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intensification protocols ought to be considered for IDC/CA+
prostate cancers in order to offset the adverse prognosis
following radical prostatectomy or image-guided radio-
therapy.
5.
Conclusions
We built upon our previous observation of a common clonal
origin in IDC and its adjacent glandular adenocarcinoma
[11], hereby showing that IDC/CA+ prostate cancer is
associated with a prostate cancer
nimbosus
, characterized
by genomic instability, hypoxia, and
SChLAP1
expression.
Collectively, the data confirm that IDC and CA are lethal
subpathologies. Patients with the constellation of adverse
prognostic factors that co-occur with IDC/CA should be
placed on close surveillance and therapy intensification due
to an increased risk of rapid failure and metastasis after
local therapy.
Part of this work has been presented as a mini-
symposium abstract at the AACR Annual Meeting, New
Orleans, 2016, and a Conquer Cancer Foundation merit
award poster abstract at the ASCO Annual Meeting, Chicago,
2016.
Author contributions:
Melvin L.K. Chua
[21_TD$DIFF]
, Theodorus H. van der Kwast and
Robert G. Bristow had full access to all the data in the study and takes
responsibility for the integrity of the data and the accuracy of the data
analysis.
Study concept and design:
Chua, Lo, Murgic, Boutros, van der Kwast,
Bristow.
Acquisition of data:
Chua, Lo, Pintilie, Murgic, Lalonde, Livingstone,
Bhandari, van Leenders, Verhoef, Hoogland, Berlin,
[22_TD$DIFF]
Dal Pra, Mahamud,
Meng, Zhang, Orain, Hovington, Picard, Bergeron, Lacombe, Fradet,
Gopalan, Kweldam, Teˆtu, Reuter, Fraser, van der Kwast.
Analysis and interpretation of data:
Chua, Lo, Pintilie, Lalonde, Livingstone,
Bhandari, Boutros, van der Kwast, Bristow.
Drafting of the manuscript:
Chua, Boutros, van der Kwast, Bristow.
Critical revision of the manuscript for important intellectual content:
Chua,
Pintilie, Lalonde, Bergeron, Kweldam, Boutros, van der Kwast, Bristow.
Statistical analysis:
Chua, Pintilie, Lalonde.
Obtaining funding:
Boutros, Bristow.
Administrative, technical, or material support:
Fleshner.
Supervision:
Boutros, van der Kwast, Bristow.
Other:
None.
Financial disclosures:
Melvin L.K. Chua certifies that all conflicts of
interest, including specific financial interests and relationships and
affiliations relevant to the subject matter or materials discussed in the
manuscript (eg, employment/affiliation, grants or funding, consultan-
cies, honoraria, stock ownership or options, expert testimony, royalties,
or patents filed, received, or pending), are the following: None.
Funding/Support and role of the sponsor:
This study was conducted with
the support of Movember funds through Prostate Cancer Canada, and
with the additional support of the Ontario Institute for Cancer Research,
funded by the Government of Ontario. This work was supported by
Prostate Cancer Canada and is proudly funded by the Movember
Foundation—Grant #RS2014-01. Melvin L.K. Chua is supported by the
Canadian Urologic Oncology Group Research Award and the National
Medical Research Council Singapore Transition Award. Paul C. Boutros
was supported by a Terry Fox Research Institute New Investigator
Award, a Prostate Cancer Canada Rising Star Fellowship, and a CIHR New
Investigator Award. This work has been funded by Fellowships from the
Canadian Institute for Health Research and the Ontario government to
Emilie Lalonde and Vinayak Bhandari. The authors gratefully thank the
Princess Margaret Cancer Centre Foundation and Radiation Medicine
Program Academic Enrichment Fund for support (to Robert G. Bristow).
Robert G. Bristow is a recipient of a Canadian Cancer Society Research
Scientist Award. The specific role of the funding organization or sponsor
is as follows: collection of the data.
Acknowledgments:
The authors thank all the members of the Boutros
and Bristow laboratories for their support and guidance.
Appendix A. Supplementary data
Supplementary data associated with this article can be
found, in the online version, at
http://dx.doi.org/10.1016/j. eururo.2017.04.034.
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