Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses.
View/ Open
Date
2016-12-01Author
Lorente, D
Omlin, A
Zafeiriou, Z
Nava-Rodrigues, D
Pérez-López, R
Pezaro, C
Mehra, N
Sheridan, E
Figueiredo, I
Riisnaes, R
Miranda, S
Crespo, M
Flohr, P
Mateo, J
Altavilla, A
Ferraldeschi, R
Bianchini, D
Attard, G
Tunariu, N
de Bono, J
Type
Journal Article
Metadata
Show full item recordAbstract
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.
Collections
Subject
Bone Marrow
Humans
Bone Neoplasms
Kallikreins
Prostate-Specific Antigen
L-Lactate Dehydrogenase
Tomography, X-Ray Computed
Biopsy
Bone Marrow Examination
Area Under Curve
Prospective Studies
Male
Prostatic Neoplasms, Castration-Resistant
Biomarkers, Tumor
Research team
Cancer Biomarkers
Prostate Cancer Targeted Therapy Group
Treatment Resistance
Language
eng
Date accepted
2016-04-22
License start date
2016-12
Citation
Clinical genitourinary cancer, 2016, 14 (6), pp. 485 - 493
Publisher
CIG MEDIA GROUP, LP