Dataset Information

Prolonged Response to an IGF-1 Receptor Antibody in a Patient with Metastatic Castration Prostate Cancer with Neuroendocrine Differentiation.

ABSTRACT: The androgen receptor is the main therapeutic target that has been successfully exploited through direct inhibition to extend survival of patients with metastatic castration-resistant prostate cancer (mCRPC). We present a patient who participated in a Phase II study of an antagonist antibody to insulin-like growth factor 1 receptor (IGF-1R) in men with mCRPC and experienced over five years of stable disease. His disease was rapidly progressing before exposure to the antibody and resumed its aggressive behavior following discontinuation of therapy, strongly supporting the attribution of his stable disease to IGF-1R inhibition. His pre-treatment biopsy exhibited increased protein expression of IGF-1R (and its downstream effector, phosphorylated-S6). Consequently, agents that target IGF-1R may provide profound and durable responses in a subset of patients and upfront molecular selection may enable us to identify those most likely to benefit.

SUBMITTER: Graff JN

PROVIDER: S-EPMC4727917 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Publications

Prolonged Response to an IGF-1 Receptor Antibody in a Patient with Metastatic Castration Prostate Cancer with Neuroendocrine Differentiation.

Graff Julie N JN Thomas George V GV Higano Celestia S CS Beer Tomasz M TM

Cureus 20151222 12

The androgen receptor is the main therapeutic target that has been successfully exploited through direct inhibition to extend survival of patients with metastatic castration-resistant prostate cancer (mCRPC). We present a patient who participated in a Phase II study of an antagonist antibody to insulin-like growth factor 1 receptor (IGF-1R) in men with mCRPC and experienced over five years of stable disease. His disease was rapidly progressing before exposure to the antibody and resumed its aggr ...[more]

PMID: 26848415

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Project description:Neuroendocrine differentiation of prostate cancer (NEDPC) includes de novo presentation and secondary to epigenetic changes, referred as therapy-induced neuroendocrine prostate cancer (t-NEPC). Molecular imaging with prostate-specific membrane antigen (PSMA) and somatostatin analogues positron emission tomography (PET/CT) in NEDPC have not been validated. 18F-FDG (fluorodeoxyglucose) PET/CT has numerous limitations in prostate cancer (PCa) and the utility in NEDPC has only been reported in a few series of cases. The objective of this study is to compare the lesions detection rate of the three radiotracers in metastatic t-NEPC patients. (1) Material and Methods: Retrospective evaluation of patients with prostate adenocarcinoma treated with androgen deprivation therapy, chemotherapy, a novel androgen receptor pathway inhibitor or a combination of them and a second tumour biopsy confirming t-NEPC was made. All patients underwent 18F PSMA-1007, 18F AlF-NOTA-Octreotide, and 18F-FDG PET/CT. Evaluation of positive lesions was determined and SUVmax of each radiotracer was estimated and correlated with computer tomography (CT) findings. (2) Results: A total of eight patients were included. The mean time from diagnosis of prostate adenocarcinoma to t-NEPC was 28.2 months, with a mean serum specific prostate antigen (PSA) of 16.6 ng/dl at the time of NEPC diagnosis. All patients were treated with antiandrogen therapy and 87.5% with chemotherapy. A total of 273 lesions were identified by CT from which 182 were detected by 18F-FDG PET/CT, 174 lesions by 18F PSMA-1007, and 59 by 18F AlF-NOTA-Octreotide. An interpatient analysis of the lesions was performed and dual tracer 18F-FDG PET/CT and 18F PSMA-1007 PET/CT detected a total of 270/273 lesions (98.9%). (3) Conclusions: NEDPC patients demonstrated wide inter and intrapatient molecular imaging heterogeneity within the three radiotracers. 18F-FDG detected most lesions in t-NEPC among all radiotracers, especially in visceral sites; 18F PSMA-1007 detected more bone lesions. 18F AlF-NOTA-Octreotide showed no significant utility.

Dataset Information

Prolonged Response to an IGF-1 Receptor Antibody in a Patient with Metastatic Castration Prostate Cancer with Neuroendocrine Differentiation.

Publications

Prolonged Response to an IGF-1 Receptor Antibody in a Patient with Metastatic Castration Prostate Cancer with Neuroendocrine Differentiation.

Similar Datasets

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