Zobrazení vlastní tkáně nádoru prostaty je při použití postupů zobrazení obvyklých u jiných nádorů obtížné, nedostatečné je používat metody zobrazení pomocí kontrastního CT vyšetření, z hybridních metod také PET/CT s aplikací 18F-fluorodeoxyglukózy. Magnetickou rezonanci je možné využít v detekci karcinomu prostaty u mužů s elevací prostatického specifického antigenu (PSA) a/nebo zvýšeným indexem zdravé prostaty (PHI). V současnosti je možné využití spojení radiologických metod a nukleární medicíny - výpočetní tomografie a pozitronové emisní tomografie (PET/CT) nebo magnetické rezonance a pozitronové emisní tomografie (PET/MR). Pro pozitronovou emisní tomografii je možné využití 18F-fluorocholinu (18F-FCH), 18F-fluciclovinu, a 18F-natriumfluoridu (18F-NaF) nebo 68Ga-PSMA-11 (ligand prostatického specifického membránového antigenu), a to ve vyhledávání, stagingu a restagingu karcinomu prostaty. PET/MR nebo PET/CT s podáním 68Ga-PSMA-11 představuje současnou optimální metodu při stagingu, restagingu a kontrole účinku terapie karcinomu prostaty.
Imaging of the prostate tumour ́s own tissue is using standard tumour imaging approaches remains difficult, the imaging using contrast enhanced computed tomography and also the hybrid imaging using PET/CT with the application of the 18F-fluorodeoxyglucose is insufficient. Magnetic resonance imaging is useful in detection of prostate cancer in patients with elevated prostatic specific antigen (PSA) and/or with increased prostate health index (PHI). Currently, it is possible to use combination of radiological and nuclear medicine methods - hybrid positron emission tomography combined with computed tomography (PET/CT) or with magnetic resonance imaging (PET/MRI) with the application of 18F-fluorocholine (FCH), 18F-fluciclovine, 18F-natriumfluoride (18F-NaF) or 68Ga-PSMA-11 (ligand of prostatic specific membrane antigen) in detection, staging or restaging of prostate carcinoma. PET/CT or PET/MRI with the application of 68Ga-PSMA-11 represents current optimal method for staging, restaging and evaluation of prostate cancer therapy response.
- MeSH
- Diagnostic Imaging classification methods MeSH
- Fluorodeoxyglucose F18 therapeutic use MeSH
- Humans MeSH
- Magnetic Resonance Imaging methods MeSH
- Multimodal Imaging * classification methods MeSH
- Prostatic Neoplasms * diagnostic imaging diagnosis MeSH
- Positron Emission Tomography Computed Tomography methods MeSH
- Prostate-Specific Antigen analysis MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Laser-induced breakdown spectroscopy (LIBS) is a promising technique for the readout of immunochemical assays utilizing indirect detection of labels (Tag-LIBS), typically based on nanoparticles. We have previously demonstrated that Tag-LIBS immunoassay employing yttrium-based photon-upconversion nanoparticles (UCNPs) can reach sensitivity similar to commonly used enzyme and fluorescence immunoassays. In this study, we report on further increasing the sensitivity of UCNP-based Tag-LIBS immunoassay by employing magnetic microbeads (MBs) as the solid phase in the determination of cancer biomarker prostate-specific antigen. Due to the possibility of analyte preconcentration, MBs enabled achieving a limit of detection (LOD) of 4.0 pg·mL-1, representing two orders of magnitude improvement compared with equivalent microtiter plate-based assay (LOD of 460 pg·mL-1). In addition, utilizing MBs opens up the possibility of an internal standardization of the LIBS readout by employing iron spectral lines, which improves the assay robustness by compensating for LIBS signal fluctuations and bead-bound immunocomplexes lost throughout the washing steps. Finally, the practical applicability of the technique was confirmed by the successful analysis of clinical samples, showing a strong correlation with the standard electrochemiluminescence immunoassay. Overall, MB-based Tag-LIBS was confirmed as a promising immunoassay approach, combining fast readout, multiplexing possibilities, and high sensitivity approaching upconversion luminescence scanning while avoiding the requirement of luminescence properties of labels.
- MeSH
- Immunoassay methods MeSH
- Lasers * MeSH
- Humans MeSH
- Limit of Detection * MeSH
- Microspheres MeSH
- Prostate-Specific Antigen * analysis immunology blood MeSH
- Spectrum Analysis methods MeSH
- Yttrium chemistry radiation effects MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Colorectal Neoplasms diagnosis prevention & control MeSH
- Humans MeSH
- Prostatic Neoplasms * diagnosis epidemiology MeSH
- Thyroid Diseases prevention & control MeSH
- Mass Screening MeSH
- Prostate-Specific Antigen analysis MeSH
- Pregnancy MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Pregnancy MeSH
- Female MeSH
Early-stage diagnosis of prostatic carcinoma is essential for successful treatment and, thus, significant prognosis improvement. In laboratory practice, the standard non-invasive diagnostic approach is the immunochemical detection of the associated biomarker, prostate-specific antigen (PSA). Ultrasensitive detection of PSA is essential for both diagnostic and recurrence monitoring purposes. To achieve exceptional sensitivity, we have developed a microfluidic device with a flow-through cell for single-molecule analysis using photon-upconversion nanoparticles (UCNPs) as a detection label. For this purpose, magnetic microparticles (MBs) were first optimized for the capture and preconcentration of PSA and then used to implement a bead-based upconversion-linked immunoassay (ULISA) in the microfluidic device. The digital readout based on counting single nanoparticle-labeled PSA molecules on MBs enabled a detection limit of 1.04 pg mL-1 (36 fM) in 50% fetal bovine serum, which is an 11-fold improvement over the respective analog MB-based ULISA. The microfluidic technique conferred several other advantages, such as easy implementation and the potential for achieving high-throughput analysis. Finally, it was proven that the microfluidic setup is suitable for clinical sample analysis, showing a good correlation with a reference electrochemiluminescence assay (recovery rates between 97% and 105%).
- MeSH
- Immunoassay instrumentation methods MeSH
- Humans MeSH
- Limit of Detection MeSH
- Microfluidic Analytical Techniques instrumentation MeSH
- Prostatic Neoplasms diagnosis blood MeSH
- Nanoparticles chemistry MeSH
- Prostate-Specific Antigen * analysis blood MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
V naší kazuistice prezentujeme komplexní léčbu pacienta s metastatickým hormonálně senzitivním karcinomem prostaty (mHSPC), se vstupně symptomatickým viscerálním postižením plic. Pacient profituje z dvojkombinační terapie (androgen deprivační terapii + apalutamid) s dobrou kvalitou života.
In our case report we want to demonstrate a complex therapy of a patient with metastatic hormone-sensitive prostate cancer (mHSPC) with initially symptomatic visceral metastases of lungs. Patient profits from doublet combination (androgen deprivation therapy + apalutamid) with good quality of life.
- Keywords
- apalutamid, degarelix, androgen deprivační terapie,
- MeSH
- Gonadotropin-Releasing Hormone therapeutic use MeSH
- Drug Therapy, Combination methods adverse effects MeSH
- Humans MeSH
- Mediastinum diagnostic imaging pathology MeSH
- Neoplasm Metastasis drug therapy MeSH
- Mediastinal Neoplasms diagnostic imaging secondary MeSH
- Lung Neoplasms diagnostic imaging secondary MeSH
- Prostatic Neoplasms * diagnosis drug therapy complications MeSH
- Pleural Effusion diagnostic imaging MeSH
- Prostate-Specific Antigen analysis MeSH
- Aged MeSH
- Neoplasm Staging MeSH
- Thiohydantoins * administration & dosage MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
Terapie metastatického hormonálně senzitivního karcinomu prostaty dosáhla v posledních letech řady změn a nabídla tak pacientům množství nových možností. V roce 2022 dvě randomizované studie fáze III, PEACE-1 a ARASENS, prokázaly účinnost časné intenzifikace terapie, kdy kombinace tripletu - androgenní deprivační terapie - ADT, ARTA (abirateron - PEACE-1, darolutamid - ARASENS) a docetaxelu prokázala zlepšení celkového přežití - OS oproti terapii dubletem (ADT - androgen deprivační terapie + docetaxel). V níže popsané kazuistice demonstrujeme úspěšné použití terapie tripletem u pacienta s pokročilým primárně metastatickým karcinomem prostaty s karcinomatózou kostní dřeně.
The treatment for metastatic hormone-sensitive prostate cancer has undergone numerous changes in recent years, thus offering patients a number of new options. In 2022, two randomized phase III trials, PEACE-1 and ARASENS, demonstrated the efficacy of early intensification therapy wherein the triplet combination therapy of androgen deprivation therapy (ADT), ARTA (abiraterone - PEACE-1, darolutamide - ARASENS), and docetaxel showed improved overall survival (OS) compared with double therapy (androgen deprivation therapy + docetaxel). The present case report demonstrates a successful use of triplet therapy in a patient with advanced primary metastatic prostate cancer with carcinomatosis of the bone marrow.
- MeSH
- Diagnosis, Differential MeSH
- Hemoglobins analysis MeSH
- Drug Therapy, Combination * methods MeSH
- Humans MeSH
- Neoplasm Metastasis MeSH
- Bone Marrow Neoplasms diagnosis secondary MeSH
- Prostatic Neoplasms * diagnosis drug therapy MeSH
- Tomography, X-Ray Computed MeSH
- Prostate-Specific Antigen analysis MeSH
- Antineoplastic Agents administration & dosage MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
V průběhu posledních desetiletí došlo ke značnému nárůstu pacientů léčených pro nezvratné selhání ledvin s diagnostikovaným karcinomem prostaty před transplantací ledviny, stejně jako k nárůstu pacientů po transplantaci ledviny s diagnostikovaným karcinomem prostaty. Vliv hrají předtransplantační screening, stárnutí populace a prodloužené přežívání po transplantaci. Nové poznatky vedou u této skupiny pacientů k úpravě některých diagnostických i léčebných postupů, jasně dané doporučené postupy však nadále chybí. Nově také u pacientů s nízce rizikovým karcinomem prostaty v aktivním sledování nebo po kurativní terapii není třeba dodržovat žádný interval před zařazením na čekací listinu k transplantaci. Zvláštní pozornost je věnována roli imunosupresivní terapie, která je nezbytná pro funkci transplantované ledviny, ale zároveň může ovlivňovat riziko a průběh onkologického onemocnění. Úprava nebo snížení imunosuprese, jak naznačuje aktuální literatura, může být v některých případech rozumným krokem, avšak vyžaduje pečlivé zvážení v kontextu individuálního pacienta. Pacienti, kteří podstoupili transplantaci ledviny a mají diagnostikovaný karcinom prostaty, dosahují podobných léčebných výsledků jako pacienti bez nezvratného selhání ledvin. V textu shrnujeme aktuální poznatky stran epidemiologie, léčebných možností i výzev, kterým čelí medicína u pacientů s karcinomem prostaty před a po transplantaci ledvin, včetně jejich odlišností od běžné populace.
Over recent decades, there has been a significant increase in patients treated for end-stage renal disease diagnosed with prostate cancer before kidney transplantation, as well as an increase in kidney transplant recipients diagnosed with prostate cancer. Pre-transplant screening, the aging population, and extended survival post-transplant play a role. New insights lead to adjustments in some diagnostic and therapeutic procedures in this patient group, yet clear recommended guidelines remain absent. Also, patients with low-risk prostate cancer in active surveillance or after curative therapy are no longer required to wait before being listed for transplantation. Special attention is given to the role of immunosuppressive therapy, which is essential for the function of the transplanted kidney but may also influence the risk and course of oncological disease. Modifying or reducing immunosuppression, as suggested by current literature, may be a reasonable step in some cases but requires careful consideration in the context of the individual patient. Patients who have undergone kidney transplantation and are diagnosed with prostate cancer achieve similar treatment outcomes as patients with no end-stage renal disease. In the text, we summarize current knowledge regarding epidemiology, treatment options, and challenges faced by medicine in patients with prostate cancer before and after kidney transplantation, including their differences from the general population.
- MeSH
- Immunosuppression Therapy classification methods MeSH
- Humans MeSH
- Disease Management MeSH
- Prostatic Neoplasms * diagnosis epidemiology drug therapy therapy MeSH
- Prostate-Specific Antigen analysis MeSH
- Radiotherapy methods MeSH
- Kidney Transplantation * methods MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
V naší kazuistice prezentujeme komplexní léčbu pacienta s metastazujícím hormonálně senzitivním karcinomem prostaty s početnou diseminací do kostí. Pacient profituje z dvojkombinační terapie (androgen deprivační terapie + apalutamid), včetně podpůrné léčby denosumabem, s dobrou kvalitou života.
In our case report we want to demonstrate a complex therapy of a patient with metastatic hormone-sensitive prostate cancer with numerous disseminations into bones. Patient profits from doublet combination (androgen deprivation therapy + apalutamide), supportive therapy with denosumab included, with good quality of life.
- Keywords
- apalutamid,
- MeSH
- Diagnostic Imaging methods MeSH
- Humans MeSH
- Neoplasm Metastasis drug therapy MeSH
- Prostatic Neoplasms * diagnosis drug therapy MeSH
- Prostate-Specific Antigen analysis MeSH
- Aged MeSH
- Thiohydantoins * pharmacology therapeutic use MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
Metastatický karcinom prostaty (mKP) je heterogenní skupinou onemocnění s mediánem přežití 42 měsíců. Základ léčby mKP tvoří vždy kombinace androgen deprivační terapie (ADT – androgen deprivation therapy) s novými antiandrogeny (ARTA – androgen receptor targeted agents), jako jsou enzalutamid, apalutamid, darolutamid, nebo s novým blokátorem syntézy testosteronu abirateron acetátem (AA) či s chemoterapií (docetaxel, kabazitaxel). Pro stanovení prognózy užíváme prognostické faktory, které korelují s délkou přežití bez ohledu na systémovou terapii. V této práci podáváme přehled aktuálně využívaných prognostických faktorů.
Metastatic prostate cancer (mPC) is a heterogeneous group of diseases with a median survival of 42 months. The basic treatment of mPC is always a combined treatment with androgen deprivation therapy (ADT - androgen deprivation therapy) with new antiandrogens (ARTA - androgen receptor targeted agents) such as enzalutamide, apalutamide, darolutamide or with the new testosterone synthesis blocker abiraterone acetate (AA) or with chemotherapy (docetaxel, cabazitaxel). To determine prognosis, we use prognostic factors that correlate with survival independent of systemic therapy. In this article, we provide an overview of the currently used prognostic factors.
- MeSH
- Carcinoma diagnosis therapy MeSH
- Humans MeSH
- Neoplasm Metastasis diagnosis therapy MeSH
- Prostatic Neoplasms * diagnosis complications therapy MeSH
- Prognosis MeSH
- Prostate-Specific Antigen analysis MeSH
- Sarcopenia diagnosis MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
