From biology to the clinic — exploring liver metastasis in prostate cancer

IF 12.1 1区 医学 Q1 UROLOGY & NEPHROLOGY
Xudong Ni, Yu Wei, Xiaomeng Li, Jian Pan, Bangwei Fang, Tingwei Zhang, Ying Lu, Dingwei Ye, Yao Zhu
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引用次数: 0

Abstract

Liver metastases from prostate cancer are associated with an aggressive disease course and poor prognosis. Results from autopsy studies indicate a liver metastasis prevalence of up to 25% in patients with advanced prostate cancer. Population data estimate that ~3–10% of patients with metastatic castration-resistant prostate cancer harbour liver metastases at the baseline, rising to 20–30% in post-treatment cohorts, suggesting that selective pressure imposed by novel therapies might promote metastatic spread to the liver. Liver metastases are associated with more aggressive tumour biology than lung metastases. Molecular profiling of liver lesions showed an enrichment of low androgen receptor, neuroendocrine phenotypes and high genomic instability. Despite advancements in molecular imaging modalities such as prostate-specific membrane antigen PET–CT, and liquid biopsy markers such as circulating tumour DNA, early detection of liver metastases from prostate cancer remains challenging, as both approaches are hampered by false positive and false negative results, impeding the accurate identification of early liver lesions. Current therapeutic strategies showed limited efficacy in this patient population. Emerging targeted radionuclide therapies, metastasis-directed therapy, and novel systemic agents have shown preliminary activity against liver metastases, but require further validation. Treatment with various novel prostate cancer therapies might lead to an increase in the prevalence of liver metastasis, underscoring the urgent need for coordinated efforts across preclinical and clinical researchers to improve characterization, monitoring, and management of liver metastases from prostate cancer. Elucidating molecular drivers of liver tropism and interactions with the liver microenvironment might ultimately help to identify actionable targets to enhance survival in this high-risk patient group. In this Review, the authors provide a comprehensive overview of the epidemiological characteristics, prognosis, biological mechanisms, detection methods and treatment options for liver metastasis in prostate cancer. Guidance for future research directions in the field is also provided.

Abstract Image

Abstract Image

从生物学到临床--探索前列腺癌的肝转移
前列腺癌肝转移与侵袭性病程和不良预后有关。尸检研究结果表明,晚期前列腺癌患者的肝转移率高达 25%。人群数据估计,约有3%-10%的转移性耐阉割前列腺癌患者在基线时患有肝转移,在治疗后的队列中上升到20%-30%,这表明新型疗法施加的选择性压力可能会促进肝转移扩散。与肺转移相比,肝转移与更具侵袭性的肿瘤生物学相关。肝脏病变的分子图谱分析表明,低雄激素受体、神经内分泌表型和高基因组不稳定性在肝脏病变中富集。尽管前列腺特异性膜抗原PET-CT等分子成像模式和循环肿瘤DNA等液体活检标记物取得了进步,但前列腺癌肝转移的早期检测仍面临挑战,因为这两种方法都受到假阳性和假阴性结果的影响,妨碍了早期肝脏病变的准确识别。目前的治疗策略对这类患者的疗效有限。新兴的放射性核素靶向疗法、转移灶定向疗法和新型全身性药物已显示出对肝脏转移灶的初步活性,但仍需进一步验证。使用各种新型前列腺癌疗法可能会导致肝转移的发生率增加,因此迫切需要临床前和临床研究人员协调努力,改善前列腺癌肝转移的特征描述、监测和管理。阐明肝脏趋向性的分子驱动因素以及与肝脏微环境的相互作用可能最终有助于确定可行的靶点,从而提高这一高风险患者群体的生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Nature Reviews Urology
Nature Reviews Urology 医学-泌尿学与肾脏学
CiteScore
12.50
自引率
2.60%
发文量
123
审稿时长
6-12 weeks
期刊介绍: Nature Reviews Urology is part of the Nature Reviews portfolio of journals.Nature Reviews' basic, translational and clinical content is written by internationally renowned basic and clinical academics and researchers. This journal targeted readers in the biological and medical sciences, from the postgraduate level upwards, aiming to be accessible to professionals in any biological or medical discipline. The journal features authoritative In-depth Reviews providing up-to-date information on topics within a field's history and development. Perspectives, News & Views articles, and the Research Highlights section offer topical discussions and opinions, filtering primary research from various medical journals. Covering a wide range of subjects, including andrology, urologic oncology, and imaging, Nature Reviews provides valuable insights for practitioners, researchers, and academics within urology and related fields.
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