Natural History of Rising Serum Prostate-Specific Antigen in Men With Castrate Nonmetastatic Prostate Cancer

2005 ◽  
Vol 23 (13) ◽  
pp. 2918-2925 ◽  
Author(s):  
Matthew R. Smith ◽  
Fairooz Kabbinavar ◽  
Fred Saad ◽  
Arif Hussain ◽  
Marc C. Gittelman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastasis ◽  
Natural History ◽  
Bone Metastases ◽  
Androgen Deprivation Therapy ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
History Of ◽  
Psa Velocity ◽  
Baseline Psa

Purpose To describe the natural history of nonmetastatic prostate cancer and rising prostate-specific antigen (PSA) despite androgen deprivation therapy. Patients and Methods: The 201 patients in this report were the placebo control group from an aborted randomized controlled trial to evaluate the effects of zoledronic acid on time to first bone metastasis in men with prostate cancer, no bone metastases, and rising PSA despite androgen deprivation therapy. Relationships between baseline covariates and clinical outcomes were assessed by Cox proportional hazard analyses. Covariates in the model were baseline PSA, Gleason sum, history of bilateral orchiectomies, regional lymph node metastases at diagnosis, prior prostatectomy, time from androgen deprivation therapy to random assignment, time from diagnosis to random assignment, and PSA velocity. Results At 2 years, 33% of patients had developed bone metastases. Median bone metastasis–free survival was 30 months. Median time to first bone metastases and overall survival were not reached. Baseline PSA level greater than 10 ng/mL (relative risk, 3.18; 95% CI, 1.74 to 5.80; P < .001) and PSA velocity (4.34 for each 0.01 increase in PSA velocity; 95% CI, 2.30 to 8.21; P < .001) independently predicted shorter time to first bone metastasis. Baseline PSA and PSA velocity also independently predicted overall survival and metastasis-free survival. Other covariates did not consistently predict clinical outcomes. Conclusion Men with nonmetastatic prostate cancer and rising PSA despite androgen deprivation therapy have a relatively indolent natural history. Baseline PSA and PSA velocity independently predict time to first bone metastasis and survival.

scholarly journals Prospective study on the effect of short-term androgen deprivation therapy on PSMA uptake evaluated with 68Ga-PSMA-11 PET/MRI in men with treatment-naïve prostate cancer

2019 ◽  
Vol 47 (3) ◽  
pp. 665-673 ◽  
Author(s):  
Otto Ettala ◽  
Simona Malaspina ◽  
Terhi Tuokkola ◽  
Pauliina Luoto ◽  
Eliisa Löyttyniemi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Androgen Deprivation Therapy ◽  
Time Course ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Short Term ◽  
Psma Pet ◽  
Treatment Naïve

Abstract Purpose Based on in vitro studies, it is known that androgen deprivation therapy (ADT) increases prostate-specific membrane antigen (PSMA) expression. Therefore, we hypothesised that ADT improves the performance of PSMA-PET imaging in primary staging of prostate cancer. The purpose of the study was to demonstrate the time course effect of ADT on PSMA uptake in different types of metastatic lesions evaluated with 68Ga-PSMA-11 PET/MRI. Methods Nine men with treatment-naïve prostate cancer were enrolled to a prospective, registered (NCT03313726) clinical trial. A 68Ga-PSMA-11 PET/MRI was performed once before and 3 times post-ADT (degarelix, Firmagon). Change of maximum standardised uptake values (SUVmax) in prostate, lymph nodes, bone metastases, and physiologically PSMA-avid organs were evaluated in a time frame of 1–8 weeks. Results All patients reached castration levels within 10 days, and 50% decrease in prostate-specific antigen (PSA) concentration was observed 14 days post-ADT. A heterogeneous increase in PSMA uptake was observed 3 to 4 weeks post-ADT. This phenomenon was definitively more evident in bone metastases: 13 (57%) of the metastasis, with a mean (range) SUVmax increase of 77% (8–238%). In one patient, already having bone metastases at baseline, three new bone metastases were observed post-ADT. Of lesions with reduced SUVmax, none disappeared. Conclusions Both in patient and region level, increase in PSMA uptake post-ADT is heterogenous and is seen most evidently in bone metastases. Preliminary results on a small cohort of patients suggest the clinical impact of ADT on improving the performance of 68Ga-PSMA PET in staging seems to be minor. However, the optimal imaging time point might be 3 to 4 weeks post-ADT. Since none of the metastases with decreasing SUVmax disappeared, it seems that short-term usage of ADT does not interfere with the interpretation of 68Ga-PSMA PET. Trial registration NCT03313726, registered 18 October 2017; EUDRA-CT, 2017-002345-29.

NATURAL HISTORY OF BONE LOSS IN MEN WITH PROSTATE CANCER RECEIVING ANDROGEN-DEPRIVATION THERAPY

2009 ◽  
Vol 181 (4) ◽  
pp. 593-594
Author(s):  
Fred Saad ◽  
Robert Feldman ◽  
Jiri Heracek ◽  
Chunlei Ke ◽  
Carsten Goessl
Keyword(s):  
Prostate Cancer ◽  
Natural History ◽  
Bone Loss ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
History Of

scholarly journals The Natural History of Men Treated With Deferred Androgen Deprivation Therapy in Whom Metastatic Prostate Cancer Developed Following Radical Prostatectomy

2008 ◽  
Vol 179 (1) ◽  
pp. 156-162 ◽  
Author(s):  
Danil V. Makarov ◽  
Elizabeth B. Humphreys ◽  
Leslie A. Mangold ◽  
Michael A. Carducci ◽  
Alan W. Partin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Natural History ◽  
Androgen Deprivation Therapy ◽  
Metastatic Prostate Cancer ◽  
Androgen Deprivation ◽  
History Of

The Role of Chromogranin A (CgA) in Monitoring Patients with Prostate Cancer Under Androgen Deprivation Therapy: Comparison with Prostatic Specific Antigen (PSA)

2008 ◽  
Vol 1 (2) ◽  
pp. 115-119
Author(s):  
Athanasios Bantis ◽  
Petros Sountoulides ◽  
Athanasios Zissimopoulos ◽  
Christos Kalaitzis ◽  
Stilianos Giannakopoulos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Chromogranin A ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Prostatic Specific Antigen

scholarly journals Consensus for Treatment of Metastatic Castration-Sensitive Prostate Cancer: Report From the First Global Prostate Cancer Consensus Conference for Developing Countries (PCCCDC)

2021 ◽  
pp. 550-558
Author(s):  
Fernando Cotait Maluf ◽  
Felipe Moraes Toledo Pereira ◽  
Pedro Luiz Serrano Uson ◽  
Diogo Assed Bastos ◽  
Diogo Augusto Rodrigues da Rosa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Developing Countries ◽  
Androgen Deprivation Therapy ◽  
Best Practice ◽  
Specific Antigen ◽  
Limited Resource ◽  
Consensus Conference ◽  
Androgen Deprivation ◽  
Limited Resources ◽  
Resource Limited

PURPOSE International guideline recommendations may not always be extrapolated to developing countries where access to resources is limited. In metastatic castration-sensitive prostate cancer (mCSPC), there have been successful drug and imaging advancements that were addressed in the Prostate Cancer Consensus Conference for Developing Countries for best-practice and limited-resource scenarios. METHODS A total of 24 out of 300 questions addressed staging, treatment, and follow-up for patients with mCSPC both in best-practice settings and resource-limited settings. Responses were compiled and presented in percentage of clinicians supporting each response. Questions had 4-8 options for response. RESULTS Recommendations for staging in mCSPC were split but there was consensus that chest x-ray, abdominal and pelvic computed tomography, and bone scan should be used where resources are limited. In both de novo and relapsed low-volume mCSPC, orchiectomy alone in limited resources was favored and in relapsed high-volume disease, androgen deprivation therapy plus docetaxel in limited resources and androgen deprivation therapy plus abiraterone in high-resource settings were consensus. A 3-weekly regimen of docetaxel was consensus among voters. When using abiraterone, a regimen of 1,000 mg plus prednisone 5 mg/d is optimal, but in limited-resource settings, half the panel agreed that abiraterone 250 mg with fatty foods plus prednisone 5 mg/d is acceptable. The panel recommended against the use of osteoclast-targeted therapy to prevent osseous complications. There was consensus that monitoring of patients undergoing systemic treatment should only be conducted in case of prostate-specific antigen elevation or progression-suggestive symptoms. CONCLUSION The treatment recommendations for most topics addressed differed between the best-practice setting and resource-limited setting, accentuating the need for high-quality evidence that contemplates the effect of limited resources on the management of mCSPC.

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