Prostate Cancer: From Pathology to Novel Therapeutic Approaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cell Biology and Pathology".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 8778

Special Issue Editor


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Guest Editor
1. Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, 779 00 Olomouc, Czech Republic
2. Department of Human Morphology and Pathology, David Tvildiani Medical University, Tbilisi, Georgia
Interests: molecular pathology of prostate and breast cancer; tumor microenvironment; extracellular matrix; identification of novel therapeutic targets

Special Issue Information

Dear Colleagues,

Prostate cancer remains the second most common cancer in men, with a diverse course from indolent cases to lethal disease. Understanding of prostate cancer biology, genetics, and molecular pathology has emerged, and several new drugs have improved outcomes of metastatic castrate-resistant prostate cancer. However, several tasks remain to be completed, for example, novel screening biomarkers to complement PSA or credential differentiation of indolent disease from aggressive course, molecular stratification of PCa using advanced approaches, novel treatment strategies for better outcomes in high-risk locally advanced cancer or metastatic disease, and the discovery of surrogate biomarkers for durable overall survival benefit. This Special Issue on “Prostate Cancer: From Pathology to Novel Therapeutic Approaches” aims to publish cutting-edge research on both preclinical and clinical studies on prostate cancer, including a comprehensive overview of tumor progression in association with the tumor microenvironment, metabolism, metastatic process, cancer treatment, immune response, or drug resistance. Review articles as well as original studies will be considered for publication. We hope that both academy and clinics working on prostate cancer will find this platform useful. We look forward to receiving exceptional submissions.

Dr. Gvantsa Kharaishvili
Guest Editor

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Keywords

  • prostate cancer
  • castration-resistant prostate cancer
  • metastatic disease
  • biomarker
  • tumor microenvironment
  • treatment
  • immunotherapy
  • drug resistance

Published Papers (5 papers)

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Research

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11 pages, 1575 KiB  
Article
Inter-Rater Variability of Prostate Lesion Segmentation on Multiparametric Prostate MRI
by Thibaut Jeganathan, Emile Salgues, Ulrike Schick, Valentin Tissot, Georges Fournier, Antoine Valéri, Truong-An Nguyen and Vincent Bourbonne
Biomedicines 2023, 11(12), 3309; https://doi.org/10.3390/biomedicines11123309 - 14 Dec 2023
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Abstract
Introduction: External radiotherapy is a major treatment for localized prostate cancer (PCa). Dose escalation to the whole prostate gland increases biochemical relapse-free survival but also acute and late toxicities. Dose escalation to the dominant index lesion (DIL) only is of growing interest. It [...] Read more.
Introduction: External radiotherapy is a major treatment for localized prostate cancer (PCa). Dose escalation to the whole prostate gland increases biochemical relapse-free survival but also acute and late toxicities. Dose escalation to the dominant index lesion (DIL) only is of growing interest. It requires a robust delineation of the DIL. In this context, we aimed to evaluate the inter-observer variability of DIL delineation. Material and Methods: Two junior radiologists and a senior radiation oncologist delineated DILs on 64 mpMRIs of patients with histologically confirmed PCa. For each mpMRI and each reader, eight individual DIL segmentations were delineated. These delineations were blindly performed from one another and resulted from the individual analysis of the T2, apparent diffusion coefficient (ADC), b2000, and dynamic contrast enhanced (DCE) sequences, as well as the analysis of combined sequences (T2ADC, T2ADCb2000, T2ADCDCE, and T2ADCb2000DCE). Delineation variability was assessed using the DICE coefficient, Jaccard index, Hausdorff distance measure, and mean distance to agreement. Results: T2, ADC, T2ADC, b2000, T2 + ADC + b2000, T2 + ADC + DCE, and T2 + ADC + b2000 + DCE sequences obtained DICE coefficients of 0.51, 0.50, 0.54, 0.52, 0.54, 0.55, 0.53, respectively, which are significantly higher than the perfusion sequence alone (0.35, p < 0.001). The analysis of other similarity metrics lead to similar results. The tumor volume and PI-RADS classification were positively correlated with the DICE scores. Conclusion: Our study showed that the contours of prostatic lesions were more reproducible on certain sequences but confirmed the great variability of prostatic contours with a maximum DICE coefficient calculated at 0.55 (joint analysis of T2, ADC, and perfusion sequences). Full article
(This article belongs to the Special Issue Prostate Cancer: From Pathology to Novel Therapeutic Approaches)
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17 pages, 1697 KiB  
Article
Extracellular Matrix- and Integrin Adhesion Complexes-Related Genes in the Prognosis of Prostate Cancer Patients’ Progression-Free Survival
by Ivana Samaržija and Paško Konjevoda
Biomedicines 2023, 11(7), 2006; https://doi.org/10.3390/biomedicines11072006 - 15 Jul 2023
Cited by 1 | Viewed by 1317
Abstract
Prostate cancer is a heterogeneous disease, and one of the main obstacles in its management is the inability to foresee its course. Therefore, novel biomarkers are needed that will guide the treatment options. The extracellular matrix (ECM) is an important part of the [...] Read more.
Prostate cancer is a heterogeneous disease, and one of the main obstacles in its management is the inability to foresee its course. Therefore, novel biomarkers are needed that will guide the treatment options. The extracellular matrix (ECM) is an important part of the tumor microenvironment that largely influences cell behavior. ECM components are ligands for integrin receptors which are involved in every step of tumor progression. An underlying characteristic of integrin activation and ligation is the formation of integrin adhesion complexes (IACs), intracellular structures that carry information conveyed by integrins. By using The Cancer Genome Atlas data, we show that the expression of ECM- and IACs-related genes is changed in prostate cancer. Moreover, machine learning methods revealed that they are a source of biomarkers for progression-free survival of patients that are stratified according to the Gleason score. Namely, low expression of FMOD and high expression of PTPN2 genes are associated with worse survival of patients with a Gleason score lower than 9. The FMOD gene encodes protein that may play a role in the assembly of the ECM and the PTPN2 gene product is a protein tyrosine phosphatase activated by integrins. Our results suggest potential biomarkers of prostate cancer progression. Full article
(This article belongs to the Special Issue Prostate Cancer: From Pathology to Novel Therapeutic Approaches)
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9 pages, 653 KiB  
Article
Identifying Patients in Whom the Follow-Up Scheme after Robot-Assisted Radical Prostatectomy Could Be Optimized in the First Year after Surgery: Reducing Healthcare Burden
by Hans Veerman, Sophia H. van der Graaf, Dennie Meijer, Marinus J. Hagens, Corinne N. Tillier, Pim J. van Leeuwen, Henk G. van der Poel and André N. Vis
Biomedicines 2023, 11(3), 727; https://doi.org/10.3390/biomedicines11030727 - 28 Feb 2023
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Abstract
Background: The currently advised follow-up scheme of PSA testing after robot-assisted radical prostatectomy (RARP) is strict and might pose a burden to our healthcare system. We aimed to optimize the 1-year follow-up scheme for patients who undergo RARP. Methods: All patients with histologically-proven [...] Read more.
Background: The currently advised follow-up scheme of PSA testing after robot-assisted radical prostatectomy (RARP) is strict and might pose a burden to our healthcare system. We aimed to optimize the 1-year follow-up scheme for patients who undergo RARP. Methods: All patients with histologically-proven prostate cancer (PCa) who underwent RARP between 2018 and August 2022 in the Prostate Cancer Network in the Netherlands were retrospectively evaluated. We excluded patients who underwent salvage RARP and patients who had <1 year of PSA follow-up. Postoperative PSA values were collected. Biochemical persistence (BCP) was defined as PSA level >0.10 ng/mL at 0–4 months after RARP, whereas biochemical recurrence (BCR) was defined as PSA level >0.2 ng/mL at any time point after RARP. We aimed to identify a group of patients who had a very low risk of BCR at different time points after surgery. Results: Of all 1155 patients, BCP was observed in 151 (13%), of whom 79 (6.8%) had PSA ≥ 0.2 ng/mL. BCR further developed in 51 (4.7%) and 37 (3.4%) patients at 5–8 and 9–12 months after RARP, respectively. In 12 patients, BCR was found at 5–8 months after RARP in the absence of BCP. These patients represented 1.2% (12/1004) of the entire group. In other words, 98.8% (992/1004) of patients who had an unmeasurable PSA level at 0–4 months after RARP also had an unmeasurable PSA level 5–8 months after surgery. Limitations are the retrospective design and incomplete follow-up. Conclusions: Patients with an unmeasurable PSA level at 3–4 months after RARP may not need to be retested until 12 months of follow-up, as almost 100% of patients will not have the biochemically recurrent disease at 5–8 months of follow-up. This will reduce PSA testing substantially at the cost of hardly any missed patients with recurrent disease. Full article
(This article belongs to the Special Issue Prostate Cancer: From Pathology to Novel Therapeutic Approaches)
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Review

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22 pages, 957 KiB  
Review
Epithelial-Mesenchymal Transition: A Fundamental Cellular and Microenvironmental Process in Benign and Malignant Prostate Pathologies
by Aviv Philip Goncharov, Nino Vashakidze and Gvantsa Kharaishvili
Biomedicines 2024, 12(2), 418; https://doi.org/10.3390/biomedicines12020418 - 11 Feb 2024
Cited by 1 | Viewed by 1520
Abstract
Epithelial-mesenchymal transition (EMT) is a crucial and fundamental mechanism in many cellular processes, beginning with embryogenesis via tissue remodulation and wound healing, and plays a vital role in tumorigenesis and metastasis formation. EMT is a complex process that involves many transcription factors and [...] Read more.
Epithelial-mesenchymal transition (EMT) is a crucial and fundamental mechanism in many cellular processes, beginning with embryogenesis via tissue remodulation and wound healing, and plays a vital role in tumorigenesis and metastasis formation. EMT is a complex process that involves many transcription factors and genes that enable the tumor cell to leave the primary location, invade the basement membrane, and send metastasis to other tissues. Moreover, it may help the tumor avoid the immune system and establish radioresistance and chemoresistance. It may also change the normal microenvironment, thus promoting other key factors for tumor survival, such as hypoxia-induced factor-1 (HIF-1) and promoting neoangiogenesis. In this review, we will focus mainly on the role of EMT in benign prostate disease and especially in the process of establishment of malignant prostate tumors, their invasiveness, and aggressive behavior. We will discuss relevant study methods for EMT evaluation and possible clinical implications. We will also introduce clinical trials conducted according to CONSORT 2010 that try to harness EMT properties in the form of circulating tumor cells to predict aggressive patterns of prostate cancer. This review will provide the most up-to-date information to establish a keen understanding of the cellular and microenvironmental processes for developing novel treatment lines by modifying or blocking the pathways. Full article
(This article belongs to the Special Issue Prostate Cancer: From Pathology to Novel Therapeutic Approaches)
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20 pages, 3058 KiB  
Review
Strategies to Re-Sensitize Castration-Resistant Prostate Cancer to Antiandrogen Therapy
by Belén Congregado Ruiz, Inés Rivero Belenchón, Guillermo Lendínez Cano and Rafael Antonio Medina López
Biomedicines 2023, 11(4), 1105; https://doi.org/10.3390/biomedicines11041105 - 6 Apr 2023
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Abstract
Since prostate cancer (PCa) was described as androgen-dependent, the androgen receptor (AR) has become the mainstay of its systemic treatment: androgen deprivation therapy (ADT). Although, through recent years, more potent drugs have been incorporated, this chronic AR signaling inhibition inevitably led the tumor [...] Read more.
Since prostate cancer (PCa) was described as androgen-dependent, the androgen receptor (AR) has become the mainstay of its systemic treatment: androgen deprivation therapy (ADT). Although, through recent years, more potent drugs have been incorporated, this chronic AR signaling inhibition inevitably led the tumor to an incurable phase of castration resistance. However, in the castration-resistant status, PCa cells remain highly dependent on the AR signaling axis, and proof of it is that many men with castration-resistant prostate cancer (CRPC) still respond to newer-generation AR signaling inhibitors (ARSis). Nevertheless, this response is limited in time, and soon, the tumor develops adaptive mechanisms that make it again nonresponsive to these treatments. For this reason, researchers are focused on searching for new alternatives to control these nonresponsive tumors, such as: (1) drugs with a different mechanism of action, (2) combination therapies to boost synergies, and (3) agents or strategies to resensitize tumors to previously addressed targets. Taking advantage of the wide variety of mechanisms that promote persistent or reactivated AR signaling in CRPC, many drugs explore this last interesting behavior. In this article, we will review those strategies and drugs that are able to resensitize cancer cells to previously used treatments through the use of “hinge” treatments with the objective of obtaining an oncological benefit. Some examples are: bipolar androgen therapy (BAT) and drugs such as indomethacin, niclosamide, lapatinib, panobinostat, clomipramine, metformin, and antisense oligonucleotides. All of them have shown, in addition to an inhibitory effect on PCa, the rewarding ability to overcome acquired resistance to antiandrogenic agents in CRPC, resensitizing the tumor cells to previously used ARSis. Full article
(This article belongs to the Special Issue Prostate Cancer: From Pathology to Novel Therapeutic Approaches)
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