1019: Clinical Value of [11C] Choline Petict in Patients with Rising PSA After Primary Treatment of Prostate Cancer

ObjectiveSimultaneous PET/MRI combines soft-tissue contrast of MRI with high molecular sensitivity of PET in one session. The aim of this prospective study was to evaluate detection rates of recurrent prostate cancer by 18F-fluciclovine PET/MRI.MethodsPatients with biochemical recurrence (BCR) or persistently detectable prostate specific antigen (PSA), were examined with simultaneous 18F-fluciclovine PET/MRI. Multiparametric MRI (mpMRI) and PET/MRI were scored on a 3-point scale (1-negative, 2-equivocal, 3-recurrence/metastasis) and detection rates (number of patients with suspicious findings divided by total number of patients) were reported. Detection rates were further stratified based on PSA level, PSA doubling time (PSAdt), primary treatment and inclusion criteria (PSA persistence, European Association of Urology (EAU) Low-Risk BCR and EAU High-Risk BCR). A detailed investigation of lesions with discrepancy between mpMRI and PET/MRI scores was performed to evaluate the incremental value of PET/MRI to mpMRI. The impact of the added PET acquisition on further follow-up and treatment was evaluated retrospectively.ResultsAmong patients eligible for analysis (n=84), 54 lesions were detected in 38 patients by either mpMRI or PET/MRI. Detection rates were 41.7% for mpMRI and 39.3% for PET/MRI (score 2 and 3 considered positive). There were no significant differences in detection rates for mpMRI versus PET/MRI. Disease detection rates were higher in patients with PSA≥1ng/mL than in patients with lower PSA levels but did not differ between patients with PSAdt above versus below 6 months. Detection rates in patients with primary radiation therapy were higher than in patients with primary surgery. Patients categorized as EAU Low-Risk BCR had a detection rate of 0% both for mpMRI and PET/MRI. For 15 lesions (27.8% of all lesions) there was a discrepancy between mpMRI score and PET/MRI score. Of these, 10 lesions scored as 2-equivocal by mpMRI were changed to a more definite score (n=4 score 1 and n=6 score 3) based on the added PET acquisition. Furthermore, for 4 of 10 patients with discrepancy between mpMRI and PET/MRI scores, the added PET acquisition had affected the treatment choice.ConclusionCombined 18F-fluciclovine PET/MRI can detect lesions suspicious for recurrent prostate cancer in patients with a range of PSA levels. Combined PET/MRI may be useful to select patients for appropriate treatment, but is of limited use at low PSA values or in patients classified as EAU Low-Risk BCR, and the clinical value of 18F-fluciclovine PET/MRI in this study was too low to justify routine clinical use.

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SBRT for the Primary Treatment of Localized Prostate Cancer: The Effect of Gleason Score, Dose and Heterogeneity of Intermediate Risk on Outcome Utilizing 2.2014 NCCN Risk Stratification Guidelines

Frontiers in Oncology ◽

10.3389/fonc.2014.00312 ◽

2014 ◽

Vol 4 ◽

Cited By ~ 7

Author(s):

Matthew Bernetich ◽

Caspian Oliai ◽

Rachelle Lanciano ◽

Alexandra Hanlon ◽

John Lamond ◽

...

Keyword(s):

Prostate Cancer ◽

Risk Stratification ◽

Gleason Score ◽

Primary Treatment ◽

Localized Prostate Cancer ◽

Intermediate Risk

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Downregulation and Prognostic Performance of MicroRNA 224 Expression in Prostate Cancer

Clinical Chemistry ◽

10.1373/clinchem.2012.191502 ◽

2013 ◽

Vol 59 (1) ◽

pp. 261-269 ◽

Cited By ~ 44

Author(s):

Konstantinos Mavridis ◽

Konstantinos Stravodimos ◽

Andreas Scorilas

Keyword(s):

Prostate Cancer ◽

Cox Regression ◽

Specific Antigen ◽

Progression Free Survival ◽

Prognostic Indicator ◽

Disease Stage ◽

Clinical Value ◽

Prostate Tumors ◽

Tissue Samples ◽

Total Rna

INTRODUCTION The extensive use of prostate-specific antigen as a general prostate cancer biomarker has introduced the hazards of overdiagnosis and overtreatment. Recent studies have revealed the immense biomarker capacity of microRNAs (miRNAs) in prostate cancer. The aim of this study was to analyze the expression pattern of miR-224, a cancer-related miRNA, in prostate tumors and investigate its clinical utility. METHODS Total RNA was isolated from 139 prostate tissue samples. After the polyadenylation of total RNA by poly(A) polymerase, cDNA was synthesized with a suitable poly(T) adapter. miR-224 expression was assessed by quantitative real-time PCR and analyzed with the comparative quantification cycle method, Cq(2−ΔΔCq). We performed comprehensive biostatistical analyses to explore the clinical value of miR-224 in prostate cancer. RESULTS miR-224 expression was significantly downregulated in malignant samples compared with benign samples (P < 0.001). Higher miR-224 expression levels were found in prostate tumors that were less aggressive (P = 0.017) and in an earlier disease stage (P = 0.018). Patients with prostate cancer who were positive for miR-224 had significantly enhanced progression-free survival intervals compared with miR-224–negative patients (P = 0.021). Univariate bootstrap Cox regression confirmed that miR-224 was associated with favorable prognosis (hazard ratio 0.314, P = 0.013); nonetheless, multivariate analysis, adjusted for conventional markers, did not identify miR-224 as an independent prognostic indicator. CONCLUSIONS miR-224 is aberrantly expressed in prostate cancer. Its assessment by cost-effective quantitative molecular methodologies could provide a useful biomarker for prostate cancer.

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Clinical value of serum interleukin-18 and nitric oxide activities in patients with prostate cancer

The Chinese-German Journal of Clinical Oncology ◽

10.1007/s10330-011-0899-z ◽

2011 ◽

Vol 10 (12) ◽

pp. 711-715

Author(s):

Shaojun Nong ◽

Yueping Zhang ◽

Chongsheng He ◽

Bin Cheng ◽

Shujun Zhou ◽

...

Keyword(s):

Prostate Cancer ◽

Nitric Oxide ◽

Interleukin 18 ◽

Clinical Value

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Validation of the decipher genomic classifier (GC) in SAKK 09/10: A phase III randomized trial of dose-escalated salvage radiotherapy (SRT) after radical prostatectomy (RP).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.5010 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 5010-5010

Author(s):

Alan Dal Pra ◽

Pirus Ghadjar ◽

Stefanie Hayoz ◽

Daniel Eidelberg Spratt ◽

Vinnie YT Liu ◽

...

Keyword(s):

Prostate Cancer ◽

Controlled Trial ◽

Multivariable Analysis ◽

Progression Free Survival ◽

Risk Groups ◽

Phase Iii ◽

Clinical Progression ◽

Clinical Value ◽

Prognostic Utility ◽

The Impact

5010 Background: GC has been shown to independently prognosticate outcomes in prostate cancer. Herein, we validate the GC in a European randomized phase III trial of dose escalated SRT after RP. Methods: SAKK 09/10 (NCT01272050) randomized 350 patients with biochemical recurrence after RP to 64Gy vs 70Gy. No patients received androgen deprivation therapy (ADT) or pelvic nodal radiotherapy. A pre-specified statistical plan was developed to assess the impact of the GC on clinical outcomes. RP samples were centrally reviewed for the highest-grade tumor and those passing quality control (QC) were run on a clinical-grade whole-transcriptome assay to obtain the GC score (0 to 1; < 0.45, 0.45-0.6, > 0.6 for low-, intermediate-, and high, respectively). The primary aim of this study was to validate the GC for the prediction of freedom from biochemical progression (FFBP) using Cox multivariable analysis (MVA) adjusting for age, T-category, Gleason score, persistent PSA after RP, PSA at randomization, and randomization arm. The secondary aims were to evaluate the association of GC with clinical progression-free survival (CPFS) and use of salvage ADT. Results: Of 233 patients with tissue available, 226 passed QC and were included for analysis. The final GC cohort was a representative sample of the overall cohort, with a median follow-up of 6.3 years (IQR 6.0-7.2). GC score (continuous per 0.1 unit, score 0-1) was independently associated with FFBP (HR 1.14 [95% CI 1.03-1.25], p = 0.009). Higher GC scores were independently associated with CPFS, use of salvage ADT, and rapid biochemical failure ( < 18 months after SRT). High- vs. low/intermediate-GC showed a HR of 2.22 ([95% CI 1.37-3.58], p = 0.001) for FFBP, 2.29 ([95% CI 1.32-3.98], p = 0.003) for CPFS, and 2.99 ([95% CI 1.50-5.95], p = 0.002) for use of salvage ADT. Patients with high-GC had 5-year FFBP of 45% [95% CI 32-59] vs 71% [95% CI 64-78] in low-intermediate GC. Similar estimates for GC risk groups were observed in the 64Gy vs 70Gy in GC high (5-year FFBP of 51% [95% CI 32-70] vs 39% [95% CI 20-59]) and in low-intermediate GC (75% [95% CI 65-84] vs 69% [95% CI 59-78]). Conclusions: This study represents the first contemporary randomized controlled trial in patients with recurrent prostate cancer treated with early SRT without ADT that has validated the prognostic utility of the GC. Independent of standard clinicopathologic variables and radiotherapy dose, patients with a high-GC were more than twice as likely than a lower GC score to experience biochemical and clinical progression and receive salvage ADT. This data confirms the clinical value of Decipher GC for tailoring treatment in the postoperative salvage setting.

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Primary Treatment Choice Over Time and Relative Survival of Prostate Cancer Patients: Influence of Age, Grade, and Stage

Oncology Research and Treatment ◽

10.1159/000477096 ◽

2017 ◽

Vol 40 (9) ◽

pp. 484-489 ◽

Cited By ~ 4

Author(s):

Katarina L. Matthes ◽

Manuela Limam ◽

Silvia Dehler ◽

Dimitri Korol ◽

Sabine Rohrmann

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Relative Survival ◽

Primary Treatment ◽

Treatment Choice ◽

Over Time

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MP46-13 RISK OF HOSPITALIZATION FOLLOWING PRIMARY TREATMENT FOR PROSTATE CANCER

The Journal of Urology ◽

10.1016/j.juro.2016.02.311 ◽

2016 ◽

Vol 195 (4S) ◽

Author(s):

Stephen Williams ◽

Zhiganag Duan ◽

Karen Hoffman ◽

Benjamin Smith ◽

Jim Hu ◽

...

Keyword(s):

Prostate Cancer ◽

Primary Treatment

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Re: Focal Irreversible Electroporation as Primary Treatment for Localized Prostate Cancer

The Journal of Urology ◽

10.1016/j.juro.2018.08.053 ◽

2018 ◽

Vol 200 (6) ◽

pp. 1145-1146

Author(s):

Jeffrey A. Cadeddu

Keyword(s):

Prostate Cancer ◽

Irreversible Electroporation ◽

Primary Treatment ◽

Localized Prostate Cancer

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Treatment methods of prostate cancer recurrence after radiotherapy. Current treatment alternatives and our clinical experience

Lietuvos chirurgija ◽

10.15388/lietchirur.2013.3.1840 ◽

2013 ◽

Vol 12 (3) ◽

pp. 138-143

Author(s):

Albertas Ulys ◽

Alvydas Vėželis ◽

Andrius Ivanauskas ◽

Marius Snicorius

Keyword(s):

Prostate Cancer ◽

Cancer Progression ◽

Cancer Recurrence ◽

Primary Treatment ◽

Salvage Treatment ◽

Prostate Cancer Progression ◽

Prostate Cancer Recurrence ◽

Salvage Cryotherapy ◽

Group 2 ◽

Group 1

Background / objectiveProstate cancer is the most common cancer among men of Lithuania. Every year about 3000 new cases of prostate cancer are diagnosed in our country. Many patients receive radiotherapy as primary treatment. Unfortunately, after several years some of the patients are diagnosed with prostate cancer recurrence. These cases are more challenging and require to apply salvage treatment methods. The aim of this article is to present our clinical experience and discuss the main features, advantages and disadvantages of the treatment methods.Patients and methodsRetrospective analysis of 10 salvage prostate cancer recurrence treatment cases was completed. All patients previously received radiotherapy as primary treatment. 5 patients received salvage high- dose brachiterapy (group 1) and other 5- salvage cryotherapy (group 2). Prostate cancer recurrences were diagnosed by multiparametric MRI and ultrasound guided transrectal or transperineal biopsies.ResultsAverage patient age was 64,2±7,9 years in group 1 and 68±3,1 years in group 2. None of the patients had prostate cancer progression to lymph nodes (N) or metastases (M) on initial diagnosis or before salvage treatment. No intraoperative complications were observed. Average time between radiotherapy and salvage therapy in both groups was 88,9±30,1 months. In both groups 1 patient suffered from salvage treatment failure- prostate cancer progression was observed.ConclusionsCurrently there is no perfect treatment method for recurrent prostate cancer. Every situation requires universal aproach. Our initial experience shows that salvage cryotherapy and brachiterapy can be a viable alternative for patients with disease progression after radiotherapy.Key words: prostate cancer, prostate cancer recurrence, salvage treatment.Prostatos vėžio recidyvų po spindulinės terapijos gydymo metodaiŠiuolaikinėje medicinoje naudojami metodai ir mūsų klinikinė patirtis Įvadas / tikslasLietuvoje kasmet nustatoma apie 3000 naujų prostatos vėžio atvejų. Daugeliui pacientų taikomas spindulinis gydymas. Deja, praėjus keletui metų, kai kuriems pacientams diagnozuojamas prostatos vėžio recidyvavimas. Šiuo metu yra daug gydymometodų, bet dažnai iškyla problemų pasirenkant optimalų. Šio straipsnio tikslas – pasidalinti mūsų klinikine patirtimi bei apžvelgti prostatos vėžio recidyvų po spindulinės terapijos gydymo alternatyvas.Pacientai ir metodaiRetrospektyviai buvo išanalizuota dešimt pacientų, kuriems po pirminio gydymo radioterapija buvo diagnozuotas prostatos vėžio recidyvavimas. 5 pacientai buvo gydomi didelių dozių brachiterapija (1 grupė), o likusiems 5 buvo skirta krioterapija(2 grupė). Prostatos vėžio recidyvai diagnozuoti multiparametriniu kontroliuojant MRT ir ultragarsu atliktomis transrektalinėmis ir transperinealinėmis prostatos biopsijomis.RezultataiPirmoje grupėje vidutinis pacientų amžius buvo 64,2±7,9 metų, o antroje grupėje 68±3,1. Nė vienam pacientui nebuvo nustatytas prostatos vėžio išplitimas į limfmazgius (N) ar metastazavimas (M). Intraoperacinių komplikacijų nepasitaikė. Vidutiniškaitarp pirminės radioterapijos ir gelbstinčio prostatos vėžio recidyvavimo gydymo praėjo 88,9±30,1 mėnesio. Gelbstintis prostatos vėžio recidyvavimo gydymas buvo nesėkmingas dviem atvejais – po vieną atvejį abiejose grupėse.IšvadosŠiuo metu nėra tobulo gydymo tų pacientų, kuriems prostatos vėžys recidyvavo po spindulinio gydymo. Tokiais atvejais reikalingi unikalūs sprendimai. Mūsų nedidelė pirmoji patirtis rodo, jog gelbstinčioji krioterapija ir brachiterapija – tinkami metodaigydyti pacientams, kuriems recidyvavo prostatos vėžys po spindulinės terapijos.Reikšminiai žodžiai: prostatos vėžys, prostatos vėžio recidyvai, gelbstintis gydymas.

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