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Scheinberg T, Lin HM, Fitzpatrick M, Azad AA, Bonnitcha P, Davies A, Heller G, Huynh K, Mak B, Mahon K, Sullivan D, Meikle PJ, Horvath LG. PCPro: a clinically accessible, circulating lipid biomarker signature for poor-prognosis metastatic prostate cancer. Prostate Cancer Prostatic Dis 2024; 27:136-143. [PMID: 37147359 PMCID: PMC10876475 DOI: 10.1038/s41391-023-00666-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Using comprehensive plasma lipidomic profiling from men with metastatic castration-resistant prostate cancer (mCRPC), we have previously identified a poor-prognostic lipid profile associated with shorter overall survival (OS). In order to translate this biomarker into the clinic, these men must be identifiable via a clinically accessible, regulatory-compliant assay. METHODS A single regulatory-compliant liquid chromatography-mass spectrometry assay of candidate lipids was developed and tested on a mCRPC Discovery cohort of 105 men. Various risk-score Cox regression prognostic models of OS were built using the Discovery cohort. The model with the highest concordance index (PCPro) was chosen for validation and tested on an independent Validation cohort of 183 men. RESULTS PCPro, the lipid biomarker, contains Cer(d18:1/18:0), Cer(d18:1/24:0), Cer(d18:1/24:1), triglycerides and total cholesterol. Within the Discovery and Validation cohorts, men who were PCPro positive had significantly shorter OS compared to those who were PCPro negative (Discovery: median OS 12.0 months vs 24.2 months, hazard ratio (HR) 3.75 [95% confidence interval (CI) 2.29-6.15], p < 0.001, Validation: median OS 13.0 months vs 25.7 months, HR = 2.13 [95% CI 1.46-3.12], p < 0.001). CONCLUSIONS We have developed PCPro, a lipid biomarker assay capable of prospectively identifying men with mCRPC with a poor prognosis. Prospective clinical trials are required to determine if men who are PCPro positive will benefit from therapeutic agents targeting lipid metabolism.
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Affiliation(s)
- Tahlia Scheinberg
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- Advanced Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Hui-Ming Lin
- Advanced Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- St Vincent's Clinical School, UNSW Sydney, Sydney, NSW, Australia
| | - Michael Fitzpatrick
- NSW Health Pathology, Department of Chemical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - Arun A Azad
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Paul Bonnitcha
- University of Sydney, Camperdown, NSW, Australia
- NSW Health Pathology, Department of Chemical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - Amy Davies
- Department of Medical Oncology, Monash Health, Melbourne, VIC, Australia
- Department of Medicine, Monash University, Melbourne, VIC, Australia
| | | | - Kevin Huynh
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Cardiovascular Research Translation and implementation, La Trobe University, Melbourne, VIC, Australia
| | - Blossom Mak
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- Advanced Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Kate Mahon
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- Advanced Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - David Sullivan
- NSW Health Pathology, Department of Chemical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Cardiovascular Research Translation and implementation, La Trobe University, Melbourne, VIC, Australia
| | - Lisa G Horvath
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
- Advanced Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.
- University of Sydney, Camperdown, NSW, Australia.
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
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