Androgen receptor mutations in patients with castration-resistant prostate cancer treated with apalutamide.

BACKGROUND: Mutations in the androgen receptor (AR) ligand-binding domain (LBD), such as F877L and T878A, have been associated with resistance to next-generation AR-directed therapies. ARN-509-001 was a phase I/II study that evaluated apalutamide activity in castration-resistant prostate cancer (CRPC). Here, we evaluated the type and frequency of 11 relevant AR-LBD mutations in apalutamide-treated CRPC patients. PATIENTS AND METHODS: Blood samples from men with nonmetastatic CRPC (nmCRPC) and metastatic CRPC (mCRPC) pre- or post-abiraterone acetate and prednisone (AAP) treatment (≥6 months' exposure) were evaluated at baseline and disease progression in trial ARN-509-001. Mutations were detected in circulating tumor DNA using a digital polymerase chain reaction-based method known as BEAMing (beads, emulsification, amplification and magnetics) (Sysmex Inostics' GmbH). RESULTS: Of the 97 total patients, 51 had nmCRPC, 25 had AAP-naïve mCRPC, and 21 had post-AAP mCRPC. Ninety-three were assessable for the mutation analysis at baseline and 82 of the 93 at progression. The overall frequency of detected AR mutations at baseline was 7/93 (7.5%) and at progression was 6/82 (7.3%). Three of the 82 (3.7%) mCRPC patients (2 AAP-naïve and 1 post-AAP) acquired AR F877L during apalutamide treatment. At baseline, 3 of the 93 (3.2%) post-AAP patients had detectable AR T878A, which was lost after apalutamide treatment in 1 patient who continued apalutamide treatment for 12 months. CONCLUSIONS: The overall frequency of detected mutations at baseline (7.5%) and progression (7.3%) using the sensitive BEAMing assay was low, suggesting that, based on this assay, AR-LBD mutations such as F877L and T878A are not common contributors to de novo or acquired resistance to apalutamide. CLINICALTRIALS.GOV IDENTIFIER: NCT01171898.

Tumor-targeting potential of radioiodinated iododeoxyuridine in bladder cancer.

UNLABELLED: Since bladder cancer arises in the superficial lining of the urothelium, it is a likely candidate for site-directed administration of 5-iodo-2'-deoxyuridine radiolabeled with the Auger electron emitter 123I or 125I (*IUdR). METHODS: We instilled *IUdR for 2 hr directly within the bladder lumen of rats bearing N-methyl-N-nitrosourea (NMU)-induced bladder cancer and conducted scintigraphic, biodistribution and autoradiography (ARG) studies 48 hr and 1 wk later. Control animals were not subjected to the carcinogen but were instilled with *IUdR. RESULTS: Two groups of animals were identified after instillation of MNU: Group A consisted of rats with hyperplasia and Group B of rats with papillary carcinoma (stages Ta and T1). Scintigraphic detection of carcinomas was achieved with high sensitivity and specificity, and increased tumor-to-normal tissue ratios were obtained in both groups. Moreover, ARG demonstrated that (1) the uptake of *IUdR was observed in the hyperplastic and carcinomatous urothelium but not in the normal urothelium; (2) uptake was detected at a very early stage of tumor development (hyperplasia stage); (3) *IUdR was able to penetrate deep within the bladder wall; and (4) other normal dividing tissues, such as the bone marrow, the small intestine and the large intestine, were free of silver grains (i.e., no DNA-incorporated *IUdR). CONCLUSION: Since this carrier of Auger electron emitters has antineoplastic effects ([123I]IUdR and [125I]IUdR) in addition to its scintigraphic potential ([123I]IUdR and [131I]IUdR), it holds promise for therapy and early diagnosis of bladder cancer.

Benign prostatic hyperplasia in a transgenic mouse: a new hormonally sensitive investigatory model.

Recent advances in molecular biology have enabled incorporation of proto-oncogenes into the mouse germline. In this study we use a transgenic mouse line that overexpresses the fibroblastic growth factor (FGF) family member, int-2, under the control of mouse mammary tumor virus (MMTV) regulatory elements. One of the tissues targeted by MMTV is the mouse prostate. Expression of the MMTV-int-2 transgene in male transgenic mouse carriers results in a dramatic enlargement of the prostate gland which on histologic examination closely resembles the epithelial/glandular BPH observed in human and canine models. Pre- and postpubertal transgenic (NR) and wild-type (WT) FVB/N male mice were evaluated for the effects of hormonal manipulation by orchiectomy and orchiectomy followed by androgen replacement. Orchiectomy results in a significant decrease in size of the prostate in both NR and WT mice (p < 0.05), regardless of sexual maturity. Exogenous hormonal replacement with testosterone or dihydrotestosterone following orchiectomy results in significant regrowth of the prostate in both NR and WT mice. Flutamide, a potent nonsteroidal anti-androgen, resulted in a 55% reduction in size of the NR prostate (p < 0.002) and a similar 44% reduction in size of the WT prostate. Similarly, treatment of both NR and WT mice with leuprolide, a GnRH agonist, resulted in a significant decrease in prostate size (p < 0.05). Treatment of both NR and WT mice with finasteride (MK-906), a 5-alpha reductase inhibitor, failed to produce any significant regression in prostatic tissue. Based upon these data, we conclude that this transgenic mouse model, expressing int-2, produces an epithelial BPH histologically similar to other animal models. This transgenic model is hormonally sensitive and appears to represent a unique model for the investigation of BPH and growth factor induced epithelial cell hyperplasia.