Differential expression of PSMA and 18F-fluciclovine transporter genes in metastatic castrate-resistant and treatment-emergent small cell/neuroendocrine prostate cancer.

Authors

Carissa Chu

Carissa Chu

University of California, San Francisco, San Francisco, CA

Carissa Chu , Mohammed Alshalalfa , Martin Sjöström , Shuang Zhao , Annika Herlemann , Jonathan Chou , Avi Lefridge Baskin , Brandon Arvin Virgil Mahal , Daniel Eidelberg Spratt , Matthew R. Cooperberg , Eric Jay Small , Rahul Raj Aggarwal , Anthony C. Wong , Sima P. Porten , Thomas Hope , Paul L. Nguyen , Edward M. Schaeffer , Peter Carroll , Felix Y Feng

Organizations

University of California, San Francisco, San Francisco, CA, Dana-Farber Cancer Institute, Vancouver, BC, Canada, Lund University, Department of Oncology and Pathology, Lund, Sweden, University of Michigan, Ann Arbor, MI, University of California San Francisco, San Francisco, CA, Harvard Radiation Oncology Program, Boston, MA, Memorial Sloan Kettering Cancer Center, New York, NY, University of California-San Francisco, San Francisco, CA, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, Dept. of Radiation Oncology, University of California, San Francisco, San Francisco, CA, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, Northwestern University Feinberg School of Medicine, Chicago, IL

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health.

Background: 18F-fluciclovine (Axumin) PET/CT imaging is recommended by the NCCN in the setting of biochemical recurrence, while prostate-specific membrane antigen (PSMA) PET/CT is preferred by the EAU. The utility of these methods in the post-androgen deprivation therapy (ADT) setting however, is less defined. Our objective was to compare relative gene expression of the molecular targets of these imaging modalities— fluciclovine transporter genes (LAT1-4, ASCT1-2) and PSMA—in metastatic castrate resistant prostate cancer (mCRPC) and treatment-emergent small cell/neuroendocrine prostate cancer (t-SCNC). Methods: Genome-wide expression profiles of five mCRPC cohorts (Aggarwal, Grasso, Kumar, Beltran, Robinson, et al) were used to characterize relative expression of fluciclovine transporter (LAT1-4, ASC1-2) and PSMA (FOLH1) genes. 3 cohorts (Kumar, Beltran, Aggarwal) were enriched with t-SCNC tumors. The GSE35988 cohort included primary tumors and mCRPC. RNA expression profiling methods were consistent within cohorts. Results: 518 mCRPC specimens were included. In the GSE35988 cohort, PSMA expression was downregulated in mCRPC when compared to primary localized tumors (p=0.01). PSMA expression was further depressed in t-SCNC when compared with mCRPC (p<0.001). Of the fluciclovine transporter genes, LAT1 and LAT4 were overexpressed in mCRPC when compared to primary tumors, while ASC2 was less expressed (p<0.001). LAT1 was further overexpressed in t-SCNC when compared to mCRPC, while LAT2 was less expressed (p<0.001). PSMA expression was negatively correlated with LAT1 (p<0.001) but positively correlated with LAT2 (p=0.006). Other fluciclovine transporters were not correlated. Conclusions: Expression of PSMA and a subset of fluciclovine transporter genes are inversely correlated in mCRPC and t-SCNC. These findings suggest that fluciclovine-based imaging may play a role in castrate resistant states. Clinical comparison between PSMA- and fluciclovine-based imaging modalities in mCRPC and t-SCNC is warranted.

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Abstract Details

Meeting

2020 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Imaging

Citation

J Clin Oncol 38, 2020 (suppl 6; abstr 24)

Abstract #

24

Poster Bd #

A12

Abstract Disclosures

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