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Cancers
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Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach
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Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 15865

Special Issue Editors

Prof. Dr. Hans Christiansen

E-Mail Website
Guest Editor
Hannover Medical School, Department of Radiotherapy and Special Oncology, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
Interests: high precision radiotherapy; radiobiology; prostate cancer; interdisciplinary oncology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Robert Michael Hermann

E-Mail Website
Guest Editor
Center for Radiotherapy and Radiooncology, Mozartstr. 30, D-26655 Westerstede, Germany
Interests: high precision radiotherapy; radiobiology; prostate cancer; interdisciplinary oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Prostate cancer is one of the leading cancer diagnoses worldwide. By improving the different interdisciplinary therapeutic approaches, cure rates could be improved, especially for patients with localized disease. For primary curative therapy, surgical and radiotherapeutic methods are used. Both methods have led to further advances in treatment over the past few decades, e.g., the establishment of robot-assisted surgery or the implementation of intensity-modulated techniques in radiotherapy. Further actual scientific aspects concern the role of modern methods of imaging (e.g., PSMA-PET/CT), salvage therapy for recurrence after primary treatment, hypofractionation in radiotherapy, and the prediction of tumor responses. In this Special Issue of Cancers titled “Actual Aspects of Prostate Cancer Treatment—An Interdisciplinary Approach”, we want to discuss at least some of these actual topics from an interdisciplinary point of view. Our scope includes current therapy concepts as well as innovative approaches.

Sincerely,

Prof. Dr. Hans Christiansen
Prof. Dr. Robert Michael Hermann
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostate cancer
  • surgery
  • radiotherapy
  • hypofractionation
  • interdisciplinarity
  • nuclear medicine
  • PSMA

Published Papers (7 papers)

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Research

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22 pages, 6198 KiB  
Article
The Prognostic Value of Liquid Biopsies for Benefit of Salvage Radiotherapy in Relapsed Oligometastatic Prostate Cancer
by Natalia V. Bogdanova, Hoda Radmanesh, Dhanya Ramachandran, Anne Caroline Knoechelmann, Hans Christiansen, Thorsten Derlin, Christoph Alexander Joachim von Klot, Roland Merten and Christoph Henkenberens
Cancers 2022, 14(17), 4095; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14174095 - 24 Aug 2022
Viewed by 1470
Abstract
To assess the prognostic value of “liquid biopsies” for the benefit of salvage RT in oligometastatic prostate cancer relapse, we enrolled 44 patients in the study between the years 2016 and 2020. All the patients were diagnosed as having an oligometastatic prostate cancer [...] Read more.
To assess the prognostic value of “liquid biopsies” for the benefit of salvage RT in oligometastatic prostate cancer relapse, we enrolled 44 patients in the study between the years 2016 and 2020. All the patients were diagnosed as having an oligometastatic prostate cancer relapse on prostate-specific membrane antigen (PSMA)-targeted PET-CT and underwent irradiation at the Department of Radiotherapy at the Hannover Medical School. Tumor cells and total RNA, enriched from the liquid biopsies of patients, were processed for the subsequent quantification analysis of relative transcript levels in real-time PCR. In total, 54 gene transcripts known or suggested to be associated with prostate cancer or treatment outcome were prioritized for analysis. We found significant correlations between the relative transcript levels of several investigated genes and the Gleason score, PSA (prostate-specific antigen) value, or UICC stage (tumor node metastasis -TNM classification of malignant tumors from Union for International Cancer Control). Furthermore, a significant association of MTCO2, FOXM1, SREBF1, HOXB7, FDXR, and MTRNR transcript profiles was found with a temporary and/or long-term benefit from RT. Further studies on larger patients cohorts are necessary to prove our preliminary findings for establishing liquid biopsy tests as a predictive examination method prior to salvage RT. Full article
(This article belongs to the Special Issue Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach)
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12 pages, 1260 KiB  
Article
Salvage Nodal Radiotherapy as Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer Detected by Positron Emission Tomography Shows Favorable Outcome in Long-Term Follow-Up
by Jörg Tamihardja, Leonie Zehner, Philipp Hartrampf, Dominik Lisowski, Susanne Kneitz, Sinan Cirsi, Gary Razinskas, Michael Flentje and Bülent Polat
Cancers 2022, 14(15), 3766; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14153766 - 02 Aug 2022
Cited by 2 | Viewed by 1695
Abstract
Background: The study aimed to access the long-term outcome of salvage nodal radiotherapy (SNRT) in oligorecurrent prostate cancer. Methods: A total of 95 consecutive patients received SNRT for pelvic and/or extrapelvic nodal recurrence after prostate-specific membrane antigen (PSMA) or choline PET from 2010 [...] Read more.
Background: The study aimed to access the long-term outcome of salvage nodal radiotherapy (SNRT) in oligorecurrent prostate cancer. Methods: A total of 95 consecutive patients received SNRT for pelvic and/or extrapelvic nodal recurrence after prostate-specific membrane antigen (PSMA) or choline PET from 2010 to 2021. SNRT was applied as external beam radiotherapy with simultaneous integrated boost up to a median total dose of 62.9 Gy (EQD21.5Gy) to the recurrent lymph node metastases. The outcome was analyzed by cumulative incidence functions with death as the competing risk. Fine–Gray regression analyses were performed to estimate the relative hazards of the outcome parameters. Genitourinary (GU)/gastrointestinal (GI) toxicity evaluation utilized Common Toxicity Criteria for Adverse Events (v5.0). The results are as follows: the median follow-up was 47.1 months. The five-year biochemical progression rate (95% CI) was 50.1% (35.7–62.9%). Concomitant androgen deprivation therapy (ADT) was adminstered in 60.0% of the patients. The five-year biochemical progression rate was 75.0% (42.0–90.9%) without ADT versus 35.3% (19.6–51.4%) with ADT (p = 0.003). The cumulative five-year late grade 3 GU toxicity rate was 2.1%. No late grade 3 GI toxicity occured. Conclusions: Metastasis-directed therapy through SNRT for PET-staged oligorecurrent prostate cancer demonstrated a favorable long-term oncologic outcome. Omittance of ADT led to an increased biochemical progression. Full article
(This article belongs to the Special Issue Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach)
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15 pages, 973 KiB  
Article
Proteomic Analysis of Prostate Cancer FFPE Samples Reveals Markers of Disease Progression and Aggressiveness
by Vasiliki Lygirou, Konstantinos Fasoulakis, Rafael Stroggilos, Manousos Makridakis, Agnieszka Latosinska, Maria Frantzi, Ioannis Katafigiotis, Christos Alamanis, Konstantinos G. Stravodimos, Constantinos A. Constantinides, Antonia Vlahou and Jerome Zoidakis
Cancers 2022, 14(15), 3765; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14153765 - 02 Aug 2022
Cited by 5 | Viewed by 2507
Abstract
Prostate cancer (PCa) is the second most common cancer in men. Diagnosis and risk assessment are widely based on serum Prostate Specific Antigen (PSA) and biopsy, which might not represent the exact degree of PCa risk. Towards the discovery of biomarkers for better [...] Read more.
Prostate cancer (PCa) is the second most common cancer in men. Diagnosis and risk assessment are widely based on serum Prostate Specific Antigen (PSA) and biopsy, which might not represent the exact degree of PCa risk. Towards the discovery of biomarkers for better patient stratification, we performed proteomic analysis of Formalin Fixed Paraffin Embedded (FFPE) prostate tissue specimens using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Comparative analysis of 86 PCa samples among grade groups 1–5 identified 301 significantly altered proteins. Additional analysis based on biochemical recurrence (BCR; BCR+ n = 14, BCR- n = 51) revealed 197 significantly altered proteins that indicate disease persistence. Filtering the overlapping proteins of these analyses, seven proteins (NPM1, UQCRH, HSPA9, MRPL3, VCAN, SERBP1, HSPE1) had increased expression in advanced grades and in BCR+/BCR- and may play a critical role in PCa aggressiveness. Notably, all seven proteins were significantly associated with progression in Prostate Cancer Transcriptome Atles (PCTA) and NPM1NPM1, UQCRH, and VCAN were further validated in The Cancer Genome Atlas (TCGA), where they were upregulated in BCR+/BCR-. UQCRH levels were also associated with poorer 5-year survival. Our study provides valuable insights into the key regulators of PCa progression and aggressiveness. The seven selected proteins could be used for the development of risk assessment tools. Full article
(This article belongs to the Special Issue Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach)
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12 pages, 3978 KiB  
Communication
EPA Modulates KLK Genes via miR-378: A Potential Therapy in Prostate Cancer
by Kai-Jie Yu, De-Yi Ji, Ming-Li Hsieh, Cheng-Keng Chuang, See-Tong Pang and Wen-Hui Weng
Cancers 2022, 14(11), 2813; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14112813 - 06 Jun 2022
Viewed by 1812
Abstract
It is known that miRNA-378a-3p (miR-378) could be induced by eicosapentaenoic acid (EPA), an omega-3 fatty acid. Herein, we first demonstrated how miR-378 exerts anti-prostate cancer (PCa) actions by influencing multiple target genes, including KLK2, KLK4, KLK6, and KLK14, which are implicated in [...] Read more.
It is known that miRNA-378a-3p (miR-378) could be induced by eicosapentaenoic acid (EPA), an omega-3 fatty acid. Herein, we first demonstrated how miR-378 exerts anti-prostate cancer (PCa) actions by influencing multiple target genes, including KLK2, KLK4, KLK6, and KLK14, which are implicated in PCa development, cell proliferation, and cell survival. Furthermore, these genes also correlate with androgen and mTOR signaling transduction, and are considered pivotal pathways for the onset and progression of PCa. In total, four PCa cell lines and eight pairing tissues (tumor vs. normal) from clinical PCa patients were included in the current study. The results showed high significance after EPA induced tumor cells containing higher expression levels of miR-378, and led the PCa cells having low cell viabilities, and they progressed to apoptosis when compared with normal prostate cells (p < 0.001). The findings indicated that EPA might become a potential therapy for PCa, especially because it is derived from the components of natural fish oil; it may prove to be a great help for solving the problem of castration-resistant prostate cancer (CRPC). Full article
(This article belongs to the Special Issue Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach)
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10 pages, 743 KiB  
Article
Effect of Clinical Parameters on Risk of Death from Cancer after Radical Prostatectomy in Men with Localized and Locally Advanced Prostate Cancer
by Daimantas Milonas, Tomas Ruzgas, Zilvinas Venclovas, Daniele Jonusaite, Aivaras Jonas Matijosaitis, Darius Trumbeckas, Edmundas Varpiotas, Stasys Auskalnis, Darijus Skaudickas, Ramunas Mickevicius, Kestutis Vaiciunas, Jonas Mickevicius and Mindaugas Jievaltas
Cancers 2022, 14(8), 2032; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14082032 - 18 Apr 2022
Cited by 1 | Viewed by 1496
Abstract
Background: The study aimed to assess predictors and to identify patients at increased risk of prostate-cancer-specific mortality (CSM) after radical prostatectomy (RP). Methods: A total of 2421 men with localized and locally advanced PCa who underwent RP in 2001–2017 were included in the [...] Read more.
Background: The study aimed to assess predictors and to identify patients at increased risk of prostate-cancer-specific mortality (CSM) after radical prostatectomy (RP). Methods: A total of 2421 men with localized and locally advanced PCa who underwent RP in 2001–2017 were included in the study. CSM predictors were assessed using multivariate competing risk analysis. Death from other causes was considered a competing event. Cumulative CSM and other-cause mortality (OCM) were calculated in various combinations of predictors. Results: During the median 8 years (interquartile range 4.4–11.7) follow-up, 56 (2.3%) of registered deaths were due to PCa. Cumulative 10 years CSM and OCM was 3.6% (95% CI 2.7–4.7) and 15.9% (95% CI 14.2–17.9), respectively. The strongest predictors of CSM were Grade Group 5 (GG5) (hazard ratio (HR) 19.9, p < 0.0001), lymph node invasion (HR 3.4, p = 0.001), stage pT3b-4 (HR 3.1, p = 0.009), and age (HR 1.1, p = 0.0007). In groups created regarding age, stage, and GG, cumulative 10 years CSM ranged from 0.4–84.9%, whereas OCM varied from 0–43.2%. Conclusions: CSM after RP is related to GGs, pathological stage, age, and combinations of these factors, whereas other-cause mortality is only associated with age. Created CSM and OCM plots can help clinicians identify patients with the most aggressive PCa who could benefit from more intensive or novel multimodal treatment strategies. Full article
(This article belongs to the Special Issue Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach)
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Review

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27 pages, 1487 KiB  
Review
The Role of PSMA PET/CT in the Primary Diagnosis and Follow-Up of Prostate Cancer—A Practical Clinical Review
by Anna Rebecca Lisney, Conrad Leitsmann, Arne Strauß, Birgit Meller, Jan Alexander Bucerius and Carsten-Oliver Sahlmann
Cancers 2022, 14(15), 3638; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14153638 - 26 Jul 2022
Cited by 13 | Viewed by 4174
Abstract
The importance of PSMA PET/CT in both primary diagnostics and prostate cancer recurrence has grown steadily since its introduction more than a decade ago. Over the past years, a vast amount of data have been published on the diagnostic accuracy and the impact [...] Read more.
The importance of PSMA PET/CT in both primary diagnostics and prostate cancer recurrence has grown steadily since its introduction more than a decade ago. Over the past years, a vast amount of data have been published on the diagnostic accuracy and the impact of PSMA PET/CT on patient management. Nevertheless, a large heterogeneity between studies has made reaching a consensus difficult; this review aims to provide a comprehensive clinical review of the available scientific literature, covering the currently known data on physiological and pathological PSMA expression, influencing factors, the differences and pitfalls of various tracers, as well as the clinical implications in initial TNM-staging and in the situation of biochemical recurrence. This review has the objective of providing a practical clinical overview of the advantages and disadvantages of the examination in various clinical situations and the body of knowledge available, as well as open questions still requiring further research. Full article
(This article belongs to the Special Issue Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach)
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12 pages, 248 KiB  
Review
Narrative Review of the Post-Operative Management of Prostate Cancer Patients: Is It Really the End of Adjuvant Radiotherapy?
by Vincent Bourbonne, Olivier Pradier and Ulrike Schick
Cancers 2022, 14(3), 719; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14030719 - 30 Jan 2022
Cited by 2 | Viewed by 2067
Abstract
Despite three randomized trials indicating a significant reduction in biochemical recurrence (BCR) in high-risk patients, adjuvant radiotherapy (aRT) was rarely performed, even in patients harboring high-risk features. aRT is associated with a higher risk of urinary incontinence and is often criticized for the [...] Read more.
Despite three randomized trials indicating a significant reduction in biochemical recurrence (BCR) in high-risk patients, adjuvant radiotherapy (aRT) was rarely performed, even in patients harboring high-risk features. aRT is associated with a higher risk of urinary incontinence and is often criticized for the lack of patient selection criteria. With a BCR rate reaching 30–70% in high-risk patients, a consensus between urologists and radiation oncologists was needed, leading to three different randomized trials challenging aRT with early salvage radiotherapy (eSRT). In these three different randomized trials with event-free survival as the primary outcome and a planned meta-analysis, eSRT appeared as non-inferior to aRT, answering, for some, this never-ending question. For many, however, the debate persists; these results raised several questions among urologists and radiation oncologists. BCR is thought to be a surrogate for clinically meaningful endpoints such as overall survival and cancer-specific survival but may be poorly efficient in comparison with metastasis-free survival. Imaging of rising prostate-specific antigen (PSA), post-operative persistent PSA and BCR was revolutionized by the broader use of MRI and nuclear imaging such as PET-PSMA; these imaging modalities were not analyzed in the previous randomized trials. A sub-group of very high-risk patients could possibly benefit from an adjuvant radiotherapy; but their usual risk factors such as high Gleason score or invaded surgical margins mean they are unable to be selected. More precise biomarkers of early BCR or even metastatic-relapse were developed in this setting and could be useful for the patients’ stratification. In this review, we insist on the need for multidisciplinary discussions to fully comprehend the individual characteristics of each patient and propose the best treatment strategy for every patient. Full article
(This article belongs to the Special Issue Actual Aspects of Prostate Cancer Treatment—an Interdisciplinary Approach)
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