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Clinical Research

Imaging, procedural and clinical variables associated with tumor yield on bone biopsy in metastatic castration-resistant prostate cancer

Prostate Cancer and Prostatic Diseases volume 17, pages 325–331 (2014)Cite this article

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Abstract

Background:

Understanding the mechanisms driving disease progression is fundamental to identifying new therapeutic targets for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC). Owing to the prevalence of bone metastases in mCRPC, obtaining sufficient tumor tissue for analysis has historically been a challenge. In this exploratory analysis, we evaluated imaging, procedural and clinical variables associated with tumor yield on image-guided bone biopsy in men with mCRPC.

Methods:

Clinical data were collected prospectively from men with mCRPC enrolled on a phase II trial with serial metastasis biopsies performed according to standard clinical protocol. Imaging was retrospectively reviewed. We evaluated the percent positive biopsy cores (PPC), calculated as the number of positive cores divided by the total number of cores collected per biopsy.

Results:

Twenty-nine men had 39 bone biopsies. Seventy-seven percent of bone biopsies had at least one positive biopsy core. We determined that lesion size and distance from the skin to the lesion edge correlated with tumor yield on biopsy (median PPC 75% versus 42% for lesions >8.8 cm3 versus ⩽8.8 cm3, respectively, P=0.05; median PPC 33% versus 71% for distance ⩾6.1 versus <6.1 cm, respectively, P=0.02). There was a trend towards increased tumor yield in patients with increased uptake on radionuclide bone scan, higher calcium levels and shorter duration of osteoclast-targeting therapy, although this was not statistically significant. Ten men had 14 soft tissue biopsies. All soft tissue biopsies had at least one positive biopsy core.

Conclusions:

This exploratory analysis suggests that there are imaging, procedural and clinical variables that have an impact on image-guided bone biopsy yield. In order to maximize harvest of prostate cancer tissue, we have incorporated a prospective analysis of the metrics described here as part of a multi-institutional project aiming to use the molecular characterization of mCRPC tumors to direct individual therapy.

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Acknowledgements

The clinical trial described in this manuscript was funded by Janssen. GlaxoSmithKline provided dutasteride for this trial. The cost of the tumor biopsies was funded through the Fairweather Family Fund and the Prostate Cancer Foundation Challenge Award.

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Authors and Affiliations

  1. Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    R R McKay, L Werner, S E Smith, Z Jiang, K Melnick, P W Kantoff & M-E Taplin

  2. Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

    K A Zukotynski

  3. Brigham and Women’s Hospital, Boston, MA, USA

    K A Zukotynski, S E Smith & X Yuan

  4. Beth Israel Deaconess Medical Center, Boston, MA, USA

    O Voznesensky, J S Wu & S P Balk

  5. Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA,

    B Montgomery

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  1. R R McKay
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Correspondence to M-E Taplin.

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Competing interests

Dr Taplin has received research funding for clinical trials of abiraterone from Janssen and has an advisory role at Janssen. The remaining authors declare no conflict of interest.

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McKay, R., Zukotynski, K., Werner, L. et al. Imaging, procedural and clinical variables associated with tumor yield on bone biopsy in metastatic castration-resistant prostate cancer. Prostate Cancer Prostatic Dis 17, 325–331 (2014). https://doi.org/10.1038/pcan.2014.28

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  • DOI: https://doi.org/10.1038/pcan.2014.28

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