C‐reactive protein as a prognostic marker for men with androgen‐independent prostate cancer

Abstract

BACKGROUND. Studies of cancer risk and molecular carcinogenesis suggest a role for inflammation in cancer development and progression. The authors sought to determine whether specific blood proteins associated with inflammation predict for outcomes in men with metastatic androgen‐independent prostate cancer (AIPC) who are initiating docetaxel‐based chemotherapy. METHODS. Baseline plasma samples were stored (−80°C) from 160 of 250 patients enrolled in the AIPC Study of Calcitriol ENhancing Taxotere (ASCENT) trial, a randomized, placebo‐controlled trial comparing weekly docetaxel plus high‐dose calcitriol with weekly docetaxel. Multiplex immunoassays measured 16 cytokine, chemokine, cardiovascular, or inflammatory markers. The Cox proportional hazards model was used to assess associations between baseline biomarkers, clinical characteristics, and survival. Logistic regression was used for analyses of associations with prostate‐specific antigen (PSA) decline. RESULTS. C‐reactive protein (CRP) was found to be significantly predictive of a shorter overall survival (hazards ratio [HR] of 1.41 for each natural logarithm [ln] [CRP] increase; 95% confidence interval [95% CI], 1.20–1.65 [P < .0001]). When CRP (continuous) was entered into a multivariate model using 13 baseline clinical variables, only elevated CRP remained a significant predictor (P < .0001) of shorter overall survival. When categorized as normal (≤8 mg/L) or abnormal (>8 mg/L), elevated CRP was found to be a significant predictor of shorter overall survival (HR of 2.96; 95% CI, 1.52–5.77 [P = .001]), as was hemoglobin (P = .007). Elevated CRP was also associated with a lower probability of PSA decline (odds ratio of 0.74 for each ln(CRP) increase; 95% CI, 0.60–0.92 [P = .007]). CONCLUSIONS. Elevated plasma CRP concentrations appear to be a strong predictor of poor survival and lower probability of PSA response to treatment in patients with AIPC who are receiving docetaxel‐based therapy. Cancer 2008. © 2008 American Cancer Society.

Subtypes of White Blood Cells in Patients with Prostate Cancer or Benign Prostatic Hyperplasia and Healthy Individuals

“…Early diagnosis and management of the disease is of utmost importance to prevent morbidity (Beer et al, 2008; The Committee for Establishment of the Guidelines on Screening for Prostate Cancer, 2010).…”

“…Although free PSA (FPSA) which is widely used in clinical practice has been studied in a number of studies in the literature, it has several disadvantages. On the other hand, total PSA (TPSA) seems to be more effective in the early diagnosis of prostate cancer (Beer et al, 2008;Terakawa et al, 2008). Although no other parameter is reliable than PSA in the diagnosis of prostate cancer today (Beer et al, 2008;Mengus et al, 2011) it may not be a sole method for the definite diagnosis in all patients.…”

“…On the other hand, total PSA (TPSA) seems to be more effective in the early diagnosis of prostate cancer (Beer et al, 2008;Terakawa et al, 2008). Although no other parameter is reliable than PSA in the diagnosis of prostate cancer today (Beer et al, 2008;Mengus et al, 2011) it may not be a sole method for the definite diagnosis in all patients. As a result, the treatment may be delayed or unnecessary and assays with a high complication rate may be performed.…”

“…Today, clinicians have been become interested in novel direct or indirect diagnostic methods to overcome such problems. Thus, several molecular, biological and serological studies have been undertaken (Jeromino et al, 2004;Beer et al, 2008;Mengus et al, 2011).…”

Presence of tumoural C-reactive protein correlates with progressive prostate cancer

“…Elevated circulating CRP levels have been shown to be linked to poor prognosis in several cancers including multiple myeloma, melanoma, lymphoma, ovarian, renal, pancreatic, lung and gastrointestinal tumours 6 . In metastatic and castrate resistant prostate cancer elevated plasma CRP levels have been recorded and shown to be independent predictors of poor survival and to be associated with a lower probability of response to chemotherapy 7,8 .…”