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Immune Modulation in Prostate Cancer Patients Treated with Androgen Receptor (AR)-Targeted Therapy

Androgen deprivation therapy (ADT) is a cornerstone of treatment for prostate cancer and, in recent years, androgen receptor (AR)-targeted therapies (abiraterone and enzalutamide) have both been used for the treatment of castration-resistant prostate cancer (CRPC). In our study, we sought to investi...

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Autores principales: Conteduca, Vincenza, Caffo, Orazio, Scarpi, Emanuela, Sepe, Pierangela, Galli, Luca, Fratino, Lucia, Maines, Francesca, Chiuri, Vincenzo Emanuele, Santoni, Matteo, Zanardi, Elisa, Massari, Francesco, Toma, Ilaria, Lolli, Cristian, Schepisi, Giuseppe, Sbrana, Andrea, Kinspergher, Stefania, Cursano, Maria Concetta, Casadei, Chiara, Modonesi, Caterina, Santini, Daniele, Procopio, Giuseppe, De Giorgi, Ugo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356925/
https://www.ncbi.nlm.nih.gov/pubmed/32580478
http://dx.doi.org/10.3390/jcm9061950
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author Conteduca, Vincenza
Caffo, Orazio
Scarpi, Emanuela
Sepe, Pierangela
Galli, Luca
Fratino, Lucia
Maines, Francesca
Chiuri, Vincenzo Emanuele
Santoni, Matteo
Zanardi, Elisa
Massari, Francesco
Toma, Ilaria
Lolli, Cristian
Schepisi, Giuseppe
Sbrana, Andrea
Kinspergher, Stefania
Cursano, Maria Concetta
Casadei, Chiara
Modonesi, Caterina
Santini, Daniele
Procopio, Giuseppe
De Giorgi, Ugo
author_facet Conteduca, Vincenza
Caffo, Orazio
Scarpi, Emanuela
Sepe, Pierangela
Galli, Luca
Fratino, Lucia
Maines, Francesca
Chiuri, Vincenzo Emanuele
Santoni, Matteo
Zanardi, Elisa
Massari, Francesco
Toma, Ilaria
Lolli, Cristian
Schepisi, Giuseppe
Sbrana, Andrea
Kinspergher, Stefania
Cursano, Maria Concetta
Casadei, Chiara
Modonesi, Caterina
Santini, Daniele
Procopio, Giuseppe
De Giorgi, Ugo
author_sort Conteduca, Vincenza
collection PubMed
description Androgen deprivation therapy (ADT) is a cornerstone of treatment for prostate cancer and, in recent years, androgen receptor (AR)-targeted therapies (abiraterone and enzalutamide) have both been used for the treatment of castration-resistant prostate cancer (CRPC). In our study, we sought to investigate the association between ADT and immune disorders, considering a potential role of androgens in the immune modulation. We retrospectively evaluated CRPC patients treated with abiraterone/enzalutamide between July 2011 and December 2018. We assessed the risk of developing immune alterations and their impact on outcome. We included 844 CRPC patients receiving AR-directed therapies, of whom 36 (4.3%) had autoimmune diseases and 47 (5.6%) second tumors as comorbidities. Median age was 70 years [interquartile range (IQR) = 63–75)]. We showed higher significant incidence of autoimmune diseases during their hormone sensitive status (p = 0.021) and the presence of autoimmune comorbidities before starting treatment with abiraterone/enzalutamide was significantly associated with worse overall survival (OS) (10.1 vs. 13.7 months, HR = 1.59, 95% CI 1.03–2.27, p = 0.038). In a multivariate analysis, the presence of autoimmune disorders was an independent predictor of OS (HR = 1.65, 95% CI 1.05–2.60, p = 0.031). In conclusion, CRPC patients with autoimmune alterations before starting AR-directed therapies may have worse prognosis. Further prospective studies are warranted to assess the role of immune modulation in the management of prostate cancer patients.
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spelling pubmed-73569252020-07-22 Immune Modulation in Prostate Cancer Patients Treated with Androgen Receptor (AR)-Targeted Therapy Conteduca, Vincenza Caffo, Orazio Scarpi, Emanuela Sepe, Pierangela Galli, Luca Fratino, Lucia Maines, Francesca Chiuri, Vincenzo Emanuele Santoni, Matteo Zanardi, Elisa Massari, Francesco Toma, Ilaria Lolli, Cristian Schepisi, Giuseppe Sbrana, Andrea Kinspergher, Stefania Cursano, Maria Concetta Casadei, Chiara Modonesi, Caterina Santini, Daniele Procopio, Giuseppe De Giorgi, Ugo J Clin Med Article Androgen deprivation therapy (ADT) is a cornerstone of treatment for prostate cancer and, in recent years, androgen receptor (AR)-targeted therapies (abiraterone and enzalutamide) have both been used for the treatment of castration-resistant prostate cancer (CRPC). In our study, we sought to investigate the association between ADT and immune disorders, considering a potential role of androgens in the immune modulation. We retrospectively evaluated CRPC patients treated with abiraterone/enzalutamide between July 2011 and December 2018. We assessed the risk of developing immune alterations and their impact on outcome. We included 844 CRPC patients receiving AR-directed therapies, of whom 36 (4.3%) had autoimmune diseases and 47 (5.6%) second tumors as comorbidities. Median age was 70 years [interquartile range (IQR) = 63–75)]. We showed higher significant incidence of autoimmune diseases during their hormone sensitive status (p = 0.021) and the presence of autoimmune comorbidities before starting treatment with abiraterone/enzalutamide was significantly associated with worse overall survival (OS) (10.1 vs. 13.7 months, HR = 1.59, 95% CI 1.03–2.27, p = 0.038). In a multivariate analysis, the presence of autoimmune disorders was an independent predictor of OS (HR = 1.65, 95% CI 1.05–2.60, p = 0.031). In conclusion, CRPC patients with autoimmune alterations before starting AR-directed therapies may have worse prognosis. Further prospective studies are warranted to assess the role of immune modulation in the management of prostate cancer patients. MDPI 2020-06-22 /pmc/articles/PMC7356925/ /pubmed/32580478 http://dx.doi.org/10.3390/jcm9061950 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Conteduca, Vincenza
Caffo, Orazio
Scarpi, Emanuela
Sepe, Pierangela
Galli, Luca
Fratino, Lucia
Maines, Francesca
Chiuri, Vincenzo Emanuele
Santoni, Matteo
Zanardi, Elisa
Massari, Francesco
Toma, Ilaria
Lolli, Cristian
Schepisi, Giuseppe
Sbrana, Andrea
Kinspergher, Stefania
Cursano, Maria Concetta
Casadei, Chiara
Modonesi, Caterina
Santini, Daniele
Procopio, Giuseppe
De Giorgi, Ugo
Immune Modulation in Prostate Cancer Patients Treated with Androgen Receptor (AR)-Targeted Therapy
title Immune Modulation in Prostate Cancer Patients Treated with Androgen Receptor (AR)-Targeted Therapy
title_full Immune Modulation in Prostate Cancer Patients Treated with Androgen Receptor (AR)-Targeted Therapy
title_fullStr Immune Modulation in Prostate Cancer Patients Treated with Androgen Receptor (AR)-Targeted Therapy
title_full_unstemmed Immune Modulation in Prostate Cancer Patients Treated with Androgen Receptor (AR)-Targeted Therapy
title_short Immune Modulation in Prostate Cancer Patients Treated with Androgen Receptor (AR)-Targeted Therapy
title_sort immune modulation in prostate cancer patients treated with androgen receptor (ar)-targeted therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356925/
https://www.ncbi.nlm.nih.gov/pubmed/32580478
http://dx.doi.org/10.3390/jcm9061950
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