Circulating tumor cells (CTCs) in biochemical recurrence (BR) of prostate cancer: Final results.

179 Background: CTCs have known prognostic implications in metastatic prostate cancer. We presented initial data on the role of CTCs in BR of prostate cancer (Aragon-Ching et. al., ASCO GU 2011). The primary aim of this study was to determine whether there is a correlation between the number of CTCs with prostate specific antigen (PSA) levels and PSA doubling time (PSADT) in men with BR. Methods: BR was defined as patients who have undergone primary treatment with prostatectomy or radiation or both, with a rise to ≥ 0.2 from a prior undetectable level for prior prostatectomy or > 2 mg/dl rise for post-nadir radiotherapy. 36 patients (pts) were enrolled from May 2010 to May 2012. CTCs were evaluated in 7.5 mL of peripheral blood using the CTC CellSearch test. Results: The median age for 36 pts was 69.5 (range: 51 – 91) with a median PSA of 1.65 ng/mL (range 0.2 – 65.8) and testosterone levels of 315 ng/dL (range: 31 – 727). Gleason scores ranged from 5 to 9 (median=7). Prostatectomy was the primary treatment in 25 pts, radiotherapy in 9 pts, Cyberknife in 1 pt and combined radiohormones in 1 pt. PSADT varied between 0.35 to 55 months, with a median of 7.43 mos. The incidence of positive CTCs was 8.3% (3 out of 36 pts) of whom 2 had biopsy-proven bony lesions upon presenting with equivocal scans. The 3 pts who had measurable CTCs had PSADT of 2.27, 4.99 and 3.08 months, respectively. Conclusions: Obtaining CTCs in unselected patients presenting with biochemical recurrence have low yield. However, obtaining a positive CTC raises the suspicion of presence of metastatic disease and may have utility for longitudinal follow-ups of patients with BR. Supported by IRG-08-091-01 from ACS to GWU Cancer Institute.

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The role of 68Ga-PSMA PET/CT scan in biochemical recurrence after primary treatment for prostate cancer: a systematic review of the literature

Minerva Urologica e Nefrologica ◽

10.23736/s0393-2249.18.03081-3 ◽

2018 ◽

Vol 70 (5) ◽

Cited By ~ 25

Author(s):

Ahmed Eissa ◽

Ahmed Elsherbiny ◽

Rafael F. Coelho ◽

Jens Rassweiler ◽

John W. Davis ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Ct Scan ◽

Biochemical Recurrence ◽

Primary Treatment ◽

Review Of The Literature ◽

Psma Pet ◽

Pet Ct ◽

Pet Ct Scan

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Role of circulating tumor cells (CTCs) in biochemical recurrence (BR) of prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.60 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 60-60

Author(s):

J. B. Aragon-Ching ◽

S. J. Simmens ◽

F. Hendricks ◽

R. Andrawis ◽

H. Frazier ◽

...

Keyword(s):

Prostate Cancer ◽

Alkaline Phosphatase ◽

Pearson Correlation ◽

Specific Antigen ◽

Primary Treatment ◽

Imaging Results ◽

Number Of Patients ◽

Secondary Endpoints ◽

Established Role

60 Background: CTCs have an established role in the prognosis of metastatic prostate cancer. Little data exists regarding the role of CTCs in BR of prostate cancer. The aim of this study was to determine whether there is a correlation between the number of CTCs in men with BR with varying prostate specific antigen (PSA) and PSA doubling time (PSADT) categories. Secondary endpoints looking at correlation of the CTCs with clinical or laboratory factors (Gleason scores, testosterone, hemoglobin, alkaline phosphatase, BMI, imaging results) will also be assessed. Methods: BR was defined as patients (pts) who have undergone primary treatment with prostatectomy or radiation or both, with rise to >/= 0.2 from a prior undetectable level for prior prostatectomy or > 2 mg/dl rise from post-nadir radiotherapy. The study was powered to detect a Pearson correlation of .46 with a sample size of 36. Eleven of planned accrual goal of 36 pts were enrolled from May to September 2010. PSADT was obtained and correlated with the CTC values, categorized as PSADT of < 3 months, 3-14.9 months and > 15 months. CTCs were evaluated in 7.5 mL of peripheral blood using the CTC CellSearch test. Results: The median age for 11 patients was 75 y/o (range: 57-91) with a median PSA of 1.6 ng/mL (range 0.2-6.5) and testosterone levels of 309 ng/dL (range: 31–471). Gleason scores were 8 (n=1), 7 (n=5), 6 (n=2), 5 (n=3). Prostatectomy was the primary treatment in 6 pts, radiotherapy in 5 pts and Cyberknife in 1 pt. Median hemoglobin was 12.43 g/dL, BMI was 26.79 and alkaline phosphatase was 69 IU/L. PSADT varied between 3 to 55 months. All pts accrued had 0 CTC levels. The latter result translates into a 95% confidence interval upper bound of approximately .27 for the proportion of patients in this population who have non-zero CTC levels. Conclusions: Prostate cancer pts with BR have negative blood CTCs and does not appear to correlate with PSA or PSADT. However, the limited number of patients precludes sufficient interpretation at this time and further accrual is ongoing. The absence of CTC levels in this patient population, if supported through further data collection, could emerge as an important unanticipated finding from this study. Supported by IRG-08-091-01 from ACS to GWU Cancer Institute. No significant financial relationships to disclose.

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What is the role of microRNA-301A expression as a diagnostic and predictive marker of biochemical recurrence for prostate cancer?

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.19 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 19-19

Author(s):

Adnan Dervishi ◽

Samarpit Rai ◽

Kristy Doan Nguyen ◽

Thomas Michael FitzGibbon ◽

Paul Knoll ◽

...

Keyword(s):

Prostate Cancer ◽

Biochemical Recurrence ◽

Clinical Decision Making ◽

Specific Antigen ◽

Predictive Marker ◽

Clinical Decision ◽

Definitive Treatment ◽

Serum Samples ◽

Prostate Hyperplasia

19 Background: Prostate specific antigen (PSA) screening for prostate cancer (PCa) remains controversial, due to its association with an increase in overdiagnosis of clinically insignificant PCa, and overtreatment. Hence, the need for more specific biomarkers to detect PCa and determine its prognosis. MicroRNA expression has previously been demonstrated as a biomarker to detect several malignancies. Studies suggest that microRNA-301a (miR-301a) inhibits the pro-apoptotic function of RUNX3, a transcription factor, and consequently activates ROCK1-mediated survival signaling in PCa. This study establishes the role of miR-301a as a reliable biomarker that can distinguish between patients with benign prostate hyperplasia (BPH) and PCa, and predict biochemical recurrence (BCR) after definitive treatment of PCa. Methods: Serum samples and tissue from prostate biopsies were collected from patients with an elevated PSA prospectively. The expression of miR- 301a was measured via reverse transcriptase-polymerase chain reaction. Additionally, miR-301a expression was retrospectively evaluated in prostatic tissue of 50 patients with PCa, including benign tissue, and correlated with clinico-pathological characteristics to predict BCR. Immunohistochemistry was performed to confirm the molecular target of miR-301a in cancerous tissue. Results: miR-301a demonstrated a significantly higher expression (p = 0.013) in both PCa tissue (Gleason 6 & 7 PCa) and serum samples (p = 0.011) when compared to BPH. Expression of miR-301a in Gleason 6 & 7 prostatectomy specimens positively correlated with patients who developed BCR when compared to patients who did not. When compared to the current nomogram for the prediction of PCa (i.e., PSA, age, race, Gleason score, and family history), incorporation of miR-301a was associated with a superior prediction of BCR at three years post-prostatectomy. Conclusions: miR-301a expression is a valuable tool for diagnosing PCa in patients with an elevated PSA. Combining miR-301a with PSA is associated with better risk stratification of PCa patients, and may help facilitate clinical decision making.

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Early prediction of prostate cancer biochemical recurrence and identification of disease persistence using PSA isoforms and human kallikrein-2

Tumor Biology ◽

10.3233/tub-211509 ◽

2021 ◽

Vol 43 (1) ◽

pp. 197-207

Author(s):

Joana Do Carmo Silva ◽

Stepan Vesely ◽

Hana Luksanova ◽

Richard Prusa ◽

Marko Babjuk

Keyword(s):

Prostate Cancer ◽

Biochemical Recurrence ◽

Specific Antigen ◽

Early Postoperative Period ◽

P Value ◽

Single Marker ◽

Human Kallikrein 2 ◽

Kallikrein 2 ◽

Disease Persistence

BACKGROUND: The role of isoforms of prostate specific antigen (PSA) and other kallikrein-related markers in early detection of biochemical recurrence (BCR) after radical prostatectomy (RP) is not well known and serum PSA is currently used in preoperative risk nomograms. OBJECTIVE: The aim of this research was to study pre- and early postoperative levels of important PSA isoforms and human kallikrein-2 to determine their ability to predict BCR and identify disease persistence (DP). METHODS: This study included 128 consecutive patients who underwent RP for clinically localized prostate cancer. PSA, fPSA, %fPSA, [–2]proPSA, PHI and hK2 were measured preoperatively, at 1 and 3 months after RP. We determined the ability of these markers to predict BCR and identify DP. RESULTS: The DP and BCR rate were 11.7%and 20.3%respectively and the median follow up was 64 months (range 3–76 months). Preoperatively, the independent predictors of BCR were PSA (p-value 0.029), [–2]proPSA (p-value 0.002) and PHI (p-value 0.0003). Post-RP, PSA was the single marker correlating with BCR, both at one (p-value 0.0047) and 3 months (p-value 0.0004). PSA, fPSA, [–2]proPSA and PHI significantly correlated to DP at 1 and 3 months post-RP (p-value < 0.05), although PSA had the most significant existing correlation (p-value < 0.0001). CONCLUSIONS: [–2]proPSA and PHI are preoperative predictors of BCR and DP that outperform the currently used serum PSA. At the early postoperative period there is no additional benefit of the other markers tested.

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THE USE OF MODERN ANALOGUES OF LUTEINIZING HORMONE RELEASING HORMONE IN THE HORMONAL THERAPY IN PATIENTS WITH PROSTATE CANCER

Research n Practical Medicine Journal ◽

10.17709/2409-2231-2017-4-2-3 ◽

2017 ◽

Vol 4 (2) ◽

pp. 23-28 ◽

Cited By ~ 1

Author(s):

E. Yu. Safronova ◽

A. A. Krasheninnikov ◽

S. A. Sergienko ◽

A. A. Kostin

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Luteinizing Hormone ◽

Gold Standard ◽

Metastatic Prostate Cancer ◽

Specific Antigen ◽

Primary Treatment ◽

The Body ◽

Luteinizing Hormone Releasing Hormone ◽

Testosterone Levels

The urgency of the problem of prostate cancer (PC) remains extremely high due to the continued growth of morbidity and mortality from this disease. Despite the introduction of diagnostics with the use of prostate specific antigen (PSA) and the increase in the number of cases of detection of localized forms of the disease, frequency of detection in the primary treatment of patients with advanced and metastatic prostate cancer remains high. Therapy aimed at reducing testosterone levels in the body of the patient with metastatic prostate cancer is the gold standard of treatment, so surgical or pharmacological castration to reduce testosterone levels, are generally accepted methods of therapy. Hormone therapy (HT) using a pharmacological castration is the major and most commonly used method of treatment of patients with metastatic prostate cancer, the effectiveness of which is comparable with surgical castration. The article presents a review of studies that compared the effectiveness and side effects of HT with the use of surgical and medical castration, as well as the results of domestic studies evaluated the effectiveness of the application of the drug buserelin-domestic analogue of LHRH.

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Prostate-specific Antigen Screening and Recent Increases in Advanced Prostate Cancer

JNCI Cancer Spectrum ◽

10.1093/jncics/pkaa098 ◽

2020 ◽

Author(s):

Yaw A Nyame ◽

Roman Gulati ◽

Alex Tsodikov ◽

John L Gore ◽

Ruth Etzioni

Keyword(s):

Prostate Cancer ◽

United States ◽

Prostate Specific Antigen ◽

Advanced Prostate Cancer ◽

Metastatic Prostate Cancer ◽

Specific Antigen ◽

The United States ◽

Models Of Disease ◽

Screening And Diagnosis

Abstract Recent studies show decreasing prostate-specific antigen utilization and increasing incidence of metastatic prostate cancer in the United States after national recommendations against screening in 2012. Yet whether the increasing incidence of metastatic prostate cancer is consistent in magnitude with the expected impact of decreased screening is unknown. We compared observed incidence of metastatic prostate cancer from the Surveillance, Epidemiology, and End Results program and published effects of continued historical screening and discontinued screening starting in 2013 projected by two models of disease natural history, screening, and diagnosis. The observed rate of new metastatic prostate cancer cases in 2017 was 44%-60% of the projected increase under discontinued screening relative to continued screening. Thus, the observed increase in incident metastatic prostate cancer is consistent with the expected impact of reduced screening. Although this comparison does not establish a causal relationship, it highlights the plausible role of decreased screening in the observed trend.

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