前治療化学療法を受けた前立腺がん患者における新規形態計測アプローチを用いた部分病理学的奏効率の定量化

Accurate assessment of partial pathological response rate (ppRR) to neoadjuvant chemotherapy (NAT) is critical for assessing the efficacy of therapy and for optimal clinical management. Because of a lack of accurate estimation of baseline cancer burden, assessment of ppRR has never been attempted in prostate histologically. We presented a novel morphometric approach assessing ppRR in patients who underwent NAT and then correlated the ppRR with patients' outcomes. A control cohort consisted of 39 NAT-naïve Caucasian patients who had high-risk PCa (defined as Gleason Grade Group >2) and an adequate biopsy sample (defined as the size of the biopsy PCa area, including PCa epithelium and stroma >2 ^mm2). A study cohort included 26 patients with high-risk PCa (defined as clinical stage T3a or higher, serum PSA >20 ng/mL, or GGG of 4-5, or with oligometastatic disease) who underwent androgen deprivation therapy plus docetaxel. Using the PCa epithelial to stromal ratio (E/S) as a metric, surrogate BCB for the study cohort was predicted from the pre-treatment biopsy samples, and ppRR was calculated. Correlation analysis of patients' ppRR with progression-free survival was performed using ppRR >80% as a cut-off. Nine of the 26 patients from the study cohort experienced a significant response to NAT (ppRR > 80%) using the PCa E/S-based approach, and these patients had significantly better progression-free survival (p = 0.006). ppRR to NAT can be reliably assessed using PCa E/S as a surrogate metric from biopsy and RP samples, and ppRR can be used to predict patients' outcomes.