Cell-free plasma DNA for the diagnosis and follow-up of prostate cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16058-e16058
Author(s):  
Marcelo L. Wroclawski ◽  
Ary Serpa ◽  
Fernando L. A. Fonseca ◽  
Oseas Castro Neves Neto ◽  
Antônio C. L. Pompeo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Area Under The Curve ◽  
Plasma Dna ◽  
Prognostic Role ◽  
Likelihood Ratios ◽  
Free Survival ◽  
Free Plasma ◽  
Diagnostic And Prognostic Value

e16058 Background: Cell free plasma DNA (CF–pDNA) may have diagnostic and prognostic value in patients with Prostate Cancer (PCa). Methods: We included 133 men with PCa and 33 controls. PCa patients had blood drawn every 3 months for 2 years. CFpDNA was measured by spectrophotometry. Results: CF-pDNA had an area under the curve of 0.824 with a sensitivity of 66.2%, a specificity of 87.9% ,a positive and negative likelihood ratios of 5.46 and 0.39, respectively. There was no statistical significant correlation between CF-pDNA levels at study entry with PSA, Gleason score, stage and biochemical recurrence free survival(BRFS). However, with a mean follow up of 13.5 months, we observed significantly shorter BRFS for patients with at least one value above 140 ng/ mL of CF-pDNA during follow up (p= 0.048). Conclusions: CF-pDNA is a potentially valuable biomarker for PCa diagnosis and may have a prognostic role during follow-up of patients with PCa.

Cell-free plasma DNA as biochemical biomarker for the diagnosis and follow-up of prostate cancer patients

Tumor Biology ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 2921-2927 ◽  
Author(s):  
Marcelo L. Wroclawski ◽  
Ary Serpa-Neto ◽  
Fernando L. A. Fonseca ◽  
Oseas Castro-Neves-Neto ◽  
Alexandre S. F. L. Pompeo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Plasma Dna ◽  
Free Plasma

Impact of testosterone replacement therapy after radical prostatectomy on prostate cancer outcomes.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 100-100
Author(s):  
Reith Sarkar ◽  
J Kellogg Parsons ◽  
John Paul Einck ◽  
Arno James Mundt ◽  
A. Karim Kader ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Biochemical Recurrence ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Recurrence Free Survival ◽  
Free Survival

100 Background: Currently there is little data to guide the use of post-radical prostatectomy (RP) testosterone replacement therapy in prostate cancer. We sought to evaluate the impact of post-RP testosterone replacement on prostate cancer outcomes in a large national cohort. Methods: We conducted a population-based cohort study using the Veterans Affairs Informatics and Computing Infrastructure. We identified node-negative and non-metastatic prostate cancer patients diagnosed between 2001-2015 treated with RP. We excluded patients for missing covariate and follow-up data. We then coded receipt of testosterone replacement after RP as a time-dependent covariate. Other covariates included: age, Charlson Comorbidity index, diagnosis year, body mass index, race, PSA, clinical T/N/M stage, Gleason score, and receipt of hormone therapy. Biochemical recurrence was defined as a post-RP PSA≥0.2. We evaluated prostate cancer-specific survival, overall survival, and biochemical recurrence free survival using multivariable Cox regression. Results: Our cohort included 28,651 patients, of whom 469 (1.6%) received testosterone replacement after RP. Median follow up was 7.4 years. There were no differences in clinical T stage, median post-RP PSA (testosterone: 0 non-testosterone: 0; p = 0.18), or hormone therapy use between treatment groups. Testosterone patients were more likely to be of younger age, have higher comorbidity, non-black, have a lower median pre-treatment PSA (5.0 vs 5.8; p < 0.001), and have higher BMI. The median time from RP to TRT was 3.0 years. After controlling for potential confounders, we found no difference in prostate cancer specific mortality (HR 0.73; 95% CI 0.32-1.62; p = 0.43), overall survival (HR 1.11; 95% CI 0.86-1.44; p = 0.43), non-cancer mortality (HR 1.17; 95% CI 0.89-1.55; p = 0.26) biochemical recurrence free survival (HR 1.07; 95% CI 0.84-1.36; p = 0.59) between testosterone users and non-users. Conclusions: Our results suggest that testosterone replacement is safe in prostate cancer patients who have undergone RP, though prospective data is necessary to confirm this finding.

scholarly journals Dr. Answer AI for Prostate Cancer: Predicting Biochemical Recurrence Following Radical Prostatectomy

2021 ◽  
Vol 20 ◽  
pp. 153303382110246
Author(s):  
Jihwan Park ◽  
Mi Jung Rho ◽  
Hyong Woo Moon ◽  
Jaewon Kim ◽  
Chanjung Lee ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Random Forest ◽  
Radical Prostatectomy ◽  
Prediction Model ◽  
Biochemical Recurrence ◽  
Clinical Decision ◽  
Outcome Variable ◽  
Tertiary Hospitals ◽  
Input Variables

Objectives: To develop a model to predict biochemical recurrence (BCR) after radical prostatectomy (RP), using artificial intelligence (AI) techniques. Patients and Methods: This study collected data from 7,128 patients with prostate cancer (PCa) who received RP at 3 tertiary hospitals. After preprocessing, we used the data of 6,755 cases to generate the BCR prediction model. There were 16 input variables with BCR as the outcome variable. We used a random forest to develop the model. Several sampling techniques were used to address class imbalances. Results: We achieved good performance using a random forest with synthetic minority oversampling technique (SMOTE) using Tomek links, edited nearest neighbors (ENN), and random oversampling: accuracy = 96.59%, recall = 95.49%, precision = 97.66%, F1 score = 96.59%, and ROC AUC = 98.83%. Conclusion: We developed a BCR prediction model for RP. The Dr. Answer AI project, which was developed based on our BCR prediction model, helps physicians and patients to make treatment decisions in the clinical follow-up process as a clinical decision support system.

scholarly journals A novel predictor of clinical progression in patients on active surveillance for prostate cancer

2019 ◽  
Vol 13 (8) ◽  
Author(s):  
Guan Hee Tan ◽  
Antonio Finelli ◽  
Ardalan Ahmad ◽  
Marian Wettstein ◽  
Alexandre Zlotta ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Cox Regression ◽  
Area Under The Curve ◽  
Progression Free Survival ◽  
Roc Curves ◽  
Standard Of Care ◽  
Low Risk ◽  
Clinical Progression

Introduction: Active surveillance (AS) is standard of care in low-risk prostate cancer (PC). This study describes a novel total cancer location (TCLo) density metric and aims to determine its performance in predicting clinical progression (CP) and grade progression (GP).     Methods: This was a retrospective study of patients on AS after confirmatory biopsy (CBx). We excluded patients with Gleason ≥7 at CBx and <2 years follow-up. TCLo was the number of locations with positive cores at diagnosis (DBx) and CBx. TCLo density was TCLo / prostate volume (PV). CP was progression to any active treatment while GP occurred if Gleason ≥7 was identified on repeat biopsy or surgical pathology. Independent predictors of time to CP or GP were estimated with Cox regression. Kaplan-Meier analysis compared progression-free survival curves between TCLo density groups. Test characteristics of TCLo were explored with receiver operating characteristic (ROC) curves.     Results: We included 181 patients who had CBx between 2012-2015, and met inclusion criteria. The mean age of patients was 62.58 years (SD=7.13) and median follow-up was 60.9 months (IQR=23.4). A high TCLo density score (>0.05) was independently associated with time to CP (HR 4.70, 95% CI: 2.62-8.42, p<0.001), and GP (HR 3.85, 95% CI: 1.91-7.73, p<0.001). ROC curves showed TCLo density has greater area under the curve than number of positive cores at CBx in predicting progression.     Conclusion: TCLo density is able to stratify patients on AS for risk of CP and GP. With further validation, it could be added to the decision-making algorithm in AS for low-risk localized PC.

Phase III study of local or systemic therapy INtensification DIrected by PET in prostate CAncer patients with post-prostaTEctomy biochemical recurrence (INDICATE): ECOG-ACRIN EA8191.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. TPS5098-TPS5098
Author(s):  
Neha Vapiwala ◽  
Yu-Hui Chen ◽  
Steve Y. Cho ◽  
Fenghai Duan ◽  
Christos Kyriakopoulos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systemic Therapy ◽  
Biochemical Recurrence ◽  
Radiographic Progression ◽  
Systemic Treatment ◽  
Phase Iii ◽  
Type I ◽  
Treatment Intensification ◽  
Free Survival ◽  
Prostate Bed

TPS5098 Background: Radiation therapy (RT) to the prostate bed and pelvic nodes with short-term androgen deprivation therapy (STAD) is considered a standard of care (SOC) salvage therapy (ST) paradigm for prostate cancer (PC) patients (pts) with post-prostatectomy (RP) biochemical recurrence (BCR). Fluciclovine-PET/CT imaging is FDA-approved in this setting, with improved accuracy for detection of metastases not identified with conventional imaging (CIM). Given PET's greater sensitivity and specificity, its findings are increasingly but variably applied to justify modification or omission of SOC therapies without high-level evidence of clinical benefit. PET may help identify candidates for local or systemic treatment intensification of the otherwise non-tailored SOC approach. Improved systemic control and disease detection with molecular imaging have led to increasing use of focally ablative metastasis-directed RT, to delay or enhance systemic therapy through increased local control. There is also interest in earlier use of systemic therapy; apalutamide (Apa) is a nonsteroidal antiandrogen with established efficacy in improving overall and radiographic progression-free survival (PFS) for non-metastatic castration-resistant and metastatic castration-sensitive PC. This study will evaluate whether pts with PET-detected lesions benefit from such local or systemic treatment intensification approaches. Methods: PC pts with post-RP BCR (PSA>0.5ng/mL; >0.2ng/mL if within 12 mos of RP) and no metastases on CIM who are candidates for SOC ST (RT to prostate bed and pelvic nodes with STAD) are eligible. Prior to study registration, pts undergo SOC baseline PET (18F-fluciclovine but PSMA radiotracers permitted pending commercial availability). Based on institutional clinical interpretation of the SOC PET, pts will be placed in Cohort 1 (PET-negative) or 2 (PET-positive for extra-pelvic metastases). Cohort 1 will be randomized to SOC ST +/- Apa for 6 months and Cohort 2 will be randomized to SOC ST and Apa +/- metastasis-directed RT to PET-positive lesions. The primary endpoint is PFS, defined as time from randomization to radiographic progression on CIM, symptomatic disease or death. Primary objectives are to evaluate whether addition of Apa to SOC ST and addition of metastasis-directed RT to SOC ST and Apa could prolong PFS in Cohorts 1 and 2, respectively. For Cohort 1, 480 pts will be randomized with 85% power to distinguish 5-year PFS rate of 90% (Apa arm) vs. 80% (SOC arm) using one-sided stratified log-rank test with type I error of 0.025. For Cohort 2, 324 pts will be randomized with 85% power to distinguish 5-year PFS rate of 76.5% in the experimental arm from 61.5% in the control arm. Secondary endpoints include overall and event-free survival, toxicity, and PET progression. Clinical trial information: NCT04423211.

scholarly journals Diagnostic and prognostic value of miRNAs in hepatoblastoma: A systematic review with meta-analysis

2021 ◽  
Author(s):  
Bin Wu ◽  
◽  
Lixia Guo ◽  
Kaikai Zhen ◽  
Chao Sun
Keyword(s):  
Systematic Review ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Prognostic Indicator ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Likelihood Ratios ◽  
Clinical Value ◽  
Diagnostic And Prognostic Value

Review question / Objective: Background and aim: Increasing evidence has revealed the valuable diagnostic and prognostic applications of dysregulated microRNAs (miRNAs) in hepatoblastoma (HB), the most common hepatic malignancy during childhood. However, these results are inconsistent and remain to be elucidated. In the present study, we aimed to systematically compile up-to-date information regarding the clinical value of miRNAs in HB. Methods: Articles concerning the diagnostic and prognostic value of single miRNAs for HB were searched from databases. The sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR), area under the curve (AUC), and hazard ratios (HRs) were separately pooled to explore the diagnostic and prognostic performance of miRNA. Subgroup and meta-regression analyses were further carried out only in the event of heterogeneity. Results: In all, 20 studies, involving 264 HB patients and 206 healthy individuals, met the inclusion criteria in the six included literature articles. For the diagnostic analysis of miRNAs in HB, the pooled SEN and SPE were 0.76 (95% CI: 0.72–0.80) and 0.75 (95% CI: 0.70–0.80), respectively. Moreover, the pooled PLR was 2.79 (95% CI: 2.12–3.66), NLR was 0.34 (95% CI: 0.26–0.45), DOR was 10.24 (95% CI: 6.55–16.00), and AUC was 0.83, indicating that miRNAs had moderate diagnostic value in HB. For the prognostic analysis of miRNAs in HB, the abnormal expressions of miR-21, miR-34a, miR-34b, miR-34c, miR-492, miR-193, miR-222, and miR-224 in patients were confirmed to be associated with a worse prognosis. The pooled HR was 1.74 (95% CI: 1.20–2.29) for overall survival (OS) and 1.74 (95% CI: 1.31–2.18) for event-free survival (EFS), suggesting its potential as a prognostic indicator for HB. Conclusion: To the best of our knowledge, this is the first comprehensive systematic review and meta-analysis that examines the diagnostic and prognostic role of dysregulated miRNAs in HB patients. The combined meta-analysis results supported the previous individual finds that miRNAs might provide a new, noninvasive method for the diagnostic and prognostic analyses ofHB.

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