Investigating High-risk Factors, Precise Diagnosis, and Treatment of Castration- Resistant Prostate Cancer (CRPC)


Цитировать

Полный текст

Аннотация

Background:The treatment of metastatic castration-resistant prostate cancer (mCRPC) in the actual world currently presents difficulties. In light of this, it is crucial to investigate high-risk factors for the progression of advanced prostate cancer and to identify methods for delaying the onset of CRPC.

Aims:This study aimed to explore the high-risk factors that impact the progression of prostate cancer and emphasize the significance of precise diagnosis and treatment based on etiological classification in the clinical management of castration-resistant prostate cancer.

Methods:A retrospective analysis was conducted on 277 newly diagnosed cases of PCa treated with endocrine therapy. A follow-up was done on prostate-specific antigen (PSA) levels and testosterone. Additionally, a prospective analysis was performed on the clinical data of 60 patients with CRPC. Following the principle of \"4W1H\", 30 patients were included in the precision treatment group for a second biopsy and related tests, while another 30 patients were included in the conventional treatment group. The therapeutic effect and prognosis of the two groups were observed.

Results:Distant metastasis (HR = 1.879, 95% CI: 1.311 ~ 2.694, P = 0.001), PSA nadir > 0.2 ng/mL (HR = 1.843, 95% CI: 1.338 ~ 2.540, P = 0.001), testosterone nadir > 20 ng/dL (HR = 1.403, 95% CI: 1.035 ~ 1.904, P = 0.029), and time to testosterone nadir > 6 months (HR = 1.919, 95% CI: 1.364 ~ 2.701, P = 0.001) were risk factors for the progression to CRPC. Patients in the CRPC group were treated with precision therapy and conventional therapy based on their molecular subtyping. The precision treatment group showed a significantly prolonged median PSA progression-free survival compared to the conventional treatment group (16.0 months vs. 13.0 months, P=0.025). The median radiographic progression-free survival was also significantly extended in the precision treatment group compared to the conventional treatment group (21.0 months vs. 16.0 months, P=0.042).

Conclusion:Patients with prostate cancer diagnosed with distant metastasis at initial presentation require early intervention. Close monitoring of PSA and serum testosterone changes is necessary during the process of endocrine therapy. After entering the CRPC stage, the etiological classification precision treatment can improve the therapeutic effect and improve the prognosis of patients.

Об авторах

Yuan Ma

Department of Urology, Second Hospital of Tianjin Medical University

Email: info@benthamscience.net

Zihao Liu

Department of Urology, Second Hospital of Tianjin Medical University

Email: info@benthamscience.net

Wenyue Yu

Tianjin Institute of Urology, Second Hospital of Tianjin Medical University

Email: info@benthamscience.net

Hua Huang

Department of Urology, Second Hospital of Tianjin Medical University

Email: info@benthamscience.net

Yong Wang

Department of Urology, Second Hospital of Tianjin Medical University

Автор, ответственный за переписку.
Email: info@benthamscience.net

Yuanjie Niu

Department of Urology,, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.

Автор, ответственный за переписку.
Email: info@benthamscience.net

Список литературы

  1. Siegel, R.L.; Miller, K.D.; Fuchs, H.E.; Jemal, A. Cancer statistics, 2022. CA Cancer J. Clin., 2022, 72(1), 7-33. doi: 10.3322/caac.21708 PMID: 35020204
  2. Xia, C.; Dong, X.; Li, H.; Cao, M.; Sun, D.; He, S.; Yang, F.; Yan, X.; Zhang, S.; Li, N.; Chen, W. Cancer statistics in China and United States, 2022: Profiles, trends, and determinants. Chin. Med. J. (Engl.), 2022, 135(5), 584-590. doi: 10.1097/CM9.0000000000002108 PMID: 35143424
  3. Achard, V.; Putora, P.M.; Omlin, A.; Zilli, T.; Fischer, S. Metastatic prostate cancer: treatment options. Oncology, 2022, 100(1), 48-59. doi: 10.1159/000519861 PMID: 34781285
  4. Vietri, M.T.; D'Elia, G.; Caliendo, G Hereditary prostate cancer: genes related, target therapy and prevention. Int. J. Mol. Sci., 2021, 22(7), 3753.
  5. Rosellini, M.; Santoni, M.; Mollica, V.; Rizzo, A.; Cimadamore, A.; Scarpelli, M.; Storti, N.; Battelli, N.; Montironi, R.; Massari, F. Treating prostate cancer by antibody–drug conjugates. Int. J. Mol. Sci., 2021, 22(4), 1551. doi: 10.3390/ijms22041551 PMID: 33557050
  6. Talkar, S.S.; Patravale, V.B. Gene Therapy for Prostate Cancer: A Review. Endocr. Metab. Immune Disord. Drug Targets, 2021, 21(3), 385-396. doi: 10.2174/1871530320666200531141455 PMID: 32473623
  7. Shang, Z.; Cai, Q.; Zhang, M.; Zhu, S.; Ma, Y.; Sun, L.; Jiang, N.; Tian, J.; Niu, X.; Chen, J.; Sun, Y.; Niu, Y. A switch from CD44+ cell to EMT cell drives the metastasis of prostate cancer. Oncotarget, 2015, 6(2), 1202-1216. doi: 10.18632/oncotarget.2841 PMID: 25483103
  8. Niu, Y.; Altuwaijri, S.; Lai, K.P.; Wu, C.T.; Ricke, W.A.; Messing, E.M.; Yao, J.; Yeh, S.; Chang, C. Androgen receptor is a tumor suppressor and proliferator in prostate cancer. Proc. Natl. Acad. Sci. USA, 2008, 105(34), 12182-12187. doi: 10.1073/pnas.0804700105 PMID: 18723679
  9. Jiang, N.; Hjorth-Jensen, K.; Hekmat, O.; Iglesias-Gato, D.; Kruse, T.; Wang, C.; Wei, W.; Ke, B.; Yan, B.; Niu, Y.; Olsen, J.V.; Flores-Morales, A. In vivo quantitative phosphoproteomic profiling identifies novel regulators of castration-resistant prostate cancer growth. Oncogene, 2015, 34(21), 2764-2776. doi: 10.1038/onc.2014.206 PMID: 25065596
  10. Lee, J.K.; Phillips, J.W.; Smith, B.A.; Park, J.W.; Stoyanova, T.; McCaffrey, E.F.; Baertsch, R.; Sokolov, A.; Meyerowitz, J.G.; Mathis, C.; Cheng, D.; Stuart, J.M.; Shokat, K.M.; Gustafson, W.C.; Huang, J.; Witte, O.N. N-Myc drives neuroendocrine prostate cancer initiated from human prostate epithelial cells. Cancer Cell, 2016, 29(4), 536-547. doi: 10.1016/j.ccell.2016.03.001 PMID: 27050099
  11. Dong, B.; Miao, J.; Wang, Y.; Luo, W.; Ji, Z.; Lai, H.; Zhang, M.; Cheng, X.; Wang, J.; Fang, Y.; Zhu, H.H.; Chua, C.W.; Fan, L.; Zhu, Y.; Pan, J.; Wang, J.; Xue, W.; Gao, W.Q. Single-cell analysis supports a luminal-neuroendocrine transdifferentiation in human prostate cancer. Commun. Biol., 2020, 3(1), 778. doi: 10.1038/s42003-020-01476-1 PMID: 33328604
  12. Liu, Z.; Wang, L.; Zhou, Y.; Wang, C.; Ma, Y.; Zhao, Y.; Tian, J.; Huang, H.; Wang, H.; Wang, Y.; Niu, Y. Application of metastatic biopsy based on "When, Who, Why, Where, How (4W1H)" principle in diagnosis and treatment of metastatic castration-resistance prostate cancer. Transl. Androl. Urol., 2021, 10(4), 1723-1733. doi: 10.21037/tau-21-23 PMID: 33968660
  13. Gourdin, T. Recent progress in treating advanced prostate cancer. Curr. Opin. Oncol., 2020, 32(3), 210-215. doi: 10.1097/CCO.0000000000000624 PMID: 32209821
  14. Chi, K.N.; Agarwal, N.; Bjartell, A.; Chung, B.H.; Pereira de Santana Gomes, A.J.; Given, R.; Juárez Soto, Á.; Merseburger, A.S.; Özgüroğlu, M.; Uemura, H.; Ye, D.; Deprince, K.; Naini, V.; Li, J.; Cheng, S.; Yu, M.K.; Zhang, K.; Larsen, J.S.; McCarthy, S.; Chowdhury, S. Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer. N. Engl. J. Med., 2019, 381(1), 13-24. doi: 10.1056/NEJMoa1903307 PMID: 31150574
  15. Nayan, M.; Carvalho, F.L.F.; Feldman, A.S. Active surveillance for intermediate-risk prostate cancer. World J. Urol., 2022, 40(1), 79-86. doi: 10.1007/s00345-021-03893-1 PMID: 35044491
  16. Fuerea, A.; Baciarello, G.; Patrikidou, A.; Albigès, L.; Massard, C.; Di Palma, M.; Escudier, B.; Fizazi, K.; Loriot, Y. Early PSA response is an independent prognostic factor in patients with metastatic castration-resistant prostate cancer treated with next-generation androgen pathway inhibitors. Eur. J. Cancer, 2016, 61, 44-51. doi: 10.1016/j.ejca.2016.03.070 PMID: 27151554
  17. Romesser, P.B.; Pei, X.; Shi, W.; Zhang, Z.; Kollmeier, M.; McBride, S.M.; Zelefsky, M.J. Prostate-Specific Antigen (PSA) Bounce After Dose-Escalated External Beam Radiation Therapy Is an Independent Predictor of PSA Recurrence, Metastasis, and Survival in Prostate Adenocarcinoma Patients. Int. J. Radiat. Oncol. Biol. Phys., 2018, 100(1), 59-67. doi: 10.1016/j.ijrobp.2017.09.003 PMID: 29254782
  18. Hah, Y.S.; Lee, J.S.; Rha, K.H.; Hong, S.J.; Chung, B.H.; Koo, K.C. Effect of prior local treatment and prostate-specific antigen kinetics during androgen-deprivation therapy on the survival of castration-resistant prostate cancer. Sci. Rep., 2019, 9(1), 11899. doi: 10.1038/s41598-019-48424-6 PMID: 31417160
  19. Crawford, E.D.; Heidenreich, A.; Lawrentschuk, N.; Tombal, B.; Pompeo, A.C.L.; Mendoza-Valdes, A.; Miller, K.; Debruyne, F.M.J.; Klotz, L. Androgen-targeted therapy in men with prostate cancer: Evolving practice and future considerations. Prostate Cancer Prostatic Dis., 2019, 22(1), 24-38. doi: 10.1038/s41391-018-0079-0 PMID: 30131604
  20. Yamamoto, S.; Sakamoto, S.; Minhui, X.; Tamura, T.; Otsuka, K.; Sato, K.; Maimaiti, M.; Kamada, S.; Takei, A.; Fuse, M.; Kawamura, K.; Imamoto, T.; Komiya, A.; Akakura, K.; Ichikawa, T. Testosterone Reduction of ≥ 480 ng/dL Predicts Favorable Prognosis of Japanese Men With Advanced Prostate Cancer Treated With Androgen-Deprivation Therapy. Clin. Genitourin. Cancer, 2017, 15(6), e1107-e1115. doi: 10.1016/j.clgc.2017.07.023 PMID: 28882738
  21. San Francisco, I.F.; Werner, L.; Regan, M.M.; Garnick, M.B.; Bubley, G.; DeWolf, W.C. Risk stratification and validation of prostate specific antigen density as independent predictor of progression in men with low risk prostate cancer during active surveillance. J. Urol., 2011, 185(2), 471-476. doi: 10.1016/j.juro.2010.09.115 PMID: 21167525
  22. Ryu, J.H.; Kim, Y.B.; Lee, J.K.; Kim, Y.J.; Jung, T.Y. Predictive factors of prostate cancer at repeat biopsy in patients with an initial diagnosis of atypical small acinar proliferation of the prostate. Korean J. Urol., 2010, 51(11), 752-756. doi: 10.4111/kju.2010.51.11.752 PMID: 21165194
  23. Gundem, G.; Van Loo, P.; Kremeyer, B.; Alexandrov, L.B.; Tubio, J.M.C.; Papaemmanuil, E.; Brewer, D.S.; Kallio, H.M.L.; Högnäs, G.; Annala, M.; Kivinummi, K.; Goody, V.; Latimer, C.; O’Meara, S.; Dawson, K.J.; Isaacs, W.; Emmert-Buck, M.R.; Nykter, M.; Foster, C.; Kote-Jarai, Z.; Easton, D.; Whitaker, H.C.; Neal, D.E.; Cooper, C.S.; Eeles, R.A.; Visakorpi, T.; Campbell, P.J.; McDermott, U.; Wedge, D.C.; Bova, G.S. The evolutionary history of lethal metastatic prostate cancer. Nature, 2015, 520(7547), 353-357. doi: 10.1038/nature14347 PMID: 25830880
  24. Ross, R.W.; Halabi, S.; Ou, S.S.; Rajeshkumar, B.R.; Woda, B.A.; Vogelzang, N.J.; Small, E.J.; Taplin, M.E.; Kantoff, P.W. Predictors of prostate cancer tissue acquisition by an undirected core bone marrow biopsy in metastatic castration-resistant prostate cancer--a Cancer and Leukemia Group B study. Clin. Cancer Res., 2005, 11(22), 8109-8113. doi: 10.1158/1078-0432.CCR-05-1250 PMID: 16299243
  25. Tannock, I.F.; de Wit, R.; Berry, W.R.; Horti, J.; Pluzanska, A.; Chi, K.N.; Oudard, S.; Théodore, C.; James, N.D.; Turesson, I.; Rosenthal, M.A.; Eisenberger, M.A. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N. Engl. J. Med., 2004, 351(15), 1502-1512. doi: 10.1056/NEJMoa040720 PMID: 15470213
  26. Ryan, C.J.; Smith, M.R.; de Bono, J.S.; Molina, A.; Logothetis, C.J.; de Souza, P.; Fizazi, K.; Mainwaring, P.; Piulats, J.M.; Ng, S.; Carles, J.; Mulders, P.F.A.; Basch, E.; Small, E.J.; Saad, F.; Schrijvers, D.; Van Poppel, H.; Mukherjee, S.D.; Suttmann, H.; Gerritsen, W.R.; Flaig, T.W.; George, D.J.; Yu, E.Y.; Efstathiou, E.; Pantuck, A.; Winquist, E.; Higano, C.S.; Taplin, M.E.; Park, Y.; Kheoh, T.; Griffin, T.; Scher, H.I.; Rathkopf, D.E. Abiraterone in metastatic prostate cancer without previous chemotherapy. N. Engl. J. Med., 2013, 368(2), 138-148. doi: 10.1056/NEJMoa1209096 PMID: 23228172
  27. Borgen, E.; Beiske, K.; Trachsel, S.; Nesland, J.M.; Kvalheim, G.; Herstad, T.K.; Schlichting, E.; Qvist, H.; Naume, B. Immunocytochemical detection of isolated epithelial cells in bone marrow: Non-specific staining and contribution by plasma cells directly reactive to alkaline phosphatase. J. Pathol., 1998, 185(4), 427-434. doi: 10.1002/(SICI)1096-9896(199808)185:43.0.CO;2-7 PMID: 9828843
  28. Grønhøj Larsen, C.; Gyldenløve, M.; Jensen, D.H.; Therkildsen, M.H.; Kiss, K.; Norrild, B.; Konge, L.; von Buchwald, C. Correlation between human papillomavirus and p16 overexpression in oropharyngeal tumours: A systematic review. Br. J. Cancer, 2014, 110(6), 1587-1594. doi: 10.1038/bjc.2014.42 PMID: 24518594

Дополнительные файлы

Доп. файлы
Действие
1. JATS XML
Скачать

© Bentham Science Publishers, 2024