bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary chemoprevention using short period (3 months) of LHRHa as an option for men with low-risk localized prostate cancer (LRPC) before active surveillance (AS).
Authors: Cussenot Olivier , Drouin Sarah , Egrot Christophe , Cornu Jean-Nicolas , Sebe Philippe , Mozer Pierre , Conort Pierre , Vaessen Christophe , Haab Francois , Bitker Marc-Olivier , Roupret Morgan 
Published: March 2020

e15105 Background: Definition of LRPC and candidates for AS remains problematic. Relevant markers that reflect tumor aggressiveness are still to be determined. When AS is used it can be difficult to assess disease progression despite surveillance with PSA and repeat biopsies. Moreover, 20-50% of patients on AS were over the windows of curability when radical treatment was triggered. The current knowledge of PC suggests that aggressiveness should be assessed not only in terms of clinical features but also in terms of response to Androgen Deprivation Therapy (ADT). Methods: 83 men with LRPC (T1c or T2a PC; PSA ≤10ng/ml; Gleason score ≤6) whom have chosen prostate cancer management without radical therapy were included. They then underwent AS after receiving one injection of ELIGARD-22.5. AS consisted of PSA every 3 months (mo) and biopsies (≥12 cores) every 12mo. Patients were stratified at diagnosis according to age at diagnosis, PSA, PSA density, PSA nadir, bio-testosterone, dynamic MRI staging, % positive cores and length of tumor on the diagnosis biopsy. Predictive factors of recurrent PC observed on biopsy were tested using a Cox regression and Markov models. Results: Mean age at diagnosis of LRPC was 64 years, (standard deviation, 6.2 years). Median time to follow-up after diagnosis biopsy was 31mo. Surveillance biopsies were positive for 37 men (44%) (7 with Gleason score>6). In the subgroup of insignificant PC according EPSTEIN criteria surveillance biopsies were positives for 17/48 men (35%) (2 with Gleason score>6). Expected results from literature on classical AS were 60-70% of positive biopsy and 10-21% of upgraded biopsy at the first repeat biopsy. Predictive factors of prostate cancer observed on biopsy were: PSA nadir at 3mo <0,1ng/ml (OR=1.8; 95%CI 1.0 to 3.3 p=0.04), positive core biopsy>1(OR=1.7; 95%CI 1.0 to 2.9; p=0,03), and >T1c detectable tumor on MRI (OR=2.9; 95%CI 1.4 to 5.9; p=0.003). Conclusions: Results obtained with 3mo of LHRHa for LRPC suggest that ADT response can be used firstly to reduce prevalence of primary PC lesions and secondly in order to identify PC able to castration resistance and consequently which require radical treatment.
Sentinel lymph node in prostate carcinoma: Methodology, feasibility, surgical, and oncological consequences, about 74 patients.
Authors: Soler Claude , Perraud Yves , Gremillet Eric , Armand Corine , Geissler Benjamin , Steiner Aline , Levigne Frederic 
Published: March 2020

e15109 Background: There are few studies in the field of prostatic sentinel lymph node (SLN) procedure: in the international literature at the most 10 publications are found. However the interest of urological surgeons and oncologists is growing fast. Goals of our study were: on the first hand to evaluate the rate of SLN SPECT-CT detection and the rate of SLN involvement, on the other hand to evaluate the incidence of the SLN biopsy results on the surgical and oncological management. Methods: 74 patients with prostate cancer were included. All patients had a Gleason score between 6 and 8. All patients were elected for a radical laparoscopic prostatectomy. Nanocis-Tc 99m was intratumorally injected, guided by transrectal ultrosonography. 2 injections of 0.6 ml in each lobe of the prostate were performed, depending on the size of the prostate. Patient underwent planar imaging and SPECT-CT 2 hours after injections. Surgery was performed 18 hours after SPECT-CT lymphoscintigraphy. Results: A lymphatic pelvic drainage was seen in 94,6 % (70/74) by SPECT-CT. Lymphatic drainage was on the right side (23), on the left side (15), or bilateral (32). The radioguided lymphadenectomy was assisted by a laparoscopic gamma-probe, the SLN detection rate was 97% (68/70); the average number of resected radioactive nodes was 1.6 (range 1 to 5). By all the ways, a limited pelvic lymph node dissection was performed in all 74 cases. An SLN involvement was found in 5 cases (5/68= 7.35%); in these 5 cases and in the 63 cases without SLN involvement, no metastatic involvement was found in the other lymph nodes, as well as in the 6 patients for which no SLN could be selectively resected (4 with no drainage seen and 2 not detected intra-operatively although visualized on lymphoscintigraphy). Conclusions: The low rate of lymphatic involvement is not surprising considering the Gleason score range 6 to 8 (low metastatic risk). So, the preliminary results are very attractive, especially for these patients that could have been falsely considered as N0. Our study is still in progress, and if these results are confirmed on a larger scale, then SLN procedure could be considered in the routine management of low risk prostatic carcinomas.
Repeat biopsy outcomes and change in QOL status at 1 year after active surveillance: Results from a Japanese multicenter prospective study and the PRIAS-JAPAN.
Authors: Sugimoto Mikio , Hirama Hiromi , Kakehi Yoshiyuki , Yamaguchi Akito , Koga Hirofumi , Hashine Katsuyoshi , Egawa Shin , Miki Jun , Shinohara Nobuo , Maruyama Satoru ,   PRIAS-JAPAN Study Group
Published: March 2020

e15127 Background: In Japan, two prospective multicenter active surveillance (AS) studies are under investigation. The 1st is a prospective Japanese AS study that has been carried out in favorable risk prostate cancer since 2002. The 2nd is the PRIAS-JAPAN; 30 institutions in Japan have been participating into the Prostate cancer Research International: Active Surveillance (PRIAS) study as the PRIAS-JAPAN since 2010. The objective of this study is to evaluate the outcomes of 1-year after AS including prostate re-biopsy and the change in QOL status using the two Japanese prospective cohorts. Methods: 134 patients with biopsy proven favorable risk prostate cancer were enrolled into study between January 2002 and December 2003. Triggers to start curable treatment were PSADT of 2 years or shorter or pathological progression at 1-year re-biopsy. AS remaining rate in 33.2% (median observation period: 78 months). On the other hand, PRIAS-JAPAN study was started since January 2010. Until December 2011, 189 patients were enrolled. 1-year after re-biopsy was recommended to all participants and QOL was assessed at enrollment and at 1-year after AS in both studies with Japanese version SF-36 and SF-8 respectively. Results: In the Japanese AS study, 64 patients who underwent re-biopsy, 42 met the pathological selection criteria again. Reclassification rate was 34.4%. In PRIAS-JAPAN, reclassification rate was 28% (p=0.467). There was no predictive parameter for reclassification in the Japanese AS study. On the other hand, number of positive cores was a significant predictive parameter for reclassification in PRIAS-Japan. Almost all domains of QOL at enrollment revealed better QOL than Norm-based Scoring (NBS). At 1-year after AS, there was no significant change and favorable QOL was maintained in both study. Conclusions: Instead of the time difference between the 2 studies was approximately 10 years, reclassification rate for the current AS cohort (PRIAS-J) was comparable or even lower than the former cohort. Health-related QOL of the Japanese patients who opted AS as an initial treatment was better than NBS and it has been maintained 1-year after AS.
Vinorelbine plus prednisone versus docetaxel plus prednisone as first-line treatment in metastatic hormone-refractory prostate cancer.
Authors: Abdel Halim Inas Ibraheim , El Sadda Wael M , Farouk Fatma , El Sherbeiny Esam , El Ashry Mohamed S 
Published: March 2020

e15129 Background: Metastatic hormone refractory prostate cancer (mHRPC) is not curable and all attempts at therapeutic intervention have been based on palliating the disease. Androgen dependent prostate carcinoma responds poorly to chemotherapy. Recent protocols using vinorelbine, mitoxantrone and docetaxel have significantly improved response rate, survival and pain control for those patients. The study aims to compare the therapeutic benefit of the use of vinorelbine versus docetaxel both plus prednisone in patients with mHRPC. Methods: Sixty pts (50% gpA, 50% gpB) were enrolled between Mar 2005 and Sep 2007. All patients had histologically confirmed prostatic adencarcinoma with evidence of metastatic disease and progression on hormonal therapy. WHO PS O-2, adequate marrow, liver and renal functions. Patients were randomized to gpA; Vinorellrine (V) IV 30mg/m2 d1 and 8, or gpB; Docetaxe (D) IV 75mg/m2 d1. All patients received 5mg of prednisone orally twice daily for 5 days starting on day 1 of the tudy. Cycles repeated every 3 weeks. Patients with PD went off the study while those with CR, PR or SD continued treatment for 8 cycles maximum. Results: All pts were evaluable for response, toxicity and survival. The median age (gpA, gpB): 59 and 58 years, median WHO PS 1 (range 0-2) in both groups , Median basal PSA were 110 (90-780) and 120 (80-850) in group A&B respectively. The overall response rates were 53.3% (gpA) and 56.7% (gpB) P=0.24, the rates of PSA decline were higher in gpA than gpB (80% vs 70%) (p=0.27). Reduction of pain was better in patients receiving (V) than those treated with (D) (60% vs 50%) (p= 0.23). The improvement in the quality of life was higher in gp A than in gpB (50% vs 40%) but the difference was statistically insignificant. No WHO G3 or 4 toxicities in gp A. G3 alopecia (60%), G3 neutropenia (20%) were noted in gpB. Conclusions: Our results suggest that vinorelbine and docetaxel demonstrate similar efficacy as first line treatment for mHRPC. Vinorelbine is however better tolerated besides being a less costly therapeutic option in Egypt. Comparative phase III trial is needed to confirm these results.
Risk of mineralocorticoid excess syndrome with CYP17 inhibitor abiraterone in prostate cancer patients.
Authors: Itwaru Sandy Ann , Gopal Arun , Bashir Omer , Shim Joomee , Zhu Xiaolei , Wu Shenhong 
Published: March 2020

e15140 Background: CYP17 inhibitor abiraterone acetate has been used for the treatment of patients with metastatic castration-refractory prostate cancer (CRPC). Hypertension, hypokalemia and edema are the major side effects associated with its use, and may be secondary to the excess of mineralocorticoids due to CYP17 inhibition. We performed a systematic review and meta-analysis of published clinical trials to determine the effect of abiraterone on the development of these side effects. Methods: Databases including Pubmed (July, 1966 to July, 2011), Web of Science, and abstracts presented at the American Society of Clinical Oncology meetings from 2008 to 2011 were searched to identify relevant studies. Eligible studies were prospective clinical trials of patients with prostate cancer receiving abiraterone acetate at the starting dose of 1,000 mg daily with available data on hypertension, hypokalemia and edema. Incidence and relative risk (RR) were calculated using a random-effects or fixed-effects model. Results: A total of seven studies including 1,387 patients with CRPC were selected for analysis. The incidences of all-grade hypertension, hypokalemia, and edema were 13.3% (95% CI: 8.3 to 20.5%), 31.4 % (95% CI: 12.5-59.5%), and 23.4 % (95% CI: 15.6-33.5%) respectively. The incidences of high-grade (grade 3 and above) toxicity were low, with a rate of 3.6% (95% CI: 2.6-5.1%), 2.8 % (95% CI: 0.9 to 8.2%), and 2.1% (95%CI: 1.3-3.2%) for hypertension, hypokalemia, and edema respectively. The risk of hypertension and edema did not change with and without the addition of prednisone (p=0.48 and p=0.40, respectively); however, the risk of hypokalemia was significantly reduced with the addition of prednisone (p = 0.003). In comparison with prednisone alone, the addition of abiraterone did not increase the risk of hypertension (RR 1.22, 95% CI: 0.82 – 1.83, p=0.31), but significantly increased the risk of edema (RR 1.36, 95% CI: 1.10-1.69, p=0.004) and hypokalemia (RR 2.04, 95% CI: 1.42–2.92, p<0.001). Conclusions: There were differential effects of abiraterone on the development of hypertension, hypokalemia, and edema in patients with advanced prostate cancer. Further studies are recommended for optimal treatment.
C11-acetate PET for docetaxel prednisone (DP) response assessment in castrate-resistant prostate cancer (CRPC).
Authors: Sharma Nancy , Menda Yusuf , Boles-Ponto Laura , Vaena Daniel A. 
Published: March 2020

e15143 Background: C11- acetate (acetate) positron-emission tomogram (PET) has shown promise in detection of metastasis in prostate cancer in recent studies. Our study tested the feasibility of acetate-PET to predict early response to DP in CRPC. Methods: Men with metastatic CRPC for whom DP was indicated were enrolled in a prospective study of acetate-PET imaging and bone scans. Patients (pts) were imaged with both modalities at study entry and after 3 cycles of DP. DP was continued beyond cycle 3 until PCWG2-defined progression or toxicity. Treating physicians were blinded to acetate-PET results. No pts were on statins. The study was IRB-approved. Results: 6 pts with documented bone metastases were imaged (5 both pre and post-therapy.) Pre-therapy acetate-PET identified osseous metastases in all 6 pts. Remarkably, in one pt with previous radiation therapy, pre-therapy acetate-PET was negative for disease in the radiated area whereas bone scan showed persistent activity. The median number of DP cycles was 7 (5-16). 4 pts had ≥ 50% PSA decline. The median time to progression (TTP) was 5 months (mo). Of the 4 pts with PSA response, 2 had response on acetate-PET with TTP 5 mo and 10 mo respectively. One pt had > 50% PSA response but progression after 3 cycles based on PET, and met PCWG2 criteria for progression at 3.5 mo. The 4th pt with PSA response had stable findings on post-therapy PET and had 13 mo TTP. The pt who had no PSA response had stable post-therapy PET and had 2 mo TTP. Bone scan was stable in 3 pts, showed progression in 1pt and showed response in 1 pt. Conclusions: Response or progression on acetate-PET can be seen after a few chemotherapy cycles for CRPC. This study supports the exploratory inclusion of acetate-PET in future therapeutic clinical trials, with the potential to enhance the early prediction of treatment outcome. Acetate-PET might also allow more precise identification of viable target lesions than bone scan.
The clonality of immunoglobulin repertoire in prostate cancer-infiltrating B cells.
Authors: Trepel Martin , Stahl Phillip R. , Bokemeyer Carsten , Flammiger Anna 
Published: March 2020

e15168 Background: There is emerging evidence that inflammation plays a role in prostate carcinogenesis. To better understand the cellular biology of the immune response in prostate cancer, we investigated the immunoglobulin (Ig) repertoire of tumor-infiltrating B cells. Methods: The Ig heavy chain variable region (VH) usage reflects the antigenic experience of tumor-infiltrating B cells and may help to identify potential therapeutic targets. We analyzed IgM-VH and IgG-VH transcripts of tumor-infiltrating B cells in four tumor samples of localized prostate cancer. Immunohistochemical staining revealed groups of CD20+ B cells surrounding neoplastic prostate glands. To exclude PCR amplification bias, two cDNA librarys were prepared from separate tissue sections of each tumor. IgM-VH and IgG-VH transcripts were amplified by RT-PCR from each cDNA library, cloned and sequenced. Results: Sequencing of a total of 80 IgM-VH and 80 IgG-VH PCR products (10 IgM-VH and 10 IgG-VH PCR products from each cDNA library) revealed an oligoclonal Ig repertoire in 3 of 4 and evidence of antigen experience of B cells in 4 of 4 prostate cancer samples. IgM and IgG B cell clones, defined by the same complementarity-determining region 3 (CDR3) and detection in two separate cDNA librarys, were widely distributed in the prostate. Prostate cancer-infiltrating B cells showed somatic hypermutation, Ig class switch and insertions or deletions indicating antigen experience. Conclusions: Clonally related B cells are widely distributed in the neoplastic prostate gland suggesting the recognition of a limited number of epitopes. Future studies will identify the antigens eliciting this immune response.
βIII-tubulin expression as a predictor of docetaxel resistance in metastatic castrate-resistant prostate cancer.
Authors: Sanchez Bertha E. , Gupta Nilesh , Mahan Meredith , Barrack Evelyn R , Reddy Prem-veer , Hwang Clara 
Published: March 2020

e15174 Background: Docetaxel is a tubulin-targeting cytotoxic that remains first-line therapy in metastatic castrate-resistant prostate cancer (mCRPC) patients (pts) even though half of pts are reported to be non-responders. A predictive marker to identify those who will benefit from docetaxel-therapy will assist clinical decision making. High βIII-tubulin (TUBB3) expression has previously been reported to correlate with lack of response to taxanes in other cancers. We evaluated TUBB3 expression as a predictor of docetaxel-resistance in mCRPC. Methods: mCRPC pts treated with at least 3 cycles of docetaxel between 1990 and 2011 were identified retrospectively. TUBB3 immunostaining was performed on archival formalin-fixed, paraffin-embedded tissue. Stain intensity was scored from 0 to 3; 2 and 3 were interpreted as positive. Rates of PSA response were compared between pts with positive (+) and negative (-) TUBB3 expression. Two definitions of PSA response were evaluated (any PSA decline and at least 50% decline). Overall survival (OS) distribution between TUBB3+ and TUBB3- pts was estimated by the Kaplan-Meier method. Results: Of 73 pts, 26 (35%) expressed TUBB3. At diagnosis, the mean age was 65.7 years and the median Gleason score was 8. At the time of docetaxel therapy, the mean age was 71.2 years, the median PSA level was 70.9 (range, 0.2-5253) and 76% had ECOG performance status ≤1. The median number of docetaxel cycles was 7 (range, 3-18). The total dose of docetaxel was not different between groups (p=0.705). The median OS was 19.2 mo. TUBB3 expression was not correlated with any clinical or pathological characteristic (age, Gleason score, stage, ECOG, PSA, LDH, alkaline phosphatase, hemoglobin, visceral disease or chemotherapy before docetaxel). 65% of TUBB3+ pts had any PSA decline compared to 89% of pts with TUBB3- (p=0.0267). 52% of TUBB3+ pts had a PSA decline of ≥ 50% compared to 70% of TUBB3- pts (p=0.0144). Median OS for TUBB3+ pts was 16.8 mo compared to 20.4 mo in TUBB3- pts (p=0.039). Conclusions: High TUBB3 expression was associated with shorter OS and lower PSA response rates in mCRPC pts treated with docetaxel. These findings need to be validated prospectively.
A matched case control study in veteran patients with high cardiovascular risk (CVR) examining cardiac medication (CMed) prescribing differences between prostate cancer (PC) patients on androgen deprivation therapy (ADT) and men without PC.
Authors: Patel Yash R. , Reed Angela D. , Moore Marietta L. , Canfield Angela C. , Kruer James A , Hahn Noah M. 
Published: March 2020

e15179 Background: Conflicting reports exist on associations between ADT and CVR in PC patients (pts). The current study tests the hypothesis that underutilization of CMeds in PC pts with known CVR contributes to their increased cardiac event rates. Methods: Veteran men without malignancy (no-PC, controls) and men with PC on ADT (cases) were consented through the IUSCC IRB-approved biorepository protocol. All pts had high CVR defined as the presence of > 2 of the following: age > 45, Body mass index (BMI) > 30 kg/m2, hypertension (HTN), hyperlipidemia (HL), diabetes (DM), and smoking history (SmHx). Prior coronary artery disease (CAD) qualified pts as severe CVR. Each case was matched with 2 controls in the following order of priority: prior CAD, HTN, DM, HL, SmHx, age, BMI, and race. CMeds prescriptions included in the table below were verified via VAMC pharmacy records. CMeds prescription differences between cases and controls were tested by one-sided chi-Squared testing for each medication and by logistic regression for different classes of medications. Results: Between 1/2007 and 6/2011, 53 cases and 254 controls were enrolled in the IUSCC VAMC clinics. After 2:1 matching, the final cohort included 53 cases and 106 controls. Demographics included: prior CAD – 27%, HTN – 60%, DM – 31%, HL – 40%, SmHx – 63%, BMI – median 29.7 kg/m2, Age – median 66 yrs. Controls were younger than cases (71.4 yrs cases – 63.1 yrs controls, p<0.0001). No statistically significant differences in CMed prescribing frequency were observed between the two groups. Conclusions: Differences in CMed prescribing practices between PC pts and no-PC men with high CVR is not a factor contributing to increased cardiac events in PC pts on ADT in our Veteran population. The study size warrants confirmation in a larger dataset. [Table: see text]
Survival benefits of second-line chemotherapy in metastatic castrate-resistant prostate cancer (CRPC) in a southeastern oncology community practice.
Authors: Gilmore James W. , Haislip Sally , Szabo Stephen , Sullivan Sean D , Ramsey Scott David , Kreilick Charles , Foltz Boklage Susan H , Sarma Syam , Asche Carl V , Shermock Kenneth M. , Sun Kai , Valluri Satish , Seal Brian S. 
Published: March 2020

e15183 Background: Clinical studies showed that chemotherapy (CT) yields survival benefits for Metastatic Castrate resistant prostate cancer (CRPC) patients. This study investigated the relationship between patients with 2nd CT and OS using a real-world data. Methods: TheGeorgia Cancer Specialist Database containing chemotherapy, medical and pharmacy information, and lab results for patients with various types of cancer (2005-2011) was used. Patients (PTs) over 18 years of age with initial stage IV CRPC were followed from the first administration of CT (index date, ID) to the earlier of death or loss to follow-up (FU). PTs with one type of CT protocol (PL) were defined as first line CT PTs (1st), those with two types were identified as second line PTs (2nd), and those with three or more types were (3rd) line PTs. Kaplan-Meier survival curve was compared across the three groups using log-rank test. The impact of line of therapy on OS was further examined using multivariate Cox model with adjustment of PTs’ baseline age, race, Charlson Comorbidity Index (CCI), bisphosphonate use, and ECOG performance scores. Sensitivity analyses (SA) was conducted using different definition to define CT lines. Results: The study included148 PTs, with 86 (58.1%) as 1st, 38 (25.7%) as 2nd, and 24 (16.2%) as 3rd, 29 (19.6%) median age 73 with a range from 18 to over 82, 52.7% as race White, 33.8% African American, and 13.5% other or unknown race, average weight was 179 LB (range 100-279), average baseline PSA was 694 ng/ml (range: 0.05-21,743), 14 (9.5%) patients ECOG score of 3 or 4, 131 (88.5%) with one or more CCI comorbid conditions. Median survival was 17 months for overall, and 12, 19, and 23 months for 1st, 2nd, and 3rd line PTs, respectively (P=0.0355). Multivariate COX model found a higher likelihood of survival for 2nd line PTs (HR=0.361, P=0.006), but not for 3rd line PTs (HR=1.25, P=0.648). SA showed same results. Conclusions: This study suggested that second line of CT was associated with prolonged OS in metastatic CRPC. 3rd line CT survival benefit was not observed. Limitations include potential channeling bias and small sample size.