Nadir prostate-specific antigen as a predictor of progression to androgen-independent prostate cancer

Benaim, Elie A.; Pace, Christopher M.; Lam, PW; Roehrborn, Claus G.

doi:10.1016/s0090-4295(01)01440-6

Cited by 58 publications

(60 citation statements)

References 11 publications

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“…Association between Gleason score and TTP was also reported in a previous study [19]. On the other hand, the impact of Gleason score on OS is controversial; some reported a positive relationship between them [11] and others negative [12,15,20,21].…”

Section: Discussionsupporting

confidence: 71%

“…In this situation, it is important to precisely evaluate the clinical efficacy of ADT consisting of traditional maximum androgen blockade (MAB) at this time. There have been several reports of outcomes from patients with prostate cancer treated with ADT [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]; however, the number of studies, that reported outcomes in patients with bone metastatic prostate cancer treated primarily with MAB without any local treatment, is limited. Recently, outcomes of MAB as an initial treatment for patients with bone metastatic prostate cancer have been reported, in which the significant impact of PSA kinetics not on OS but on disease progression was demonstrated [16].…”

Section: Open Accessmentioning

confidence: 99%

See 1 more Smart Citation

Impact of initial time to prostate-specific antigen nadir on survival in prostate cancer with bone metastasis initially treated with maximum androgen blockade therapy

Yamamoto¹,

Nozawa²,

Itami³

et al. 2013

J Cancer Res Ther

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Section: Discussionsupporting

confidence: 71%

Section: Open Accessmentioning

confidence: 99%

Impact of initial time to prostate-specific antigen nadir on survival in prostate cancer with bone metastasis initially treated with maximum androgen blockade therapy

Yamamoto¹,

Nozawa²,

Itami³

et al. 2013

J Cancer Res Ther

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“…8,9 All patients in our study achieved a nadir within 8 months (median time to nadir, 0.54 years; interquartile range, 0.32-0.65 years). Patients were followed every 3 to 6 months with serum PSA measurements and digital rectal examinations.…”

Section: Follow-upmentioning

confidence: 87%

“…These cut-off points were PSA nadir 0.2 ng/mL versus >0.2 ng/mL, 6,9 Gleason score 7 versus >8, 4 time to PSA failure <3 years versus !3 years, 4 PSA DT <3 months versus 3 to 6 months, 1,4 and pre-ADT PSA level 10 ng/ mL versus >10 ng/mL. The time to PSA nadir after ADT was analyzed as a continuous variable.…”

Section: Discussionmentioning

confidence: 99%

Predictors of mortality after androgen‐deprivation therapy in patients with rapidly rising prostate‐specific antigen levels after local therapy for prostate cancer

Rodrigues¹,

Chen²,

Catàlona³

et al. 2006

Cancer

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BACKGROUND. The authors identified biochemical and pathologic factors that were associated significantly with prostate cancer‐specific mortality (PCSM) after androgen deprivation therapy (ADT) in men who had rapidly rising prostate‐specific antigen (PSA) levels after they received local treatment. METHODS. The study population consisted of 67 patients who had a PSA doubling time (DT) ≤6 months after radical prostatectomy (n = 50 patients) or external beam radiation therapy (n = 17 patients) for localized prostate cancer. Multivariate Cox proportional hazards regression analysis was used to evaluate whether the interval to PSA failure, pre‐ADT PSA DT, PSA level at the time of ADT initiation, time to PSA nadir, PSA nadir after 8 months on ADT, and Gleason score were associated significantly with the time to PCSM 8 months after the initiation of ADT. RESULTS. A PSA nadir >0.2 ng/mL (adjusted hazard ratio [HR], 8.0; 95% confidence interval [95% CI], 1.7–38.7; P = 0.009) and a Gleason score ≥8 (adjusted HR, 5.2; 95% CI, 1.3–20.6; P = 0.02) were associated significantly with a short time to PCSM. The cumulative incidence estimates of 3‐year PCSM were 5.8% versus 50.9% for patients with a PSA nadir ≤0.2 ng/mL versus >0.2 ng/mL, respectively, and 10.8% versus 35.8% for patients who had tumors with a Gleason score ≤7 versus ≥8, respectively. CONCLUSIONS. Among men with a PSA DT ≤6 months, both a PSA nadir >0.2 ng/mL after ADT and a Gleason score ≥8 cancer identified men who were at high risk for PCSM. These men would be ideal candidates for Phase III studies that evaluate the impact on survival of new systemic therapies for prostate cancer. Cancer 2006. © 2006 American Cancer Society.

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“…Some investigators have demonstrated the prognostic significance of nadir PSA after androgen deprivation therapy for locally advanced and/or metastatic prostate cancer in terms of survival or progression to androgenindependent status. [19][20][21][22][23][24] The EORTC 30892 study has demonstrated that PSA response at 6 months after androgen deprivation therapy for metastatic prostate cancer can predict survival. 19 Median overall survival rates were 6.4, 3.8 and 2.3 years in patients with nadir PSA p1, 1-10 and 410 ng ml -1 , respectively.…”

Section: 9%mentioning

confidence: 99%

Impact of pretreatment factors, biopsy Gleason grade volume indices and post-treatment nadir PSA on overall survival in patients with metastatic prostate cancer treated with step-up hormonal therapy

Miyamoto

Ito

Miyakubo

et al. 2011

Prostate Cancer Prostatic Dis

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BACKGROUND:In the era when various treatment agents for advanced-stage prostate cancer are available, it is important to investigate overall survival for metastatic prostate cancer treated with step-up hormonal treatment as a reference against new treatment regimens, including antitumor agents and/or new hormonal derivatives, and it is desirable to explore pretreatment, biopsy-related and post-treatment prognostic factors to establish tailor-made treatment strategies. METHODS:Between 1992 and 2002, 94 patients were diagnosed with prostate cancer with distant metastases in our facility. Various pretreatment clinical findings including serum PSA, testosterone, alkaline phosphatase (ALP), digital rectal examination (DRE) and extension of disease score were investigated for predicting outcomes in step-up hormonal treatment. We also investigated the impact of pathological findings including Gleason grading, tumor volume indices, various Gleason grade 5 volume indices in biopsy specimens, and post-treatment PSA nadir following step-up hormonal treatment on overall survival. RESULTS:The 3-and 5-year overall survival was 72.4% and 62.5%, respectively. According to univariate analyses, patients with PSA p100 ng ml -1 , ALP o440 IU l -1 , T1c to T3 on DRE, extension of disease (EOD) score 0-3, no Gleason grade 5 cancer in biopsy specimens or less such cancer and good response at any stage of hormonal therapy had significantly better overall survival than did patients with alternative status. A multivariate Cox proportional hazard model revealed that PSA nadir after first-line hormonal treatment, PSA nadir after second-line treatment and Gleason grade 5 volume index were independent prognostic factors.CONCLUSIONS: Even in very advanced prostate cancer, local pathological indices, a Gleason grade 5 volume index in particular, could differentiate patients with better prognosis from worse prognosis.Step-up hormonal therapy including luteinizing hormone-releasing hormone agonist, estrogen derivatives and steroid hormones may be valuable in patients with metastatic prostate cancer, especially in good responders at any stage of hormonal therapy.

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Nadir prostate-specific antigen as a predictor of progression to androgen-independent prostate cancer

Cited by 58 publications

References 11 publications

Impact of initial time to prostate-specific antigen nadir on survival in prostate cancer with bone metastasis initially treated with maximum androgen blockade therapy

Impact of initial time to prostate-specific antigen nadir on survival in prostate cancer with bone metastasis initially treated with maximum androgen blockade therapy

Predictors of mortality after androgen‐deprivation therapy in patients with rapidly rising prostate‐specific antigen levels after local therapy for prostate cancer

Impact of pretreatment factors, biopsy Gleason grade volume indices and post-treatment nadir PSA on overall survival in patients with metastatic prostate cancer treated with step-up hormonal therapy

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