Browsing by Subject "Neuroendocrine"

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    ItemOpen Access
    Predictors of survival in 211 patients with stage IV pulmonary and gastroenteropancreatic mIBG positive neuroendocrine tumors treated with I-131 mIBG.
    (Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2018-05-18) Kane, Ari; Thorpe, Matthew P; Morse, Michael A; Howard, Brandon A; Oldan, Jorge D; Zhu, Jason; Wong, Terence Z; Petry, Neil A; Reiman, Robert; Borges-Neto, Salvador
    Purpose: This retrospective analysis identifies predictors of survival in a cohort of patients with mIBG positive stage IV pulmonary and gastroenteropancreatic neuroendocrine tumor (P/GEP-NET) treated with I-131 mIBG therapy, in order to inform treatment selection and post-treatment monitoring. Methods: Survival, symptoms, imaging, and biochemical response were extracted via chart review from n = 211 P/GEP-NET patients treated with mIBG between 1991-2014. For patients with computed tomography (CT) follow up (n = 125), imaging response was assessed by Response Evaluation Criteria on Solid Tumors (RECIST) 1.1 where images were available (n = 76) or by chart review of the radiology report where images could not be reviewed (n = 49). Kaplan Meier analysis and Cox multivariate regression estimated survival and progression free survival benefits predicted by initial imaging, biochemical and symptomatic response. Results: All patients had stage IV disease at time of treatment. Median survival was 29 months from time of treatment. 71% of patients demonstrated symptomatic response with median duration of symptomatic relief of 12 months. Symptomatic response at first follow-up predicted a survival benefit of 30 months (p<0.001). Biochemical response at first clinical follow up was seen in 34% of patients with stability of labs in 48%; response/stability vs. progression extended survival 40 months (p<0.03). Imaging response (20% of patients) or stability (60%) at initial 3 month follow up imaging extended survival 32 months (p<0.001). Additionally, multiple mIBG treatments was associated with 24 months additional survival (p<0.05). Conclusion: Therapeutic I-131-mIBG for metastatic pulmonary or gastroenteropancreatic neuroendocrine tumors appears to be an effective means of symptom palliation. Imaging, biochemical, and symptomatic follow-up each help prognosticate expected survival following mIBG therapy. Multiple rounds of mIBG are associated with prolonged survival; it is unclear whether this represents cause or effect.
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    Targeting androgen receptor-independent pathways in therapy-resistant prostate cancer.
    (Asian journal of urology, 2019-01) Xu, Lingfan; Chen, Junyi; Liu, Weipeng; Liang, Chaozhao; Hu, Hailiang; Huang, Jiaoti
    Since androgen receptor (AR) signaling is critically required for the development of prostate cancer (PCa), targeting AR axis has been the standard treatment of choice for advanced and metastatic PCa. Unfortunately, although the tumor initially responds to the therapy, treatment resistance eventually develops and the disease will progress. It is therefore imperative to identify the mechanisms of therapeutic resistance and novel molecular targets that are independent of AR signaling. Recent advances in pathology, molecular biology, genetics and genomics research have revealed novel AR-independent pathways that contribute to PCa carcinogenesis and progression. They include neuroendocrine differentiation, cell metabolism, DNA damage repair pathways and immune-mediated mechanisms. The development of novel agents targeting the non-AR mechanisms holds great promise to treat PCa that does not respond to AR-targeted therapies.