Imaging tumor lactate is feasible for identifying intermediate-risk prostate cancer patients with postsurgical biochemical recurrence

Author:

Sushentsev Nikita1ORCID,Hamm Gregory2,Richings Jack2,McLean Mary A.1,Menih Ines Horvat1,Ayyappan Vinay1,Mills Ian G.345ORCID,Warren Anne Y.6,Gnanapragasam Vincent J.78ORCID,Barry Simon T.9,Goodwin Richard J. A.2ORCID,Gallagher Ferdia A.1ORCID,Barrett Tristan1ORCID

Affiliation:

1. Department of Radiology, Addenbrooke’s Hospital and University of Cambridge, Cambridge Biomedical Campus, CB2 0QQ Cambridge, United Kingdom

2. Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, Research & Development, AstraZeneca, Cambridge CB2 0AA, United Kingdom

3. Patrick G. Johnston Centre for Cancer Research, Genito-Urinary and Prostate Focus Group, Queen’s University Belfast, Belfast BT9 7AE, United Kingdom

4. Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 7DQ, United Kingdom

5. Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen 5021, Norway

6. Department of Pathology, Cambridge University Hospitals National Health Service Foundation Trust, CB2 0QQ Cambridge, United Kingdom

7. Department of Urology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom

8. Cambridge Urology Translational Research and Clinical Trials Office, Cambridge Biomedical Campus, Addenbrooke’s Hospital, Cambridge CB2 0QQ, United Kingdom

9. Bioscience, Discovery, Oncology Research & Development, AstraZeneca, Cambridge CB20AA, United Kingdom

Abstract

While radical prostatectomy remains the mainstay of prostate cancer (PCa) treatment, 20 to 40% of patients develop postsurgical biochemical recurrence (BCR). A particularly challenging clinical cohort includes patients with intermediate-risk disease whose risk stratification would benefit from advanced approaches that complement standard-of-care diagnostic tools. Here, we show that imaging tumor lactate using hyperpolarized 13 C MRI and spatial metabolomics identifies BCR-positive patients in two prospective intermediate-risk surgical cohorts. Supported by spatially resolved tissue analysis of established glycolytic biomarkers, this study provides the rationale for multicenter trials of tumor metabolic imaging as an auxiliary tool to support PCa treatment decision-making.

Funder

Prostate Cancer UK

Cancer Research UK

NIHR | NIHR Cambridge Biomedical Research Centre

AstraZeneca

Publisher

Proceedings of the National Academy of Sciences

Subject

Multidisciplinary

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