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. 2018 May 8;18(1):32.
doi: 10.1186/s12894-018-0353-4.

Impact of early changes in serum biomarkers following androgen deprivation therapy on clinical outcomes in metastatic hormone-sensitive prostate cancer

Hiromi Sato  1 , Shintaro Narita  2 , Norihiko Tsuchiya  3 , Atsushi Koizumi  1 , Taketoshi Nara  1 , Sohei Kanda  1 , Kazuyuki Numakura  1 , Hiroshi Tsuruta  1 , Atsushi Maeno  1 , Mitsuru Saito  1 , Takamitsu Inoue  1 , Shigeru Satoh  4 , Kyoko Nomura  5 , Tomonori Habuchi  1
Affiliations

Impact of early changes in serum biomarkers following androgen deprivation therapy on clinical outcomes in metastatic hormone-sensitive prostate cancer

Hiromi Sato et al. BMC Urol. .

Abstract

Background: Less evidence is known about the role of early changes in serum biomarker after androgen deprivation therapy (ADT) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Here we evaluated the impact of pre-treatment prognostic factors and early changes in serum biomarkers on prostate specific antigen (PSA) progression-free and overall survival rates in mHSPC.

Methods: We retrospectively reviewed the medical records of 60 mHSPC patients (median age 72 years) treated with ADT whose laboratory data at baseline and following 12 weeks were available.

Results: Forty-four patients (73%) had PSA progression and 27 patients (45.0%) died during a median follow-up of 34 months. The multivariable Cox hazard model demonstrated that a log-transformed baseline PSA level (p = 0.003) and an extent of bone disease (EOD) score of ≥3 (p = 0.004) were statistically associated with an increased risk for PSA progression whereas one unit increase in a log-transformed PSA change (baseline-12 weeks) was associated with a decreased risk for PSA progression (p = 0.004). For overall survival, a high level of alkaline phosphatase (ALP) at 12 weeks was associated with increased risk (p = 0.030) whereas a one-unit increase in the log-transformed PSA change was associated with decreased risk (p = 0.001).

Conclusions: An increased level of PSA at baseline, or an EOD score of ≥3 may be a good predictor of PSA progression, and a high level of ALP at 12 weeks may be a risk predictor of death. A larger decline in PSA at 12 weeks from the baseline was associated with both PSA progression-free and overall survival time. Early changes in serum biomarkers may be useful in predicting poor outcomes in patients with mHSPC who are initially treated with ADT.

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Conflict of interest statement

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
a Time to PSA progression-free survival according to the percentage change in the PSA level at 12 weeks. b Overall survival according to the percentage change in the PSA level at 12 weeks
Fig. 2
Fig. 2
Comparison of overall survival in patients with dichotomized according to subgroups in the CHAARTED trial and percentage change in the PSA level at 12 weeks. The low-volume disease in the CHAARTED trial was dichotomized according to the percentage change in the PSA level at 12 weeks
See this image and copyright information in PMC

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