGF secretion and in vitro endothelial cell tube formation and blocked tumor spheroid growth, suggesting that ω3 molecules can directly hinder prostate cancer cell growth. Altogether, our results suggest that fatty acids regulate prostate cancer growth and that a tumor-specific microenvironment is required for the anti-vascular effect of MAG-EPA in patients with prostate cancer. IMPLICATIONS: Increasing the amount of ingested EPA omega-3 subtype for patients with prostate cancer might help to reduce prostate tumor progression by reducing tumor vascularization.
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Affiliation(s)
- Nikunj Gevariya
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de Recherche sur le Cancer de l'Université Laval, Québec, Québec, Canada
| | - Gabriel Lachance
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de Recherche sur le Cancer de l'Université Laval, Québec, Québec, Canada.,Centre de recherche de l'IUCPQ, Québec, Québec, Canada
| | - Karine Robitaille
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de Recherche sur le Cancer de l'Université Laval, Québec, Québec, Canada
| | - Charles Joly Beauparlant
- Endocrinology and Nephrology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Laboratoire de bio-informatique and Centre de Génomique du Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Lisanne Beaudoin
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de Recherche sur le Cancer de l'Université Laval, Québec, Québec, Canada
| | - Éric Fournier
- Centre de Recherche sur le Cancer de l'Université Laval, Québec, Québec, Canada.,Endocrinology and Nephrology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Laboratoire de bio-informatique and Centre de Génomique du Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Yves Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de Recherche sur le Cancer de l'Université Laval, Québec, Québec, Canada
| | - Arnaud Droit
- Endocrinology and Nephrology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Laboratoire de bio-informatique and Centre de Génomique du Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Pierre Julien
- Endocrinology and Nephrology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de recherche en endocrinologie, métabolisme et inflammation de l'Université Laval, Québec, Québec, Canada
| | - André Marette
- Centre de recherche de l'IUCPQ, Québec, Québec, Canada
| | - Alain Bergeron
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de Recherche sur le Cancer de l'Université Laval, Québec, Québec, Canada
| | - Vincent Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada. .,Centre de Recherche sur le Cancer de l'Université Laval, Québec, Québec, Canada.,Centre nutrition, santé et société (NUTRISS) et Institut sur la nutrition et les aliments fonctionnels (INAF), Québec, Québec, Canada
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Vittrant B, Bergeron A, Molina OE, Leclercq M, Légaré XP, Hovington H, Picard V, Martin-Magniette ML, Livingstone J, Boutros PC, Collins C, Fradet Y, Droit A. Immune-focused multi-omics analysis of prostate cancer: leukocyte Ig-Like receptors are associated with disease progression. Oncoimmunology 2020; 9:1851950. [PMID: 33299664 PMCID: PMC7714461 DOI: 10.1080/2162402x.2020.1851950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 01/09/2023] Open
Abstract
Prostate cancer (PCa) immunotherapy has shown limited efficacy so far, even in advanced-stage cancers. The success rate of PCa immunotherapy might be improved by approaches more adapted to the immunobiology of the disease. The objective of this study was to perform a multi-omics analysis to identify immune genes associated with PCa progression to better characterize PCa immunobiology and propose new immunotherapeutic targets. mRNA, miRNA, methylation, copy number aberration, and single nucleotide variant datasets from The Cancer Genome Atlas PRAD cohort were analyzed after filtering for genes associated with immunity. Sparse partial least squares-discriminant analyses were performed to identify features associated with biochemical recurrence (BCR) in each type of omics data. Selected features predicted BCR with a balanced error rate (BER) of 0.20 to 0.51 in single-omics and of 0.05 in multi-omics analyses. Amongst features associated with BCR were genes from the Immunoglobulin Ig-like Receptor (LILR) family which are immune checkpoints with immunotherapeutic potential. Using Multivariate INTegrative (MINT) analysis, the association of five LILR genes with BCR was quantified in a combination of three RNA-seq datasets and confirmed with Kaplan-Meier analysis in both these and in an independent RNA-seq dataset. Finally, immunohistochemistry showed that a high number of LILRB1 positive cells within the tumors predicted long-term adverse outcomes. Thus, tumors characterized by abnormal expression of LILR genes have an elevated risk of recurring after definitive local therapy. The immunotherapeutic potential of these regulators to stimulate the immune response against PCa should be evaluated in pre-clinical models.
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Affiliation(s)
- Benjamin Vittrant
- Computational Biology Laboratory, CHU de Québec - Université Laval Research Center, Québec City, QC, Canada
- Laboratoire d’Uro-Oncologie Expérimentale, Axe Oncologie, Centre de Recherche Du CHU de Québec-Université Laval, Québec, Canada
| | - Alain Bergeron
- Laboratoire d’Uro-Oncologie Expérimentale, Axe Oncologie, Centre de Recherche Du CHU de Québec-Université Laval, Québec, Canada
| | - Oscar Eduardo Molina
- Laboratoire d’Uro-Oncologie Expérimentale, Axe Oncologie, Centre de Recherche Du CHU de Québec-Université Laval, Québec, Canada
| | - Mickael Leclercq
- Computational Biology Laboratory, CHU de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Xavier-Philippe Légaré
- Laboratoire d’Uro-Oncologie Expérimentale, Axe Oncologie, Centre de Recherche Du CHU de Québec-Université Laval, Québec, Canada
| | - Hélène Hovington
- Laboratoire d’Uro-Oncologie Expérimentale, Axe Oncologie, Centre de Recherche Du CHU de Québec-Université Laval, Québec, Canada
| | - Valérie Picard
- Laboratoire d’Uro-Oncologie Expérimentale, Axe Oncologie, Centre de Recherche Du CHU de Québec-Université Laval, Québec, Canada
| | - Marie-Laure Martin-Magniette
- Universities of Paris Saclay, Paris, Evry, CNRS, INRAE, Institute of Plant Sciences Paris Saclay (IPS2), Gif Sur Yvette, France
| | - Julie Livingstone
- Departments of Human Genetics & Urology, Jonsson Comprehensive Cancer Center and Institute for Precision Health, University of California, Los Angeles, USA
| | - Paul C. Boutros
- Departments of Human Genetics & Urology, Jonsson Comprehensive Cancer Center and Institute for Precision Health, University of California, Los Angeles, USA
- Departments of Medical Biophysics and Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Colin Collins
- Vancouver Prostate Cancer Centre, Vancouver, British Columbia, Canada
| | - Yves Fradet
- Laboratoire d’Uro-Oncologie Expérimentale, Axe Oncologie, Centre de Recherche Du CHU de Québec-Université Laval, Québec, Canada
| | - Arnaud Droit
- Computational Biology Laboratory, CHU de Québec - Université Laval Research Center, Québec City, QC, Canada
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Koti M, Berman DM, Siemens DR, Lange D, Wang E, Toren P, Eigl BJ, Hardy C, Purves R, Fradet V, Fradet Y, Mansure J, Kassouf W, Black PC. Building a Canadian Translational Bladder Cancer Research Network. Can Urol Assoc J 2020; 14:E475-E481. [PMID: 33275556 DOI: 10.5489/cuaj.6887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bladder cancer research has historically lagged behind efforts in other disease sites with substantial underfunding relative to the heavy morbidity and mortality suffered by patients. Alongside increasing advocacy however, more recent advances in our understanding of the molecular biology of bladder cancer has ushered in a period of renaissance with exciting prospects for novel, precise diagnostics and therapeutics. Given significant and diverse assets within the research community across Canada, an inaugural translational research forum was convened to identify research gaps and strengths, and to formalize investigational themes that would be apposite for multi-institutional collaboration. The virtual meeting brought together a multi-disciplinary network of genitourinary cancer researchers, including clinicians and basic scientists, and entailed detailed environmental scans of the Canadian clinical and translational research landscape as well as selected “elevator pitches” of potential research themes. The results of these discussions are detailed herein and have provided the impetus to formalize the Canadian Bladder Cancer Research Network (CBCRN). Working groups have been created to focus future multi-institutional collaborations in four inter-related initiatives: biomarker development, epigenetic targeting, immuno-oncology and the microbiome.
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Affiliation(s)
- Madhuri Koti
- Queen's Cancer Research Institute, Kingston, ON, Canada.,Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - David M Berman
- Queen's Cancer Research Institute, Kingston, ON, Canada.,Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.,Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - D Robert Siemens
- Queen's Cancer Research Institute, Kingston, ON, Canada.,Department of Urology, Queen's University, Kingston, ON, Canada
| | - Dirk Lange
- Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | | | - Paul Toren
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Bernhard J Eigl
- Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Céline Hardy
- Queen's Cancer Research Institute, Kingston, ON, Canada.,Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | | | - Vincent Fradet
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Yves Fradet
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Jose Mansure
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Wassim Kassouf
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Peter C Black
- Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
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48
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Turcotte B, Paquet S, Blais AS, Blouin AC, Bolduc S, Bureau M, Caumartin Y, Cloutier J, Deschênes-Rompré MP, Dujardin T, Fradet Y, Lacombe L, Moore K, Morin F, Nadeau G, Simonyan D, Soucy F, Tiguert R, Toren P, Lodde M, Pouliot F. A prospective, multisite study analyzing the percentage of urological cases that can be completely managed by telemedicine. Can Urol Assoc J 2020; 14:319-321. [PMID: 33275552 DOI: 10.5489/cuaj.6862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has accelerated the development of telemedicine due to confinement measures. However, the percentage of outpatient urological cases that could be managed completely by telemedicine outside of the COVID-19 pandemic remains to be determined. We conducted a prospective, multisite study involving all urologists working in the region of Quebec City. METHODS During the first four weeks of the regional confinement, 18 pediatric and adult urologists were asked to determine, after each telemedicine appointment, if it translated into a complete (CCM), incomplete (ICM), or suboptimal case management (SCM, adequate only in the context of the pandemic). RESULTS A total of 1679 appointments representing all urological areas were registered. Overall, 67.6% (95% confidence interval [CI] 65.3; 69.8), 27.1% (25.0; 29.3), and 4.3% (3.5; 5.4) were reported as CCM, SCM, and ICM, respectively. The CCM ratio varied according to the reason for consultation, with cancer suspicion (52.9% [42.9; 62.8]) and pediatric reasons (38.0% [30.0; 46.6]) showing the lowest CCM percentages. CCM percentages also varied significantly based on the setting where it was performed, ranging from 61.1% (private clinic) to 86.8% (endourology and general hospital). CONCLUSIONS We show that two-thirds of all urological outpatient cases could be completely managed by telemedicine outside of the pandemic. After the pandemic, it will be important to incorporate telemedicine as an alternative for a patient's first or followup visit, especially those with geographical, pathological, and socioeconomic considerations.
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Affiliation(s)
- Bruno Turcotte
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Sophie Paquet
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Anne-Sophie Blais
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Annie-Claude Blouin
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Stéphane Bolduc
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Michel Bureau
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Yves Caumartin
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Jonathan Cloutier
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | | | - Thierry Dujardin
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Yves Fradet
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Louis Lacombe
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Katherine Moore
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Fannie Morin
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Geneviève Nadeau
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - David Simonyan
- Clinical and Evaluative Research Platform, Research Centre, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Frédéric Soucy
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Rabi Tiguert
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Paul Toren
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Michele Lodde
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Frédéric Pouliot
- Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Quebec City, QC, Canada
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Bellmunt J, de Wit R, Fradet Y, Climent M, Petrylak D, Lee JL, Fong L, Necchi A, Sternberg C, Grivas P, O’Donnell P, Powles T, Plimack E, Cristescu R, Lunceford J, Ma J, Rajasagi M, Godwin J, Moreno B, Bajorin D. 747P Association of TMB with efficacy of pembrolizumab (pembro) in patients (pts) with advanced urothelial cancer (UC): Results from KEYNOTE-045 and KEYNOTE-052. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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50
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Grivas P, Balar A, Vuky J, de Wit R, Vogelzang N, Choueiri T, Bajorin D, Castellano Gauna D, Gerritsen W, Gurney H, Quinn D, Culine S, Fradet Y, Saadatpour A, Loboda A, Ma J, Rajasagi M, Godwin J, Moreno B, Bellmunt J. 744P Association between gene expression signatures (sigs) and pembrolizumab (pembro) efficacy in patients (pts) with advanced urothelial cancer (UC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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