Prostate Cancer and Prostatic Diseases最新文献

{"title":"HLA class I expression shapes the tumor immune microenvironment and influences prognosis in prostate cancer.","authors":"Pornlada Likasitwatanakul, Carissa Besonen, Alexander K Tsai, Negar Sadeghipour, Andrew Elliott, Ali T Arafa, Rachel Passow, Lisa Chesner, Martin Felices, Philippa R Kennedy, Akash Patnaik, Vivek Narayan, James Hamrick, Laura A Sena, Nicholas A Zorko, Justin H Hwang, Emmanuel S Antonarakis","doi":"10.1038/s41391-025-01045-9","DOIUrl":"https://doi.org/10.1038/s41391-025-01045-9","url":null,"abstract":"<p><strong>Background: </strong>Human leukocyte antigen (HLA) class I encompasses peptide-binding proteins that regulate T-cell interactions. We examined HLA class I expression in prostate cancers (PC), exploring associations with clinical outcomes, molecular features, and tumor immune microenvironment.</p><p><strong>Methods: </strong>We analyzed 8040 PC samples from the Caris Life Sciences database, stratifying them into HLA-high (upper quartile) and -low (lower quartile) groups. Genomic and transcriptomic alterations were compared. Immune cell fractions were inferred using quanTIseq, and overall survival (OS) data was obtained from insurance claims. Differences were computed with Cox proportional hazards.</p><p><strong>Results: </strong>Among 66 cancer types, PC ranked 3^rd-, 11^th-, and 19^th-lowest for HLA-A, -B, and -C expression, respectively. In PC, genes tied to androgen receptor (AR) signaling, immune checkpoint molecules (CTLA4, PD-L1), and the epithelial-mesenchymal transition were significantly higher in HLA-high tumors. HLA-high status was linked to greater tumor immune activity, marked by higher T cell fractions and enhanced immune hallmarks. HLA-high tumors were less likely to possess alterations in AR, FOXA1, and CDK12, but harbored increased alterations in tumor suppressor gene (RB1, PTEN) alterations. Tumors with high HLA-A and HLA-B had elevated TMB-H/MSI-H/dMMR status. Finally, shorter OS was observed in patients with high HLA-A or HLA-B expression, while longer OS was associated with high HLA-C expression.</p><p><strong>Conclusions: </strong>In PC, elevated HLA class I levels correlate with immune activity, molecular characteristics, and clinical outcomes. We suggest considering HLA expression as a supplementary marker of immune activity in PC, alongside genetic mutations and transcriptomic markers.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STEAP1-targeted strategies in advanced prostate cancer: a review on therapeutic and diagnostic implications.","authors":"Ja Yoon Heo, Minzhi Sheng, Daniel Khalaf, Hon S Leong, Urban Emmenegger","doi":"10.1038/s41391-025-01038-8","DOIUrl":"https://doi.org/10.1038/s41391-025-01038-8","url":null,"abstract":"<p><strong>Background/objectives: </strong>Six transmembrane epithelial antigen of prostate 1 (STEAP1), a cell surface protein, is highly expressed in prostate cancer and is known to be associated with disease progression and poor prognosis. Based on its specificity for prostate cancer, significant progress has been made over the past decade to capitalize on STEAP1 as a diagnostic and treatment target, and its potential future role in prostate cancer care is of considerable interest.</p><p><strong>Subjects/methods: </strong>This review evaluates the current and emerging strategies targeting STEAP1, integrating findings from preclinical studies and clinical trials.</p><p><strong>Results: </strong>This review discusses STEAP1-based diagnostics, including molecular imaging (89Zr-DFO-MSTP2109A) and liquid biopsy methods, as well as therapeutics, such as STEAP1 antibodies, antibody-drug conjugates (DSPT3086S, ADRX-0405, ABBV-969, and DXC008), chimeric antigen receptor T-cell therapy (STEAP1 CAR-T), bispecific T-cell engagers (Xaluritamig/AMG 509, BC261), and cancer vaccines.</p><p><strong>Conclusions: </strong>STEAP1 represents a promising diagnostic and therapeutic target in prostate cancer, and its potential role in shaping future management of the disease warrants continued investigation.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"4K density: Adjusting the 4Kscore for prostate volume to improve risk stratification of clinically significant prostate cancer in men undergoing prostate biopsy.","authors":"Timothy Guerard, Joao G Porto, Thomas Fekete, Omri Nativ, Gareth Reid, Adam Williams, Jonathan Ryan, Kevin Zhou, Elena Cortizas, Pedro Freitas, Archan Khandekar, Bruno Nahar, Chad Ritch, Mark Gonzalgo, Dipen J Parekh, Sanoj Punnen","doi":"10.1038/s41391-025-01043-x","DOIUrl":"https://doi.org/10.1038/s41391-025-01043-x","url":null,"abstract":"<p><strong>Background: </strong>The 4K Score is a blood-based test that estimates the risk of clinically significant prostate cancer (Grade Group ≥2, GG2 + ) by combining four kallikrein markers with clinical variables. However, benign prostatic hyperplasia (BPH) can elevate PSA levels, potentially leading to risk overestimation in men with large prostates. We developed a novel metric, 4K Density (4K Score divided by prostate volume), to adjust for prostate size and improve risk stratification.</p><p><strong>Methods: </strong>We retrospectively reviewed 3150 men who underwent 4K Score testing at the University of Miami Desai Sethi Urology Institute from 2014 to 2024. After excluding those without a prostate biopsy or MRI within six months of the 4K Score, 1983 men remained. Statistical analysis using SAS v9.4 included logistic regression, receiver operating characteristic (ROC) analysis, and Youden's Index to determine optimal cutoffs for GG2+ detection. The performance of 4K Density was compared to the 4Kscore and PSA Density in predicting GG2+ cancer.</p><p><strong>Results: </strong>Among the 1983 men, 661 (33%) had GG2+ cancer. 4K Density was significantly higher in men with GG2+ cancer compared to those without (median 0.93 vs. 0.25, p < .0001). In multivariable analysis, 4K Density was the strongest independent predictor (OR 3.51, 95% CI 3.64-4.66), outperforming 4Kscore and PSA density. 4K Density also had the highest AUC (0.81, (95%CI)), compared to 4Kscore (0.76, 95 %CI, <0.0001) and PSA density (0.76, 95% CI, <0.0001). At an optimized cutoff of 0.56, 4K Density achieved 89.9% NPV and 48.5% PPV for detecting GG2+ cancer.</p><p><strong>Conclusions: </strong>4K Density is a novel, volume-adjusted biomarker that improves detection of clinically significant prostate cancer and outperforms PSA density and the 4Kscore test. It may be helpful in larger prostates, where confounding from BPH is present. Prospective validation is warranted to confirm its clinical utility.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroscience in prostate cancer.","authors":"Ziteng Liu, Qiang Peng, Yuliang Wang, Peter Ka-Fung Chiu, Jeremy Yuen-Chun Teoh, Rongjiang Wang, Xiaodong Liu, Dinglan Wu, Chi-Fai Ng","doi":"10.1038/s41391-025-01042-y","DOIUrl":"https://doi.org/10.1038/s41391-025-01042-y","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence in cancer neuroscience indicates that the nervous system interacts directly or indirectly with cancer cells, promoting tumor progression. The prostate gland contains an extensive neural network essential for regulating key physiological functions of prostate cells, and the significant neural distribution observed in prostate cancer highlights its critical role in driving cancer pathogenesis. Unfortunately, Comprehensive reviews systematically summarizing progress in cancer neuroscience for prostate cancer are currently lacking.</p><p><strong>Method: </strong>We synthesize existing research on interactions between the nervous system and prostate cancer cells, explore the neural distribution within the prostate, and evaluate the impact of neural innervation on prostate cancer development and progression. Additionally, we also assess the potential neural regulation mechanisms in neuroendocrine prostate cancer (NEPC).</p><p><strong>Result: </strong>We found that neural interactions significantly influence prostate cancer development. Neural circuitry within the tumor microenvironment drives progression and contributes to the aggressiveness of lethal subtypes like NEPC. Targeting neuromodulation emerges as a promising therapeutic approach, potentially allowing the repurposing of established medications for treating advanced tumors.</p><p><strong>Conclusion: </strong>Neuromodulation offers a promising therapeutic option for advanced prostate cancer, particularly NEPC, which faces limited treatment options. However, further research is necessary to fully understand the neural regulatory mechanisms involved in prostate cancer development and to identify new therapeutic targets and strategies for advanced stages.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life in low-risk prostate cancer under active surveillance or following radical treatments: the START cohort study.","authors":"Rosalba Rosato, Stefano De Luca, Andrea Zitella, Fernando Munoz, Carlo Giuliano Baima, Maurizio Barale, Franco Bardari, Debora Beldì, Luca Bellei, Andrea Rocco Bellissimo, Diego Bernardi, Giorgio Biamino, Michele Billia, Roberto Borsa, Domenico Cante, Emanuele Castelli, Danilo Centrella, Enrico Checcucci, Devis Collura, Pietro Coppola, Ettore Dalmasso, Andrea Di Stasio, Michele Fiorio, Marco Gatti, Elisabetta Garibaldi, Giuseppe Girelli, Daniele Griffa, Alessia Guarneri, Stefano Guercio, Carlo Giuseppe Iorio, Roberto Migliari, Franco Montefiore, Maurizio Moroni, Giovanni Muto, Marco Oderda, Eva Pagano, Massimo Pasquale, Francesca Ponti di Sant'Angelo, Riccardo Rossi, Luca Ruggiero, Omid Sedigh, Armando Serao, Maria Sara Squeo, Salvatore Stancati, Francesco Varvello, Alessandro Volpe, Stefano Zaramella, Giovanni Zarrelli, Enrico Bollito, Paolo Gontero, Francesco Porpiglia, Claudia Galassi, Giovannino Ciccone","doi":"10.1038/s41391-025-01032-0","DOIUrl":"https://doi.org/10.1038/s41391-025-01032-0","url":null,"abstract":"<p><strong>Background: </strong>Real-world evidence on quality of life (QoL) changes associated with treatment decisions is crucial for informed choices by patients with low-risk prostate cancer (LRPC).</p><p><strong>Methods: </strong>A prospective cohort study was conducted in the Piemonte and Valle d'Aosta Regional Oncology Network, NW Italy (4.5 million population), including nearly all urology (N = 22) and radiation oncology (N = 6) centres. Patients newly diagnosed with LRPC, eligible for radical treatments, received balanced information on risks and benefits of available options and could choose among active surveillance (AS), radical prostatectomy (RP), or radiotherapy (RT). Longitudinal changes in QoL were assessed via patient-reported outcomes in four domains: general QoL, mental health, sexual function and urinary/bowel symptoms. The main comparison was between AS and RP. A secondary comparison was between AS and all radical treatments (RP or RT). Data were analysed by multivariable generalised linear or logistic models, following the intention-to-treat principle and accounting for correlation within centres and subjects.</p><p><strong>Results: </strong>A total of 651 patients (76.4% of those enrolled, 559 in AS, 76 in RP and 16 in RT) with baseline questionnaires were included (median [IQR] age, 70 [64-74] years). During a median follow-up of 37 months, no differences in general QoL or mental health were observed between AS and RP. Men in AS had better scores for sexual function (β = 8.27, 95% CI: 5.57-10.96) and activity (β = 6.70, 95% CI: 4.19-9.20). Use of incontinence aids was significantly lower in the AS group (OR = 0.14; 95% CI: 0.09-0.23). Prostatic obstructive symptoms remained stable in AS but decreased in the RP group (OR = 2.77; 95% CI: 1.52-5.06). Results were similar comparing AS to RP or RT.</p><p><strong>Conclusions: </strong>Compared to radical prostatectomy, AS preserved urinary continence and sexual function but was associated with persistent obstructive symptoms, without differences in general QoL or mental health. This real-world study supports existing evidence, aiding LRPC patients in making informed decisions.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating systemic therapy and metastasis-directed therapy in oligometastatic hormone-sensitive prostate cancer.","authors":"Xiaolei Shi, Jarey H Wang, Brian F Chapin, Ana Aparicio, Sumit K Subudhi, Phuoc T Tran, Ryan J Park, Matthew P Deek, Hong Zhang, Kevin C Bylund, Micheal Cummings, Andrew J Armstrong, Chad Tang, Philip Sutera","doi":"10.1038/s41391-025-01041-z","DOIUrl":"https://doi.org/10.1038/s41391-025-01041-z","url":null,"abstract":"<p><strong>Background: </strong>Oligometastatic hormone-sensitive prostate cancer (omHSPC) represents a favorable and potentially curable disease state in which metastasis-directed therapy (MDT) improves outcomes. The combination of MDT and systemic treatment is the next frontier of omHSPC.</p><p><strong>Objective: </strong>To review and synthesize current evidence from prospective trials evaluating MDT alone or combined with systemic therapy in synchronous and metachronous omHSPC, and to highlight the evolving role of advanced imaging, genomics, and ongoing efforts in refining treatment strategies.</p><p><strong>Methods: </strong>This review synthesizes data from prospective trials, meta-analyses, and ongoing studies assessing MDT in omHSPC. Key trials include STOMP, ORIOLE, EXTEND, RADIOSA, and the X-MET meta-analysis, with emphasis on clinical outcomes and biomarkers RESULTS: In metachronous omHSPC, STOMP and ORIOLE phase II trials demonstrated that MDT significantly improves progression-free survival (PFS) and delays androgen deprivation therapy (ADT) compared to observation. The EXTEND and RADIOSA trials suggest combining MDT with short-term ADT further improves outcomes. The X-MET meta-analysis confirmed benefits in PFS, radiographic PFS, and castration-resistance-free survival with MDT. No randomized trial has yet evaluated MDT with current standard of care ADT + androgen receptor pathway inhibitor (ARPI) therapy, though EXTEND did include a limited subset of patients receiving ARPI. Advanced imaging, especially PSMA-PET, is transforming MDT planning by enabling more accurate lesion detection than conventional imaging. In synchronous omHSPC, the role of MDT remains under investigation in ongoing trials such as TERPS, STAMPEDE2 and START-MET.</p><p><strong>Conclusions: </strong>MDT offers clinical benefit in metachronous omHSPC, particularly when combined with systemic therapy. Advanced imaging and genomic profiling are critical tools for refining patient selection. Most data stem from phase II studies without ADT + ARPI control groups; larger randomized trials are needed to define the role of MDT in standard practice and optimize personalized care strategies.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors of PSMA-targeted radioligand therapy in metastatic castration-resistant prostate cancer: a systematic review and meta-analysis.","authors":"Takafumi Yanagisawa, Akihiro Matsukawa, Paweł Rajwa, Marcin Miszczyk, Tamás Fazekas, Benjamin Pradere, Keiichiro Miyajima, Yuki Enei, Angelo Cormio, Alessandro Dematteis, Timo Soeterik, Atsuya Okada, Hidetoshi Kuruma, Nat Lenzo, Shahrokh F Shariat, Kenta Miki, Takahiro Kimura","doi":"10.1038/s41391-025-01034-y","DOIUrl":"https://doi.org/10.1038/s41391-025-01034-y","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) is a widely accepted treatment option for metastatic castration-resistant prostate cancer (mCRPC). However, synthesized evidence regarding potential prognostic factors for oncologic outcomes in patients treated with PSMA-RLT is lacking. We aimed to synthesize prognosticators of oncologic outcomes in patients with mCRPC treated with PSMA-RLT.</p><p><strong>Methods: </strong>PubMed®, Web of Science™, and Embase® databases were systemically searched in March 2025 for studies. Eligible studies investigated pretreatment clinical, hematologic, or radiographical prognostic factors for oncologic outcomes, such as progression-free (PFS) or overall survivals (OS) in patients with mCRPC treated with PSMA-RLT. Only parameters assessed through multivariable analysis adjusting for potential confounders were synthesized. (CRD42024598718) RESULTS: A total of 39 studies (n = 4819) were included in the systematic review and 32 studies (n = 3038) were included in the meta-analysis. Prior chemotherapy (pooled HR: 1.43, 95%CI: 1.10-1.85), visceral metastases (pooled HR: 1.41, 95%CI: 1.05-1.89), and liver metastasis (pooled HR: 1.75, 95%CI: 1.37-2.25) were associated with worse PFS. Poor performance status (PS) (pooled HR: 1.99, 95%CI: 1.45-2.74), prior chemotherapy (pooled HR: 1.39, 95%CI: 1.19-1.63), visceral metastasis (pooled HR: 1.65, 95%CI: 1.33-2.05), bone metastasis (pooled HR: 2.09, 95%CI: 1.39-3.13), liver metastasis (pooled HR: 2.15, 95%CI: 1.84-2.50), and lower pretreatment hemoglobin levels (pooled HR: 1.25, 95%CI: 1.09-1.43) were associated with poorer OS. Higher pretreatment SUV_mean was associated with improved OS benefit (pooled HR: 0.91, 95%CI: 0.85-0.97). PSA decline after treatment initiation, particularly ≥50%, was associated with improved PFS and OS.</p><p><strong>Conclusions: </strong>Prior chemotherapy use and location of metastases influence the prognosis of patients with mCRPC treated with PSMA-RLT. A higher pre-treatment SUV_mean is predictive of better PSMA-RLT efficacy, and a greater PSA 'response is associated with improved survival outcomes. These findings may help guide clinical decision-making regarding PSMA-RLT and support prognostication of its oncological benefits.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and ethnic differences in valuation of life expectancy in prostate cancer treatment decision making.","authors":"John M Masterson, Renning Zheng, Michael Luu, Adam Murphy, Yaw A Nyame, Chad Ritch, Rebecca Gale, Brennan Spiegel, Stephen J Freedland, Timothy J Daskivich","doi":"10.1038/s41391-025-01036-w","DOIUrl":"https://doi.org/10.1038/s41391-025-01036-w","url":null,"abstract":"<p><strong>Background: </strong>Life expectancy (LE) is essential for triage between aggressive and conservative management for all prostate cancer risk subtypes. We sought to investigate differences in how Black and Hispanic men interpret LE in treatment decision-making.</p><p><strong>Methods: </strong>We used targeted crowdsourcing to sample a cohort reflecting sociodemographics of a US prostate cancer population. Subjects completed a conjoint analysis exercise where they iteratively chose between aggressive treatment versus conservative management across levels of 4 tradeoffs-tumor risk (lives saved by aggressive treatment at 5/10/20 year); erectile dysfunction; urinary incontinence; and irritative urinary symptoms-while considering their LE as calculated by the Prostate Cancer Comorbidity Index. Multinomial conditional logistic regression compared odds of choosing aggressive vs. conservative treatment across LEs ranging from 0 to 20 years overall and across racial/ethnic subgroups.</p><p><strong>Results: </strong>Of 2046 men, 435 (22%) were Black and 230 (11%) were Hispanic. Across all men, the odds of aggressive treatment choice increased by 17% for every 5 years of additional LE (OR = 1.17, 95%CI = 1.12-1.22, p < 0.001). Men were significantly more likely to choose aggressive treatment at LE > 13 y and non-aggressive treatment at LE ≤ 10 y. Among Black men, LE was not associated with treatment choice, as they consistently preferred aggressive treatment across all LE categories. Among Hispanic men, increased LE was associated with a higher likelihood of choosing aggressive treatment, with significant preference for aggressive treatment observed only when LE > 10 years. These patterns remained consistent when further stratified by tumor risk.</p><p><strong>Conclusions: </strong>LE had no impact on treatment decisions in Black men, in contrast to other races and ethnicities. Future research is needed to identify reasons for this phenomenon and to inform culturally relevant approaches to communicating competing mortality risks.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound echogenicity is complementary to PI-RADS for risk stratification of clinically significant prostate cancer.","authors":"Garret Wegner, Amir Khan, Michael Panagos, Shu Wang, Alexa Van Besien, Michael Naslund, Mohummad Minhaj Siddiqui","doi":"10.1038/s41391-025-01033-z","DOIUrl":"https://doi.org/10.1038/s41391-025-01033-z","url":null,"abstract":"<p><strong>Background: </strong>The combination of multiparametric magnetic resonance imaging (MP-MRI) and ultrasound-guided fusion biopsy is increasingly recognized as a valuable tool for diagnosing prostate cancer. However, up to 80% of PI-RADS 3 lesions and 50% of PI-RADS 4 lesions are benign. This study evaluates whether lesion echogenicity observed during MRI-ultrasound fusion biopsy is associated with detecting clinically significant prostate cancer (csPCa).</p><p><strong>Methods: </strong>In this retrospective analysis (March 2017-February 2022), we reviewed patients who underwent both standard 12-core random biopsies and targeted MP-MRI/US fusion-guided biopsies at our institution. Lesions were categorized as strongly hypoechoic, weakly hypoechoic, or non-hypoechoic based on ultrasound echogenicity. CsPCa was defined as a Gleason score ≥7.</p><p><strong>Results: </strong>Among 222 biopsy patients, 59.3% were diagnosed with PCa, and 68% had csPCa. Of 420 lesions, 19.1% were strongly hypoechoic (45% csPCa), 29.5% were weakly hypoechoic (25% csPCa), and 51.4% were non-hypoechoic (11.8% csPCa) (p < 0.001). Echogenicity improved csPCa detection for PI-RADS ≤ 3 lesions from 7.5% (non-hypoechoic) to 27.5% (strongly hypoechoic), for PI-RADS 4 from 13.1% to 35.1%, and for PI-RADS 5 from 42% to 63.5%. The ROC analysis demonstrated AUCs of 0.6958 for PI-RADS, 0.6929 for echogenicity, and 0.7434 for their combination (all p < 0.001).</p><p><strong>Conclusion: </strong>Lesion echogenicity observed during MRI-ultrasound fusion biopsy enhances csPCa detection and complements PI-RADS scoring. Incorporating echogenicity into risk assessment may improve biopsy decision-making and diagnostic accuracy.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond PSMA: theranostic cell surface targets in metastatic prostate cancer.","authors":"Bilal Ashraf, Jane McKenzie, Andrew J Armstrong","doi":"10.1038/s41391-025-01037-9","DOIUrl":"https://doi.org/10.1038/s41391-025-01037-9","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in treatment, metastatic prostate cancer remains a lethal disease. As prostate cancer becomes resistant to standard of care treatments like androgen receptor pathway inhibitors (ARPIs) and chemotherapy, cell surface tumor antigens and receptors become increasingly heterogeneous and diverse, dependent on androgen receptor dependency with relevance for both diagnostic positron emission tomography (PET) imaging and cell surface targeting therapeutics. Our review aims to describe emerging theranostic targets and agents in cell surface imaging and therapies.</p><p><strong>Methods: </strong>A literature search was carried out in March 2025, on Pubmed, as well as Clinicaltrials.gov to determine cell surface targets with viable trials for imaging and/or therapeutic agents. Keyword searches included \"Prostate Cancer\" AND \"CRPC\" AND \"Cell Surface Targets.\"</p><p><strong>Results: </strong>Among the literature, 13 novel targets with robust supporting literature were found. Targets were subsequently divided into targets of interest in AR-positive and AR-negative (NEPC and/or double negative) mCRPC. Ongoing and completed trials for imaging and/or therapeutics leveraging these targets was described.</p><p><strong>Conclusion: </strong>Numerous prostate cancer cell surface markers are emerging as theranostic targets. For patients ineligible for or developing progression following PSMA-targeting therapies, extending cell surface targeting therapeutics, whether they are ADCs, cellular therapies, or RPTs, is increasingly vital.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}