Independent prognostic role of circulating chromogranin A in prostate cancer patients with hormone-refractory disease

2005 ◽  
Vol 12 (1) ◽  
pp. 109-117 ◽  
Author(s):  
A Berruti ◽  
A Mosca ◽  
M Tucci ◽  
C Terrone ◽  
M Torta ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Chromogranin A ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Specific Antigen ◽  
Serum Lactate Dehydrogenase ◽  
Refractory Disease ◽  
Prognostic Role ◽  
Hormone Refractory

The presence of neuroendocrine (NE) differentiation in the context of predominantly exocrine prostate cancer may play a key role in androgen-independent tumor growth. The prognostic significance of plasma chromogranin A (CgA) was assessed in a series of consecutive prostate cancer patients with hormone-refractory disease. One hundred and eight patients with newly diagnosed hormone-refractory prostate cancer entered the study. Plasma CgA levels and other biochemical parameters, such as serum prostate specific antigen, serum alkaline phosphatase, serum lactate dehydrogenase, serum albumin and hemoglobin concentration, were measured at baseline (i.e. when hormone refractoriness occurred) and their prognostic role was evaluated together with patient performance status, Gleason score (at diagnosis of prostate cancer) and the presence of visceral metastases. Furthermore, plasma CgA was prospectively evaluated in 50 patients undergoing chemotherapy. At baseline, 45 patients (43.3%) showed elevated CgA values. Plasma CgA negatively correlated with survival, either in univariate analysis (P=0.008) or in multivariate analysis, after adjusting for previously mentioned prognostic parameters (P<0.05). In the patient subset undergoing chemotherapy, median CgA (range) values were 13.3 (3.0–141.0) U/l at baseline, 19.1 (3.0–486.0) U/l after 3 months, 20.8 (3.0–702.0) U/l after 6 months and 39.4 (3.0–414.0) U/l after 9 months (P<0.01). The corresponding supranormal rates were 17/50 (34%), 23/50 (46%), 26/50 (52%) and 34/50 (68%) respectively (P<0.005). Elevated plasma CgA levels are frequently observed in prostate cancer patients with hormone-refractory disease and correlate with poor prognosis. NE differentiation in hormone-refractory patients is a time-dependent phenomenon and is not influenced by conventional antineoplastic treatments.

LB22 Prognostic role of plasma chromogranin a levels in prostate cancer patients with hormone refractory disease

2004 ◽  
Vol 3 (2) ◽  
pp. 237
Author(s):  
C. Terrone ◽  
R. Tarabuzzi ◽  
C. Cracco ◽  
S. Guercio ◽  
M. Poggio ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Chromogranin A ◽  
Refractory Disease ◽  
Prognostic Role ◽  
Hormone Refractory

Prognostic role of plasma chromogranin A levels in prostate cancer patients with hormone refractory disease

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 9563-9563
Author(s):  
A. Mosca ◽  
A. Berruti ◽  
M. Tucci ◽  
F. Vana ◽  
R. Bitossi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Chromogranin A ◽  
Refractory Disease ◽  
Prognostic Role ◽  
Hormone Refractory

Prognostic role of plasma chromogranin A levels in prostate cancer patients with hormone refractory disease

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 9563-9563
Author(s):  
A. Mosca ◽  
A. Berruti ◽  
M. Tucci ◽  
F. Vana ◽  
R. Bitossi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Chromogranin A ◽  
Refractory Disease ◽  
Prognostic Role ◽  
Hormone Refractory

Prostate-specific antigen as a measure of disease outcome in metastatic hormone-refractory prostate cancer.

1993 ◽  
Vol 11 (4) ◽  
pp. 607-615 ◽  
Author(s):  
W K Kelly ◽  
H I Scher ◽  
M Mazumdar ◽  
V Vlamis ◽  
M Schwartz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Specific Antigen ◽  
Phase Iii ◽  
Cancer Center ◽  
Hormone Refractory Prostate Cancer ◽  
Data Set ◽  
Hormone Refractory

PURPOSE To evaluate the prognostic significance of pretreatment parameters and posttherapy declines in prostate-specific antigen (PSA) in relation to the survival of patients with hormone-refractory prostate cancer. PATIENTS AND METHODS One hundred ten assessable patients treated on seven sequential protocols at Memorial Sloan-Kettering Cancer Center (MSKCC) for hormone-refractory prostate cancer were evaluated for 29 different pretherapy and posttherapy parameters, including a posttherapy decline in PSA of 50% and 80% from baseline. RESULTS In the univariate analysis, initial Karnofsky performance status (KPS) > or = 80% was associated with a favorable outcome (P = .005), while age, extent of disease on bone scan, and individual sites of metastatic disease were not significant. No difference in survival was observed between patients with measurable or assessable (bone only) disease. Initial hemoglobin (HGB; P = .0012), alkaline phosphatase (ALK; P = .0015), and lactate dehydrogenase (LDH; P = .0002) levels were significant discriminators, while the initial PSA was not. Using a landmark analysis, a significantly longer median survival rate was observed for patients with a > or = 50% decline in PSA (median not reached) versus patients with a less than 50% decline in PSA (median, 8.6 months; P = .0001). Multivariate analysis using the Cox proportional hazards model showed that a > or = 50% decline in PSA (P = .0004) and the natural log of LDH (P = .0001) were the two most significant variables predicting survival. The model was confirmed on an independent data set from the Norwegian Radium Hospital (NRH) in Oslo, Norway. CONCLUSION The results suggest that posttherapy PSA declines can be used as a surrogate end point to evaluate new agents in hormone-refractory prostate cancer. The criteria for response need prospective validation in phase III trials.

Circulating chromogranin A as a marker for poor-prognosis hormone refractory prostate cancer without neuroendocrine features: Prospective analyses of a cohort of patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16130-e16130
Author(s):  
P. Maroto-Rey ◽  
N. Sala ◽  
J. Mora ◽  
H. Villavicencio ◽  
S. Esquena ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Alkaline Phosphatase ◽  
Gleason Score ◽  
Chromogranin A ◽  
Poor Prognosis ◽  
Serum Alkaline Phosphatase ◽  
Refractory Disease ◽  
Initial Biopsy ◽  
Double Time ◽  
Hormone Refractory

e16130 Background: Some patients may develop hormone refractory prostate (HRPC) cancer with neuroendocrine features, although they were not recognizable in the initial biopsy. Serum chromogranin is a marker for tumors with neuroendrocrine differentiation. Purpose: To analyze if serum levels of chromogranin A may identify poor prognosis HRPC patients in patients without neuroendocrine features in the initial biopsy. Methods: Circulating chromogranin A was prospectively analyzed in 34 patients when they were diagnosed under the standard criteria of HRPC. A patient was considered to have higher than normal levels of serum chromogranin if levels were above 100 ug/L. Patients were also assessed for serum PSA, enolase, serum alkaline phosphatase, albumin, and hemoglobin. Results were correlated with clinical prognostic factors as ECOG, PSA double time and Gleason score. We analyzed the time to hormone-refractory disease since diagnosis, and overall survival, as well as pattern of relapse (visceral vs. nonvisceral disease). Results: Median age was 63 (49–85). Median PSA was 33 (0.04–1455). At baseline, 16 patients were chromogranin-negative (46%), and 18 patients were chromogranin-positive (54). Chromogranin A did not correlate with either enolase or PSA. Patients with positive (>100 ug/L) had stadistically significant lower levels of hemoglobine (13.8 vs 12.3), and a trend to have more visceral disease vs locoregional diasease or bone metastases, a lower albumine level (39.85 vs 45.05), higher alkaline phosphatase (221 vs 111), and LDH (1,914.5 vs 415). In this group of patients, we did not find differences in PSA double time, time to hormone-refractory disease or Gleason score. Conclusions: The analysis of this cohort of patients suggests that serum chromogranine A correlates with other known adverse prognosis factors of survival in prostate cancer patients. No significant financial relationships to disclose.

Prognostic Significance of Disseminated Tumor Cells in the Bone Marrow of Prostate Cancer Patients Treated With Neoadjuvant Hormone Treatment

2008 ◽  
Vol 26 (30) ◽  
pp. 4928-4933 ◽  
Author(s):  
Jens Köllermann ◽  
Steffen Weikert ◽  
Martin Schostak ◽  
Carsten Kempkensteffen ◽  
Klaus Kleinschmidt ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Marrow ◽  
Radical Prostatectomy ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Prognostic Significance ◽  
Specific Antigen ◽  
Disseminated Tumor Cells ◽  
Significant Prognostic Factor

Purpose To explore whether the presence of occult disseminated tumor cells (DTCs) in the bone marrow before neoadjuvant hormone therapy influences the prognosis of patients with organ confined prostate cancer treated by radical prostatectomy. Patients and Methods Pretreatment bone marrow aspirates from 193 cT (1-4) pN0M0 prostate cancer patients submitted to neoadjuvant hormone therapy (mean, 8 months) followed by radical prostatectomy were immunohistochemically evaluated by anticytokeratin antibody A45-B/B3 previously validated for the detection of DTCs. Bone marrow status was compared with established clinical and histopathologic risk parameters. Patients’ outcome was evaluated using prostate-specific antigen (PSA) blood serum measurements as surrogate marker for recurrence over a median follow-up of 44 months. Results DTCs were detected in 44.6% of patients. Bone marrow status neither correlated with tumor grade and stage, nor with the pretreatment PSA risk category (all P values > .05). In the univariate Kaplan-Meier analysis, the presence of DTCs was a significant prognostic factor with respect to poor PSA progression-free survival (log-rank test P = .0035). Using a multivariable piecewise Cox regression model, the presence of DTCs was an independent predictor of PSA relapse (relative risk 1.82; P = .014). Conclusion The presence of DTCs in the bone marrow of patients with prostate cancer before neoadjuvant hormone therapy and subsequent surgery represents an independent prognostic parameter, suggesting that DTCs may contribute to the failure of current neoadjuvant hormone therapy regimens.

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