Analysis of biochemical bone markers as prognostic factors for survival in patients with hormone-resistant prostate cancer and bone metastases

Petrioli, Roberto; Rossi, Stefania; Caniggia, Mario; Pozzessere, Daniele; Messinese, Simona; Sabatino, Marianna; Marsili, Stefania; Correale, Pierpaolo; Salvestrini, Francesco; Manganelli, Antonio; Francini, Guido

doi:10.1016/j.urology.2003.09.044

Cited by 16 publications

(8 citation statements)

References 27 publications

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“…Elevated serum BAP in patients with CRPC with bone metastases is associated with a higher risk of adverse skeletal events occurring . However, BAP does not seem to be prognostic of the survival of patients treated with chemotherapy . The relevance of BAP changes in patients, who underwent PSMA‐RLT, has not been reported in previous studies.…”

Section: Discussionmentioning

confidence: 91%

The value of tumor markers in men with metastatic prostate cancer undergoing [¹⁷⁷Lu]Lu‐PSMA therapy

et al. 2019

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Background Currently, prostate‐specific membrane antigen‐radioligand therapy (PSMA‐RLT) is considered a last‐line treatment option in advanced castration‐resistant prostate cancer. Despite these patients' poor prognosis, accurate estimation of their overall survival (OS) is essential to determine whether benefits exist from the treatment and whether the loss of valuable time and unnecessary side effects can be avoided. The aim of the present study is to evaluate whether various biochemical markers can predict OS in men undergoing PSMA‐RLT and whether the changes assessed after PSMA‐RLT correlate with the OS. Methods The tested tumor markers in this retrospective analysis were alkaline phosphatase (ALP), bone‐specific alkaline phosphatase (BAP), prostate‐specific antigen (PSA), lactate dehydrogenase (LDH), chromogranin A, and pro‐gastrin‐releasing peptide (pro‐GRP). For the evaluation, we performed blood tests before each PSMA‐RLT cycle and during follow‐up visits (which were 2‐3 months apart). All patients were followed up until their deaths. To test the correlations between the tumor markers and survival, we conducted the logrank tests and the multivariate Cox proportional‐hazards regression model. The significance level was set at P < .05. Results The study included 137 patients who received a total of 487 PSMA‐RLT cycles between January 2015 and November 2017. Of the tested biochemical tumor markers, baseline ALP (120 U/L cut‐off), LDH (248 U/L cut‐off), and PSA (first quartile cut‐off) correlated significantly with survival post‐PSMA‐RLT (P < .001 for ALP and LDH, and P = .007 for PSA). Stable and/or decreased values in most of the initially abnormal parameters were associated with significantly better OS; these parameters were ALP (P = .009), LDH (P = .005), PSA (P < .001), and pro‐GRP (P = .013). The BAP and ALP responses also correlated significantly with survival in patients with bone metastases (P = .002 and P < .001, respectively). Furthermore, there was a strong correlation of the kinetic patterns of PSA, ALP, BAP, and LDH with the survival, showing that patients with steadily increasing markers had the shortest OS. Conclusion Along with the established tumor marker PSA, ALP, LDH, BAP, and pro‐GRP were correlated with the OS post‐PSMA‐RLT in the univariate and multivariate analyses.

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Section: Discussionmentioning

confidence: 91%

The value of tumor markers in men with metastatic prostate cancer undergoing [¹⁷⁷Lu]Lu‐PSMA therapy

et al. 2019

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“…Bone turnover markers may be helpful in monitoring the efficacy of bisphosphonates (BPs). However, changes in urinary levels of NTx and CTx require long periods of time [12] and their use in the routine care is still controversial.…”

Section: Clinical and Laboratory Manifestations Of Bone Metastasesmentioning

confidence: 99%

SEOM Clinical Guideline for bone metastases from solid tumours (2016)

Grávalos

Rodrı́guez

Sabino³

et al. 2016

Clin Transl Oncol

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Bone metastases are common in many advanced solid tumours, being breast, prostate, thyroid, lung, and renal cancer the most prevalent. Bone metastases can produce skeletal-related events (SREs), defined as pathological fracture, spinal cord compression, need of bone irradiation or need of bone surgery, and hypercalcaemia. Patients with bone metastases experience pain, functional impairment and have a negative impact on their quality of life. Several imaging techniques are available for diagnosis of this disease. Bone-targeted therapies include zoledronic acid, a potent biphosfonate, and denosumab, an anti-RANKL monoclonal antibody. Both reduce the risk and/or delay the development of SREs in several types of tumours. Radium 233, an alpha-particle emitter, increases overall survival in patients with bone metastases from resistant castration prostate cancer. Multidisciplinary approach is essential and bone surgery and radiotherapy should be integrated in the treatment of bone metastases when necessary. This SEOM Guideline reviews bone metastases pathogenesis, clinical presentations, lab tests, imaging techniques for diagnosis and response assessment, bone-targeted agents, and local therapies, as radiation and surgery, and establishes recommendations for the management of patients with metastases to bone.

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“…The use of urinary markers as a prognostic tool has also been explored in many studies in the literature [2,4,12–20] . While other bone markers such as serum bone alkaline phosphatase (BAP) [2] , serum BSP [28] , serum PINP [29] , and serum ICTP [30] have proved useful in the prognostic setting, NTX has been shown to be the most consistent urinary marker for prognostic use [2,30,31] .…”

Section: Resultsmentioning

confidence: 99%

“…Many studies over the past 20 years have shown the potential of urinary markers in the detection of the presence of bone metastases [3–11] , the use of urinary markers for its prognostic value in bone disease [2,4,12–20] , as well as directing therapy for bone metastases patients [2,6,12–18,21–25] . The purpose of this review is to summarize relevant studies reporting the potential and advances in using urinary markers in the management of bone metastases.…”

Section: Introductionmentioning

confidence: 99%

Use of urinary markers in cancer setting: A literature review

Chiu

Wong

DeAngelis

et al. 2015

Journal of Bone Oncology

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IntroductionIn bone metastases, the disruption of normal bone processes results in increased resorption and formation rates, which can often be quantitatively measured by biomarkers in the urine and blood. The purpose of this review is to summarize relevant studies of urinary markers used as a diagnostic and/or prognostic tool, as well as its potential and advances in directing therapy.MethodsA literature search was conducted using Ovid MEDLINE (1950 to July 2014), EMBASE (1950 to 2014 week 30) and Cochrane Central Register of Controlled Trials (3rd Quarter 2014) to identify studies that detailed the use of urinary markers in the cancer setting, specifically involving markers for bone metastases. Search terms included “urinary markers”, “cancer”, and “bone metastases”.ResultsA total of 35 articles, with 24 original studies, were identified. In general, urinary markers can be used to detect early signs of bone metastases prior to skeletal imaging, but still must be used in conjunction with imaging to avoid false positive results. The use of urinary markers, such as N-telopeptide, as a prognostic tool remains controversial, but can provide information on the relative risk of skeletal related events (SREs), disease progression, as well as death. Finally, while urinary markers have shown to be potentially useful in confirming the efficacy of bone metastases treatments, exploring the appropriate dosages for treatment, and directing therapy, it is still unclear to what extent urinary markers should be reduced by.ConclusionThe potential use of urinary markers in the management of bone metastases is promising as it can allow for earlier and more convenient detection of bone metastases in comparison to other techniques. However, additional studies involving prospective clinical trials are suggested to further examine the potential of urinary markers in developing appropriate treatment strategies and endpoints, especially in developing a clearer protocol on the extent urinary markers should be reduced by to correlate with achievement of clinical benefit.

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Analysis of biochemical bone markers as prognostic factors for survival in patients with hormone-resistant prostate cancer and bone metastases

Cited by 16 publications

References 27 publications

The value of tumor markers in men with metastatic prostate cancer undergoing [¹⁷⁷Lu]Lu‐PSMA therapy

The value of tumor markers in men with metastatic prostate cancer undergoing [¹⁷⁷Lu]Lu‐PSMA therapy

SEOM Clinical Guideline for bone metastases from solid tumours (2016)

Use of urinary markers in cancer setting: A literature review

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Analysis of biochemical bone markers as prognostic factors for survival in patients with hormone-resistant prostate cancer and bone metastases

Cited by 16 publications

References 27 publications

The value of tumor markers in men with metastatic prostate cancer undergoing [177Lu]Lu‐PSMA therapy

The value of tumor markers in men with metastatic prostate cancer undergoing [177Lu]Lu‐PSMA therapy

SEOM Clinical Guideline for bone metastases from solid tumours (2016)

Use of urinary markers in cancer setting: A literature review

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The value of tumor markers in men with metastatic prostate cancer undergoing [¹⁷⁷Lu]Lu‐PSMA therapy

The value of tumor markers in men with metastatic prostate cancer undergoing [¹⁷⁷Lu]Lu‐PSMA therapy