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Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses

BACKGROUND: The urgent need for castration-resistant prostate cancer molecular characterization to guide treatment has been constrained by the disease's predilection to metastasize primarily to bone. We hypothesized that the use of clinical and imaging criteria could maximize tissue acquisition...

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Autores principales: Lorente, David, Omlin, Aurelius, Zafeiriou, Zafeiris, Nava-Rodrigues, Daniel, Pérez-López, Raquel, Pezaro, Carmel, Mehra, Niven, Sheridan, Elizabeth, Figueiredo, Ines, Riisnaes, Ruth, Miranda, Susana, Crespo, Mateus, Flohr, Penny, Mateo, Joaquín, Altavilla, Amelia, Ferraldeschi, Roberta, Bianchini, Diletta, Attard, Gerhardt, Tunariu, Nina, de Bono, Johann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132155/
https://www.ncbi.nlm.nih.gov/pubmed/27246360
http://dx.doi.org/10.1016/j.clgc.2016.04.016
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author Lorente, David
Omlin, Aurelius
Zafeiriou, Zafeiris
Nava-Rodrigues, Daniel
Pérez-López, Raquel
Pezaro, Carmel
Mehra, Niven
Sheridan, Elizabeth
Figueiredo, Ines
Riisnaes, Ruth
Miranda, Susana
Crespo, Mateus
Flohr, Penny
Mateo, Joaquín
Altavilla, Amelia
Ferraldeschi, Roberta
Bianchini, Diletta
Attard, Gerhardt
Tunariu, Nina
de Bono, Johann
author_facet Lorente, David
Omlin, Aurelius
Zafeiriou, Zafeiris
Nava-Rodrigues, Daniel
Pérez-López, Raquel
Pezaro, Carmel
Mehra, Niven
Sheridan, Elizabeth
Figueiredo, Ines
Riisnaes, Ruth
Miranda, Susana
Crespo, Mateus
Flohr, Penny
Mateo, Joaquín
Altavilla, Amelia
Ferraldeschi, Roberta
Bianchini, Diletta
Attard, Gerhardt
Tunariu, Nina
de Bono, Johann
author_sort Lorente, David
collection PubMed
description BACKGROUND: The urgent need for castration-resistant prostate cancer molecular characterization to guide treatment has been constrained by the disease's predilection to metastasize primarily to bone. We hypothesized that the use of clinical and imaging criteria could maximize tissue acquisition from bone marrow biopsies (BMBs). We aimed to develop a score for the selection of patients undergoing BMB. MATERIALS AND METHODS: A total of 115 BMBs were performed in 101 patients: 57 were included in a derivation set and 58 were used as the validation set. The clinical and laboratory data and prebiopsy computed tomography parameters (Hounsfield units [HUs]) were determined. A score for the prediction of biopsy positivity was developed from logistic regression analysis of the derivation set and tested in the validation set. RESULTS: Of the 115 biopsy specimens, 75 (62.5%) were positive; 35 (61.4%) in the test set and 40 (69%) in the validation set. On univariable analysis, hemoglobin (P = .019), lactate dehydrogenase (P = .003), prostate-specific antigen (P = .005), and mean HUs (P = .004) were selected. A score based on the LDH level (≥ 225 IU/L) and mean HUs (≥ 125) was developed in multivariate analysis and was associated with BMB positivity in the validation set (odds ratio, 5.1; 95% confidence interval, 1.9%-13.4%; P = .001). The area under the curve of the score was 0.79 in the test set and 0.77 in the validation set. CONCLUSION: BMB of the iliac crest is a feasible technique for obtaining tumor tissue for genomic analysis in patients with castration-resistant prostate cancer metastatic to the bone. A signature based on the mean HUs and LDH level can predict a positive yield with acceptable internal validity. Prospective studies of independent cohorts are needed to establish the external validity of the score.
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spelling pubmed-51321552016-12-08 Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses Lorente, David Omlin, Aurelius Zafeiriou, Zafeiris Nava-Rodrigues, Daniel Pérez-López, Raquel Pezaro, Carmel Mehra, Niven Sheridan, Elizabeth Figueiredo, Ines Riisnaes, Ruth Miranda, Susana Crespo, Mateus Flohr, Penny Mateo, Joaquín Altavilla, Amelia Ferraldeschi, Roberta Bianchini, Diletta Attard, Gerhardt Tunariu, Nina de Bono, Johann Clin Genitourin Cancer Original Study BACKGROUND: The urgent need for castration-resistant prostate cancer molecular characterization to guide treatment has been constrained by the disease's predilection to metastasize primarily to bone. We hypothesized that the use of clinical and imaging criteria could maximize tissue acquisition from bone marrow biopsies (BMBs). We aimed to develop a score for the selection of patients undergoing BMB. MATERIALS AND METHODS: A total of 115 BMBs were performed in 101 patients: 57 were included in a derivation set and 58 were used as the validation set. The clinical and laboratory data and prebiopsy computed tomography parameters (Hounsfield units [HUs]) were determined. A score for the prediction of biopsy positivity was developed from logistic regression analysis of the derivation set and tested in the validation set. RESULTS: Of the 115 biopsy specimens, 75 (62.5%) were positive; 35 (61.4%) in the test set and 40 (69%) in the validation set. On univariable analysis, hemoglobin (P = .019), lactate dehydrogenase (P = .003), prostate-specific antigen (P = .005), and mean HUs (P = .004) were selected. A score based on the LDH level (≥ 225 IU/L) and mean HUs (≥ 125) was developed in multivariate analysis and was associated with BMB positivity in the validation set (odds ratio, 5.1; 95% confidence interval, 1.9%-13.4%; P = .001). The area under the curve of the score was 0.79 in the test set and 0.77 in the validation set. CONCLUSION: BMB of the iliac crest is a feasible technique for obtaining tumor tissue for genomic analysis in patients with castration-resistant prostate cancer metastatic to the bone. A signature based on the mean HUs and LDH level can predict a positive yield with acceptable internal validity. Prospective studies of independent cohorts are needed to establish the external validity of the score. Elsevier 2016-12 /pmc/articles/PMC5132155/ /pubmed/27246360 http://dx.doi.org/10.1016/j.clgc.2016.04.016 Text en © 2016 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Study
Lorente, David
Omlin, Aurelius
Zafeiriou, Zafeiris
Nava-Rodrigues, Daniel
Pérez-López, Raquel
Pezaro, Carmel
Mehra, Niven
Sheridan, Elizabeth
Figueiredo, Ines
Riisnaes, Ruth
Miranda, Susana
Crespo, Mateus
Flohr, Penny
Mateo, Joaquín
Altavilla, Amelia
Ferraldeschi, Roberta
Bianchini, Diletta
Attard, Gerhardt
Tunariu, Nina
de Bono, Johann
Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses
title Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses
title_full Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses
title_fullStr Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses
title_full_unstemmed Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses
title_short Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses
title_sort castration-resistant prostate cancer tissue acquisition from bone metastases for molecular analyses
topic Original Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132155/
https://www.ncbi.nlm.nih.gov/pubmed/27246360
http://dx.doi.org/10.1016/j.clgc.2016.04.016
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