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Cancer Causes & Control : CCC Apr 2021To test for racial differences in associations between family history (FH) of prostate cancer (PC) and prostate cancer aggressiveness in a racially diverse equal access...
PURPOSE
To test for racial differences in associations between family history (FH) of prostate cancer (PC) and prostate cancer aggressiveness in a racially diverse equal access population undergoing prostate biopsy.
SUBJECTS/PATIENTS AND METHODS
We prospectively enrolled men undergoing prostate biopsy at the Durham Veterans Administration from 2007 to 2018 and assigned case or control status based on biopsy results. Race and FH of PC were self-reported on questionnaires. Logistic regression was used to test the association between FH and PC diagnosis overall and by tumor aggressiveness [high- (Grade Group 3-5) or low-grade (Grade Group 1-2) vs. no cancer], overall, and stratified by race. Models were adjusted for age and year of consent, race, PSA level, digital rectal exam findings, prostate volume, and previous (negative) biopsy receipt.
RESULTS
Of 1,225 men, 323 had a FH of PC and 652 men were diagnosed with PC on biopsy. On multivariable analysis, FH was associated with increased odds of high-grade PC in black (OR 1.85, p = 0.041) and all men (OR 1.56, p = 0.057) and was unrelated to overall or low-grade PC diagnosis, overall, or stratified by race (all p ≥ 0.325). In sensitivity analyses among men without a previous biopsy, results were slightly more pronounced.
CONCLUSION
In this setting of equal access to care, positive FH of PC was associated with increased tumor aggressiveness in black men, but not non-black men undergoing prostate biopsy. Further research is required to tease apart the contribution of genetics from increased PC awareness potentially influencing screening and biopsy rates in men with FH.
Topics: Black or African American; Aged; Biopsy; Health Services Accessibility; Humans; Male; Medical History Taking; Middle Aged; Neoplasm Grading; Prostatic Neoplasms
PubMed: 33532986
DOI: 10.1007/s10552-020-01389-8 -
Archivos Espanoles de Urologia Mar 2022The use of prostatespecific antigen (PSA) is useful for the diagnosis ofprostate cancer. Its main limitation is its low specificity,which has led to the search for new... (Review)
Review
INTRODUCTION
The use of prostatespecific antigen (PSA) is useful for the diagnosis ofprostate cancer. Its main limitation is its low specificity,which has led to the search for new biomarkersin order to identify clinically significant prostatecancer and to reduce overdiagnosis and overtreatment.The aim of this article is to summarize the currentliterature on urinary biomarkers used in thediagnosis of prostate cancer.A PubMed-based literature search was conductedup to December 2020. We selected the most recentand relevant original articles, clinical trials and reviewsthat have provided relevant information onthe use of biomarkers.In this review, we have discussed four importanturinary biomarkers useful for prostate cancer diagnosis:PCA3, Select MDX, ExoDX, TMPRSS2:ERG.
CONCLUSION
The use of urinary biomarkers hasimproved of clinically significant prostate cancerdiagnosis. Their use reduces the number of unnecessarybiopsies and avoids overtreatment of indolentprostate cancer.
Topics: Antigens, Neoplasm; Biomarkers, Tumor; Biopsy; Humans; Male; Prostate; Prostatic Neoplasms
PubMed: 35332886
DOI: No ID Found -
Oncology (Williston Park, N.Y.) Nov 2017Cancer progresses in a stepwise fashion. Oligometastatic cancer is an intermediate stage of tumor spread between localized disease and disseminated metastases.... (Review)
Review
Cancer progresses in a stepwise fashion. Oligometastatic cancer is an intermediate stage of tumor spread between localized disease and disseminated metastases. Oligometastatic prostate cancer is defined as up to five extrapelvic lesions on conventional imaging. There are controversies surrounding the management of this malignancy, but retrospective and population-based studies suggest a role for radical prostatectomy. Despite insufficient data to draw conclusions regarding the effectiveness of aggressive therapies on overall or cancer-specific survival of patients with oligometastatic prostate cancer, current studies suggest that surgery decreases tumor burden, disease-related morbidity, and the need for palliative surgical intervention, while increasing the period of time to development of castration-resistant disease.
Topics: Humans; Male; Neoplasm Metastasis; Prostatectomy; Prostatic Neoplasms
PubMed: 29179248
DOI: No ID Found -
Journal of Hematology & Oncology Jan 2017The causative role of the pro-inflammatory cytokine IL-6 in prostate cancer progression has been well established at molecular level. However, whether and how IL-6 may...
BACKGROUND
The causative role of the pro-inflammatory cytokine IL-6 in prostate cancer progression has been well established at molecular level. However, whether and how IL-6 may play a role in prostate cancer risk and development is not well defined. One limitation factor to acquiring this knowledge is the lack of appropriate animal models.
METHODS
We generated a novel line of prostate-specific IL-6 transgenic mouse model. We compared the prostate pathology, tumorigenic signaling components, and prostate tumor microenvironment of the IL-6 transgenic mice with wild type littermates.
RESULTS
With this model, we demonstrate that IL-6 induces prostate neoplasm autonomously. We further demonstrate that transgenic expression of IL-6 in the prostate activates oncogenic pathways, induces autocrine IL-6 secretion and steadily-state of STAT3 activation in the prostate tissue, upregulates paracrine insulin-like growth factor (IGF) signaling axis, reprograms prostate oncogenic gene expression, and more intriguingly, amplifies inflammation in the prostate and peri-prostatic adipose tissue.
CONCLUSIONS
The pro-inflammatory IL-6 is autonomous oncogene for the prostate. IL-6 induces prostate oncogenesis through amplifying local inflammation. We also presented a valuable animal model to study inflammation and prostate cancer development.
Topics: Adipose Tissue; Animals; Cell Transformation, Neoplastic; Disease Models, Animal; Inflammation; Insulin-Like Growth Factor I; Interleukin-6; Male; Mice; Mice, Transgenic; Oncogenes; Prostate; Prostatic Neoplasms; STAT3 Transcription Factor; Signal Transduction; Transgenes
PubMed: 28077171
DOI: 10.1186/s13045-016-0386-7 -
Physica Medica : PM : An International... Mar 2016For radiotherapy of prostate cancer, MRI is used increasingly for delineation of the prostate gland. For focal treatment of low-risk prostate cancer or focal dose... (Review)
Review
For radiotherapy of prostate cancer, MRI is used increasingly for delineation of the prostate gland. For focal treatment of low-risk prostate cancer or focal dose escalation for intermediate and high-risk cancer, delineation of the tumor is also required. While multi-parametric MRI is well established for detection of tumors and for staging of the disease, delineation of the tumor inside the prostate is not common practice. Guidelines, such as the PI-RADS classification, exist for tumor detection and staging, but no such guidelines are available for tumor delineation. Indeed, interobserver studies show substantial variation in tumor contours. Computer-aided tumor detection and delineation may help improve the robustness of the interpretation of multi-parametric MRI data. Comparing the performance of an earlier developed model for tumor segmentation with expert delineations, we found a significant correlation between tumor probability in a voxel and the number of experts identifying this voxel as tumor. This suggests that the model agrees with 'the wisdom of the crowd', and thus could serve as a reference for individual physicians in their decision making. With multi-parametric MRI it becomes feasible to revisit the GTV-CTV concept in radiotherapy of prostate cancer. While detection of index lesions is quite reliable, contouring variability and the low sensitivity to small lesions suggest that the remainder of the prostate should be treated as CTV. Clinical trials that investigate the options for dose differentiation, for example with dose escalation to the visible tumor or dose reduction to the CTV, are therefore warranted.
Topics: Humans; Magnetic Resonance Imaging; Male; Neoplasm Staging; Prostatic Neoplasms
PubMed: 26858164
DOI: 10.1016/j.ejmp.2016.01.484 -
The Canadian Journal of Urology Apr 2014Newer approaches to the management of advanced prostate cancer have rapidly evolved. While basic androgen deprivation remains as the first line in newly diagnosed...
INTRODUCTION
Newer approaches to the management of advanced prostate cancer have rapidly evolved. While basic androgen deprivation remains as the first line in newly diagnosed hormone naïve metastatic prostate cancer, the agents used and strategies followed have undergone significant changes. Numerous new agents such as sipuleucel-T, abiraterone, enzalutamide, cabazitaxel and radium 223 have all been approved since 2010 to treat metastatic castration resistant prostate cancer (CRPC). New imaging techniques to detect advanced disease such as F-18 PET, 11 C-choline PET and other modalities are becoming available. The concepts of "bone health" and the management of side effects related to androgen deprivation therapy are also gaining attention as men are being treated with longer courses of androgen deprivation. Understanding the theory behind these new agents and management approaches while focusing on the practical clinical considerations are essential to improve outcomes in advanced prostate cancer.
MATERIALS AND METHODS
A review of the current state of the art in the management of advanced and castration resistant prostate cancer presented in this Canadian Journal of Urology International supplement was performed. Key findings are summarized and presented along with critical updates based on recent publications and meeting presentations.
RESULTS
Key concepts identified in the management of advanced prostate cancer included the new understanding of prostate cancer based on translational discoveries, applications of various hormonally based strategies in advanced disease including traditional and recently approved agents. The use of new imaging modalities to identify metastatic disease, immunotherapy approaches and discussions of sequencing and which new agents are likely to be available in the future in the management of CRPC were identified. Bone targeted strategies are also addressed in the setting of androgen deprivation and metastatic disease.
CONCLUSIONS
The management of men with advanced prostate cancer has become more multidisciplinary as treatment options have expanded. As the use of these agents and new strategies expand, urologists, medical oncologists and radiation oncologists must all become familiar with this rapidly changing field in order to maximize the outcome of patients with advanced and castration resistant prostate cancer.
Topics: Androgen Antagonists; Diagnostic Imaging; Disease Management; Disease Progression; Drug Therapy; Humans; Immunotherapy; Male; Neoplasm Staging; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Translational Research, Biomedical
PubMed: 24775717
DOI: No ID Found -
Chinese Clinical Oncology Dec 2018Prostate cancer was the first cancer in which immunotherapy vaccine was approved by FDA in 2010 named Sipuleucel-T. No new immunotherapies have been approved since, as... (Review)
Review
Prostate cancer was the first cancer in which immunotherapy vaccine was approved by FDA in 2010 named Sipuleucel-T. No new immunotherapies have been approved since, as phase 3 trials didn't show any improvement in overall survival (OS) especially with immune checkpoint inhibitors. Currently tremendous amount of research is going on, in studying microenvironment of prostate cancer, finding new targets and biomarkers, and trying different combination therapies. Some of the new targets explored are VISTA and PARP inhibitors. Combination therapies have shown promising results in early phase trials and likely in near future we will have an effective immunotherapy for advanced prostate cancer. In this article we will review the current data and future of immunotherapy in prostate cancer.
Topics: Humans; Immunotherapy; Male; Neoplasm Metastasis; Prostatic Neoplasms
PubMed: 29860848
DOI: 10.21037/cco.2018.02.01 -
The Canadian Journal of Urology Apr 2024
Topics: Male; Humans; Prostatic Neoplasms; Gallium Isotopes; Positron-Emission Tomography; Neoplasm Staging
PubMed: 38642457
DOI: No ID Found -
Journal of Cellular Physiology Aug 2008The cancer stem cell (CSC) model states that tumors contain a reservoir of self-renewing cells that maintain the heterogeneous cell population of the tumor. These cells... (Review)
Review
The cancer stem cell (CSC) model states that tumors contain a reservoir of self-renewing cells that maintain the heterogeneous cell population of the tumor. These cells appear to be resistant to therapy and can therefore survive to repopulate the tumor during progression to therapy resistant disease. The biology of CSCs is still not definitive since it is difficult to isolate them from solid tumors and analyze their characteristics in vitro. Another challenge is to correlate these characteristics with tumor development and progression in vivo. Using the prostate CSC as a model, this review presents the CSC hypothesis, reviews the origin, identification and functions of prostate CSCs, and discusses the clinical implications and therapeutic challenges CSCs have for cancer therapy.
Topics: Animals; Biomarkers, Tumor; Humans; Male; Neoplasm Recurrence, Local; Prostate; Prostatic Neoplasms; Stem Cells
PubMed: 18459113
DOI: 10.1002/jcp.21489 -
Scientific Reports May 2016Previous studies indicate that prostate cancer antigen 3 (PCA3) is highly expressed in prostatic tumors. However, its clinical value has not been characterized. The aim... (Meta-Analysis)
Meta-Analysis Review
Previous studies indicate that prostate cancer antigen 3 (PCA3) is highly expressed in prostatic tumors. However, its clinical value has not been characterized. The aim of this study was to investigate the clinical value of the urine PCA3 test in the diagnosis of prostate cancer by pooling the published data. Clinical trials utilizing the urine PCA3 test for diagnosing prostate cancer were retrieved from PubMed and Embase. A total of 46 clinical trials including 12,295 subjects were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and area under the curve (AUC) were 0.65 (95% confidence interval [CI]: 0.63-0.66), 0.73 (95% CI: 0.72-0.74), 2.23 (95% CI: 1.91-2.62), 0.48 (95% CI: 0.44-0.52), 5.31 (95% CI: 4.19-6.73) and 0.75 (95% CI: 0.74-0.77), respectively. In conclusion, the urine PCA3 test has acceptable sensitivity and specificity for the diagnosis of prostate cancer and can be used as a non-invasive method for that purpose.
Topics: Antigens, Neoplasm; Humans; Male; Odds Ratio; Prostatic Neoplasms; ROC Curve; Sensitivity and Specificity
PubMed: 27161545
DOI: 10.1038/srep25776