125 Baseline bone metabolism markers as predictors for progression-free survival of patients with treatment-naïve bone-metastatic prostate cancer treated with zoledronic acid plus combined androgen blockade

2012 ◽  
Vol 11 (1) ◽  
pp. e125-e125a
Author(s):  
M. Nozawa ◽  
T. Inagaki ◽  
K. Nagao ◽  
T. Nishioka ◽  
T. Komura ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Zoledronic Acid ◽  
Bone Metabolism ◽  
Metastatic Prostate Cancer ◽  
Progression Free Survival ◽  
Bone Metabolism Markers ◽  
Free Survival ◽  
Combined Androgen Blockade ◽  
Treatment Naïve ◽  
Androgen Blockade

Effect of zoledronic acid and biochemical relapse in treatment-naive patients with bone-metastatic prostate cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 136-136
Author(s):  
Hideyasu Matsuyama ◽  
Masahiro Nozawa ◽  
Takeshi Inagaki ◽  
Kazuhiro Nagao ◽  
Isao Hara ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Zoledronic Acid ◽  
Bone Metabolism ◽  
Metastatic Prostate Cancer ◽  
Type I Collagen ◽  
Type I ◽  
Biochemical Relapse ◽  
Bone Metabolism Markers ◽  
Treatment Naïve ◽  
Baseline Psa

136 Background: Recent reports suggest that zoledronic acid have anti-proliferative activity, and that bone metabolism markers predict patient outcome in prostate cancer. Aims of this study are if bone metabolism markers may predict patient outcome who are treated with zoledronic acid concomitant with androgen deprivation therapy (ADT), and if zoledronic acid has oncological benefit in patients with metastatic prostate cancer. Methods: A multi-institutional prospective phase II study was conducted for 54 treatment-naïve patients with bone-metastatic prostate cancer who were treated with zoledronic acid concomitant with ADT (ADT-Z group). Median age, baseline PSA of the patients were 72, and 249ng/ml, respectively. Patients were treated with zoledronic acid (4 mg iv every 4 weeks) in combination with bicalutamide (80mg po) and goserelin acetate (10.8mg sc every 3 months), and followed with a median follow-up of 24.6 months. Serum bone metabolism markers, including bone-specific alkaline phosphatase (BAP) and cross-linked C-terminal telopeptides of type I collagen (I-CTP) and urine levels of cross-linked N-terminal telopeptides of type I collagen (NTx), were measured before treatment followed by every 3 months thereafter, and were compared with biochemical relapse (BCR). BCR of those patients was compared with that of 180 patients who were treated with ADT alone (ADT group) as historical control. Results: Baseline NTx (>100), baseline PSA (>225), EOD (>2) were significantly linked with BCR. Baseline NTx (>100) was an independent predictor for BCR in multivariate analysis (p=0.02). Time to BCR was significantly longer in ADT-Z group than that in ADT group (p<0.0001, median TTP: not reached in ADT-Z vs. 15.4 months in ADT). Conclusions: Zoledronic acid may improve patient prognosis, and baseline NTx may be a useful predictor for BCR in treatment-naïve metastatic prostate cancer patients with zoledronic acid combined with ADT.

scholarly journals Efficacy and safety of combined androgen blockade with antiandrogen for advanced prostate cancer

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Y. Yang ◽  
R. Chen ◽  
T. Sun ◽  
L. Zhao ◽  
F. Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Efficacy And Safety ◽  
First Line ◽  
Combined Androgen Blockade ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Grade 3 ◽  
Androgen Blockade

Background Combined androgen blockade (cab) is a promising treatment modality for prostate cancer (pca). In the present meta-analysis, we compared the efficacy and safety of first-line cab using an antiandrogen (aa) with castration monotherapy in patients with advanced pca.Methods PubMed, embase, Cochrane, and Google Scholar were searched for randomized controlled trials (rcts) published through 12 December 2016. Hazard ratios (hrs) with 95% confidence intervals (cis) were determined for primary outcomes: overall survival (os) and progression-free survival (pfs). Subgroup analyses were performed for Western compared with Eastern patients and use of a nonsteroidal aa (nsaa) compared with a steroidal aa (saa).Results Compared with castration monotherapy, cab using an aa was associated with significantly improved os (n = 14; hr: 0.90; 95% ci: 0.84 to 0.97; p = 0.003) and pfs (n = 13; hr: 0.89; 95% ci: 0.80 to 1.00; p = 0.04). No significant difference in os (p = 0.71) and pfs (p = 0.49) was observed between the Western and Eastern patients. Compared with castration monotherapy, cab using a nsaa was associated with significantly improved os (hr: 0.88; 95% ci: 0.82 to 0.95; p = 0.0009) and pfs (hr: 0.85; 95% ci: 0.73 to 0.98; p = 0.007)—a result that was not achieved with cab using a saa. The safety profiles of cab and monotherapy were similar in terms of adverse events, including hot flushes, impotence, and grade 3 or 4 events, with the exception of risk of diarrhea and liver dysfunction or elevation in liver enzymes, which were statistically greater with cab using an aa.Conclusions Compared with castration monotherapy, first-line cab therapy with an aa, especially a nsaa, resulted in significantly improved os and pfs, and had an acceptable safety profile in patients with advanced pca.

scholarly journals Impact of Monthly 120 Mg Denosumab on Bone Metabolism in Bone-metastatic Prostate Cancer Undergoing Androgen Deprivation Therapy

2017 ◽  
Vol 2 (3) ◽  
pp. 41-46
Author(s):  
Jimpei Miyakawa ◽  
Satoru Taguchi ◽  
Motofumi Suzuki ◽  
Kaori Endo ◽  
Yorito Nose ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Metabolism ◽  
Androgen Deprivation Therapy ◽  
Metastatic Prostate Cancer ◽  
Androgen Deprivation ◽  
Mineral Density ◽  
Bone Metabolism Markers ◽  
The Impact

Background: While semiannual 60 mg denosumab is a common treatment for osteoporosis, impact of monthly 120 mg denosumab, the common treatment protocol for bone metastases from solid tumors, on bone metabolism is unclear.Materials and Methods: We reviewed 15 patients with bone-metastatic prostate cancer who initiated monthly 120 mg denosumab in conjunction with androgen deprivation therapy between 2013 and 2014. Bone mineral density (BMD) was measured at lumbar spine and femoral neck using dual energy X-ray absorptiometry (DXA), before treatment and annually thereafter. Bone metabolism markers, including urine N-terminal telopeptide (uNTx) and bone type alkaline phosphatase (BAP), were monitored monthly.Results: Twelve of 15 (80%) patients had evaluable DXA before treatment, and of them, eight underwent DXA after a year of initiation without discontinuation of denosumab. Percent changes in BMD from baseline were +6.2% at lumbar spine and +7.6% at femoral neck, both of which were significant increases (both P<0.01). Bone metabolism markers were evaluable in 11 (73%) patients: uNTx decreased rapidly, while BAP declined gradually after initiating denosumab. These effects were similar to those seen by the standardized dose for osteoporosis in previous literature. There were no denosumab-related severe adverse events during the follow-up period. Conclusions: The impact of monthly 120 mg denosumab on bone metabolism was significant, but almost equivalent to that of the standard dose for osteoporosis (60mg semiannually) in bone-metastatic prostate cancer undergoing androgen deprivation therapy. Whereas the higher dose has reportedly reduced skeleton-related events, the effect on bone metabolism seemed plateaued or showed no dose-dependency.

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