Optimizing the diagnosis and management of ductal prostate cancer

Ranasinghe, Weranja Kalana Bodhisiri; Shapiro, Daniel D.; Zhang, Miao; Bathala, Tharakeswara K.; Navone, Nora M.; Thompson, Timothy C.; Broom, Bradley M.; Aparicio, Ana; Tu, Shi Ming; Tang, Chad; Davis, John W.; Pisters, Louis L.; Chapin, Brian F.

doi:10.1038/s41585-021-00447-3

Cited by 24 publications

(22 citation statements)

References 134 publications

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“…IDC-P and acinar adenocarcinoma of the prostate have highly conserved genomic profiles and are clonally related, thus indicating that they may originate from the same progenitor cells [ 6 ]. Furthermore, the identification of reliable genomic markers for IDC-P remains a challenging issue.…”

Section: Genomic Alterations Of Idc-pmentioning

confidence: 99%

Genomic Features and Clinical Implications of Intraductal Carcinoma of the Prostate

Kang

Lee

Byeon

et al. 2021

IJMS

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Intraductal carcinoma of the prostate (IDC-P) is a rare and unique form of aggressive prostate carcinoma, which is characterized by an expansile proliferation of malignant prostatic epithelial cells within prostatic ducts or acini and the preservation of basal cell layers around the involved glands. The vast majority of IDC-P tumors result from adjacent high-grade invasive cancer via the retrograde spreading of tumor cells into normal prostatic ducts or acini. A subset of IDC-P tumors is rarely derived from the de novo intraductal proliferation of premalignant cells. The presence of IDC-P in biopsy or surgical specimens is significantly associated with aggressive pathologic features, such as high Gleason grade, large tumor volume, and advanced tumor stage, and with poor clinical courses, including earlier biochemical recurrence, distant metastasis, and worse survival outcomes. These architectural and behavioral features of IDC-P may be driven by specific molecular properties. Notably, IDC-P possesses distinct genomic profiles, including higher rates of TMPRSS2–ERG gene fusions and PTEN loss, increased percentage of genomic instability, and higher prevalence of germline BRCA2 mutations. Considering that IDC-P tumors are usually resistant to conventional therapies for prostate cancer, further studies should be performed to develop optimal therapeutic strategies based on distinct genomic features, such as treatment with immune checkpoint blockades or poly (adenosine diphosphate–ribose) polymerase inhibitors for patients harboring increased genomic instability or BRCA2 mutations, as well as genetic counseling with genetic testing. Patient-derived xenografts and tumor organoid models can be the promising in vitro platforms for investigating the molecular features of IDC-P tumor.

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Section: Genomic Alterations Of Idc-pmentioning

confidence: 99%

Genomic Features and Clinical Implications of Intraductal Carcinoma of the Prostate

Kang

Lee

Byeon

et al. 2021

IJMS

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“…Most of the literature is based on demographic data, such as the SEER database study [ 1 ]. These reports, including a review article on PDA, consistently reported poor prostate cancer-specific survival in PDA patients [ 1 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Very high-risk locally advanced prostate ductal adenocarcinoma cured using low-dose-rate brachytherapy, with seminal vesicle implantation in combination with external beam radiotherapy at a biologically effective dose ≥ 220 Gy: two case reports with a long-term follow-up

Okamoto¹

2022

jcb

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Purpose: Prostate ductal adenocarcinoma (PDA) is an aggressive, rare variant of histologic sub-type of prostate cancer. Patients with PDA present with more aggressive clinical features and have a poorer prognosis than patients with acinar adenocarcinoma. So far, an optimal treatment for PDA has yet to be established. Furthermore, the effectiveness of low-dose-rate (LDR) brachytherapy for PDA has not been reported previously.Case presentation: In this paper, we present two case reports on very high-risk locally advanced PDA, in which patients were successfully treated with LDR brachytherapy, with seminal vesicle implantation in combination with external beam radiotherapy (EBRT) at a biologically effective dose (BED) ≥ 220 Gy and short-term androgen deprivation therapy (ADT). There was no grade 2 genitourinary (GU) and gastrointestinal (GI) toxicities during follow-up, and no evidence of hematuria nor rectal bleeding during follow-up. The patients stay healthy without biochemical failure and without bowel or urinary difficulties at 11.5 years and 8 years, respectively.Conclusions: High-BED LDR-based radiotherapy in combination with EBRT (BED ≥ 220 Gy) may be an ideal treatment for very high-risk locally advanced PDA patients.

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“…Treatment guidelines are limited due to the small number of case series reports, however a multimodal aggressive treatment approach is often undertaken. 2 We report an atypical presentation of this rare condition.…”

Section: Introductionmentioning

confidence: 87%

“…Ductal adenocarcinoma of the prostate is the most common variant histological subtype accounting for between 0.1 and 12.7% of prostate cancer. 1 , 2 Managed traditionally as a high risk cohort, 3 due to delayed diagnosis as often associated with low Prostate Specific Antigen (PSA) levels, and an affinity for early metastasis particularly to visceral organs. Treatment guidelines are limited due to the small number of case series reports, however a multimodal aggressive treatment approach is often undertaken.…”

Section: Introductionmentioning

confidence: 99%

Case report: Recurrent urethral polyps, an atypical presentation of ductal prostate adenocarcinoma

Holmes

Tissot

Kearns

2022

Urology Case Reports

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Optimizing the diagnosis and management of ductal prostate cancer

Cited by 24 publications

References 134 publications

Genomic Features and Clinical Implications of Intraductal Carcinoma of the Prostate

Genomic Features and Clinical Implications of Intraductal Carcinoma of the Prostate

Very high-risk locally advanced prostate ductal adenocarcinoma cured using low-dose-rate brachytherapy, with seminal vesicle implantation in combination with external beam radiotherapy at a biologically effective dose ≥ 220 Gy: two case reports with a long-term follow-up

Case report: Recurrent urethral polyps, an atypical presentation of ductal prostate adenocarcinoma

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