Experts Develop New Guideline for Advanced Prostate Cancer

Broderick, Jason M.

doi:10.46883/onc.2020.3408.0305

Cited by 1 publication

(1 citation statement)

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“…Specific HLA-A alleles, including, but not restricted to, those described here, i.e., HLA-A*02:01 and HLA-A*24:02, as independent prognostic biomarkers, may change therapeutic and clinical follow-up time scheduling, thus significantly contributing to overcome overdiagnosis and over-treatment of PCa patients. For instance, in accordance with the newly suggested guidelines [51] and according to our data from this study, patients carrying the HLA-A*24:02 genotype and experiencing BCR after local therapy may start ADT after metastatic disease diagnosis, thus avoiding for a long time the significant side effects of antiandrogens, and consequently enjoying an improved quality of life for longer periods. On the contrary, PCa patients with more aggressive disease, as those HLA-A*02:01 genotyped, should immediately start appropriate treatment schemes to delay metastases (including ADT, second-line anti-androgens, and/or chemotherapy) according to other risk-indicative clinicopathological characteristics.…”

Section: Discussionsupporting

confidence: 62%

The Prognostic Significance of Selected HLA Alleles on Prostate Cancer Outcome

Stokidis,

Baxevanis,

Fortis

2023

IJMS

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Recently, we have shown that HLA-A*02:01 and HLA-A*24:02 in de novo metastatic prostate cancer (MPCa) have an important role in disease progression. Since de novo MPCa represents a small group among patients diagnosed with prostate cancer (PCa), it was obvious to try to extend the validity of our results to larger cohorts of PCa patients. Herein, we analyzed patients irrespective of their disease status at diagnosis to include, besides patients with MPCa, those with localized PCa (LPCa). Our goal was to specify the prognostic value of HLA-A*02:01 and HLA-A*24:02 for overall survival (OS) prospectively and for early biochemical recurrence (BCR) and castrate resistance (CR) as additional clinical endpoints in a prospective/retrospective manner, to improve clinical decisions for patients covering all stages of PCa. On univariate analysis, HLA-A alleles were significantly associated as prognostic biomarkers with early BCR (p = 0.028; HR = 1.822), OS (p = 0.013; HR = 1.547) and showed a trend for CR (p = 0.150; HR = 1.239). On multivariate analysis, HLA-A alleles proved to be independent prognosticators for early BCR (p = 0.017; HR = 2.008), CR (p = 0.005; HR = 1.615), and OS (p = 0.002; HR = 2.063). Kaplan–Meier analyses revealed that patients belonging to the HLA-A*02:01+HLA-A*24:02− group progressed much faster to BCR and CR and had also shorter OS compared to HLA-A*24:02+ patients. Patients being HLA-A*02:01−HLA-A*24:02− exhibited varying clinical outcomes, pointing to the presence of additional HLA-A alleles with potential prognostic value. Our data underline the HLA-A alleles as valuable prognostic biomarkers for PCa that may assist with the appropriate treatment and follow-up schedule based on the risk for disease progression to avoid over-diagnosis and over-treatment.

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Section: Discussionsupporting

confidence: 62%