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Intraductal Carcinoma Predicts Poor Response to Neoadjuvant Therapy in High-risk Prostate Cancer

2025-12Artigo científico Acesso aberto
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dc.contributor.authorBernardino, Rui M.
dc.contributor.authorBernardino, Rui
dc.contributor.authorYin, Leyi B.
dc.contributor.authorLajkosz, Katherine
dc.contributor.authorWinquist, Eric
dc.contributor.authorCockburn, Jessica G.
dc.contributor.authorJenjitranant, Pocharapong
dc.contributor.authorVeloso, Rosette
dc.contributor.authorÓConnell, Clare
dc.contributor.authorBenitez, Aurora Mejia
dc.contributor.authorNguyen, David Dan
dc.contributor.authorMatthiesen, Rune
dc.contributor.authorMatthiesen, Rune
dc.contributor.authorHenrique, Rui
dc.contributor.authorJoshua, Anthony M.
dc.contributor.authorvan der Kwast, Theodorus
dc.contributor.authorFleshner, Neil E.
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutioniNOVA4Health - pólo NMS
dc.contributor.pblElsevier BV
dc.date.accessioned2025-10-21T22:02:40Z
dc.date.available2025-10-21T22:02:40Z
dc.date.issued2025-12
dc.descriptionPublisher Copyright: © 2025 The Author(s)
dc.description.abstractBackground and objective: High-risk localized prostate cancer (PCa) patients may require neoadjuvant treatment (androgen deprivation therapy [ADT] plus abiraterone with or without taxane-based chemotherapy) before radical prostatectomy (RP). Intraductal carcinoma of the prostate (IDC) is an aggressive histological variant of prostate adenocarcinoma. This study aims to evaluate the association of IDC on biopsy with pathological response in such PCa patients. Methods: A retrospective analysis was conducted using the prospective trial data from 75 patients with high-risk localized/locally advanced PCa treated with 24 wk of neoadjuvant therapy comprising ADT and abiraterone, with or without taxane-based chemotherapy, followed by RP. Pathological responses, including pathological complete response (pCR), minimal residual disease (MRD), and adverse pathology outcomes (ypN1 or ≥ypT3b), were analyzed. Multivariable logistic regression identified the predictors of poor pathological response. Key findings and limitations: Among 75 patients, 35 (47%) had IDC on biopsy. Patients with IDC had worse pathological outcomes: 32 of 35 (91%) failed to achieve a favorable response (pCR or MRD) compared with 26 of 40 (65%) in those without IDC. IDC was also associated with higher rates of adverse pathology at RP, occurring in 27 of 35 patients (77%) versus nine of 40 patients (22%) without IDC. IDC independently predicted poor response (odds ratio 6.18, 95% confidence interval 1.16–32.8; p = 0.032) after adjusting for tumor volume, Gleason grade, and prostate-specific antigen (PSA). In contrast, cribriform (Crib) pattern at biopsy did not impact response significantly. Metastatic progression and survival data were unavailable. Conclusions and clinical implications: IDC, but not Crib, on biopsy predicts poor pathological response to neoadjuvant therapy (ADT plus abiraterone with or without taxane-based chemotherapy) in high-risk PCa after adjusting for tumor volume and PSA. An understanding of this treatment-resistant phenotype will improve PCa biology insights and guide novel therapeutic strategies. Patient summary: Intraductal carcinoma (IDC) is a more aggressive form of prostate cancer that does not respond well to treatment. In our study, we found that 91% of patients who had IDC detected in their biopsy before surgery did not show a good response to presurgery therapy.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent7
dc.format.extent345885
dc.identifier.doi10.1016/j.euros.2025.09.015
dc.identifier.issn2666-1691
dc.identifier.otherPURE: 132553094
dc.identifier.otherPURE UUID: e646baaf-0b5a-4bfa-8cab-7d3bff62b3e2
dc.identifier.otherScopus: 105018636832
dc.identifier.urihttp://hdl.handle.net/10362/189587
dc.identifier.urlhttps://www.scopus.com/pages/publications/105018636832
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAndrogen deprivation therapy
dc.subjectIntraductal carcinoma
dc.subjectNeoadjuvant treatment
dc.subjectProstatic neoplasms
dc.subjectUrology
dc.subjectSDG 3 - Good Health and Well-being
dc.titleIntraductal Carcinoma Predicts Poor Response to Neoadjuvant Therapy in High-risk Prostate Canceren
dc.title.subtitleA Retrospective Analysis of a Prospective Trialen
dc.typejournal article
degois.publication.firstPage52
degois.publication.lastPage58
degois.publication.titleEuropean Urology Open Science
degois.publication.volume82
dspace.entity.typePublication
person.familyNameBernardino
person.familyNameMatthiesen
person.givenNameRui
person.givenNameRune
person.identifier1319342
person.identifier.ciencia-idAA11-5720-275C
person.identifier.ciencia-idBB1A-A606-EE77
person.identifier.orcid0000-0001-8076-4550
person.identifier.orcid0000-0002-6353-2616
person.identifier.scopus-author-id57218568589
person.identifier.scopus-author-id9741897800
rcaap.rightsopenAccess
relation.isAuthorOfPublicationd6e40df5-8a9a-4aa3-aac0-7df5a103c72e
relation.isAuthorOfPublication67181d3c-b83e-4151-9a74-0ea14aeb7f05
relation.isAuthorOfPublication.latestForDiscovery67181d3c-b83e-4151-9a74-0ea14aeb7f05

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