Progression of Prostate Cancer Despite an Extremely Low Serum Level of Prostate-Specific Antigen

Lee, Dong Kil; Park, Jeong Hyun; Kim, Jae-Han; Lee, Seung Joon; Jo, Moon Ki; Gil, Myung Cheol; Song, Kang; Park, Jong Wook

doi:10.4111/kju.2010.51.5.358

Cited by 21 publications

(15 citation statements)

References 8 publications

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“…A perceived limitation of the quantitative model may be the use of PSA dynamics as the sole biomarker of progression. PCa can become aggressive and metastatic despite low levels of serum PSA 37,38 with development of androgen independence, most notably in neuroendocrine PCa. Additional serum biomarkers such as circulating tumor cells (CTCs) and cell-free DNA (cfDNA) may prove useful in estimating intratumoral evolutionary dynamics in subsequent trials.…”

Section: Discussionmentioning

confidence: 99%

Prostate-specific antigen dynamics predict individual responses to intermittent androgen deprivation

et al. 2020

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Intermittent androgen deprivation therapy (IADT) is an attractive treatment for biochemically recurrent prostate cancer (PCa), whereby cycling treatment on and off can reduce cumulative dose and limit toxicities. We simulate prostate-specific antigen (PSA) dynamics, with enrichment of PCa stem-like cell (PCaSC) during treatment as a plausible mechanism of resistance evolution. Simulated PCaSC proliferation patterns correlate with longitudinal serum PSA measurements in 70 PCa patients. Learning dynamics from each treatment cycle in a leave-one-out study, model simulations predict patient-specific evolution of resistance with an overall accuracy of 89% (sensitivity = 73%, specificity = 91%). Previous studies have shown a benefit of concurrent therapies with ADT in both low-and high-volume metastatic hormone-sensitive PCa. Model simulations based on response dynamics from the first IADT cycle identify patients who would benefit from concurrent docetaxel, demonstrating the feasibility and potential value of adaptive clinical trials guided by patient-specific mathematical models of intratumoral evolutionary dynamics.

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Section: Discussionmentioning

confidence: 99%

Prostate-specific antigen dynamics predict individual responses to intermittent androgen deprivation

et al. 2020

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“…It may not be expressed in all patients with prostatic adenocarcinoma [6], the most commonly encountered histopathological form [7]. In addition, the development of metastatic prostate cancer producing undetectable or low serum PSA levels is not uncommon [8]. Having a patient with a PSA at 3.47 ng/ml and an extension at the level of the cavernous body, the urethra and the rectum by a very painful ulcero-budding rectal lesion, as in our case, raises questions.…”

Section: Discussionmentioning

confidence: 72%

Advanced Prostate Cancer: A Case Report

Opara¹,

Atipo²,

Odzébé³

et al. 2019

OJU

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There are few reported cases in the prostate adenocarcinoma literature with locoregional extension and normal prostate-specific antigen (PSA). We present the case of a patient with prostate adenocarcinoma and metastases with PSA values within the normal range, despite evidence of clinical and radiological progression of the disease. This is a 72-year-old patient presenting with a dysectatic syndrome in which there is a budding ulceration of the glans, an induration of the corpora cavernosa and whose rectal examination has objectified a malignant prostate. PSA was assayed at 3.47 ng/ml; prostatic biopsy and magnetic resonance imaging (MRI) revealed prostate cancer with extension to the urethral, cavernous and rectal areas. Hormone therapy was instituted and the course after two months was marked by the occurrence of several episodes of anemia treated by blood transfusion.

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“…Almost all patients with metastatic prostate cancer present with a high PSA level, thereby enabling the marker to be used as a measure of disease burden/response to treatment. Less than 1% of metastatic prostate cancer cases have low serum PSA levels [11]. To the authors' knowledge, metastatic prostate cancer to the lungs presenting as multiple bilateral cavitary lung lesions without bony metastases and normal PSA has not been previously reported.…”

Section: Discussionmentioning

confidence: 74%

A Cavitary Conundrum

Andrews

2013

J Med Cases

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Prostate cancer is the second most common cancer in the male population after skin cancer. Approximately 220,000 men in the United States are diagnosed with prostate cancer annually, 29,000 of which succumb to the disease. In the overwhelming majority of cases, metastatic prostate cancer presents with an elevated PSA and osseous involvement. We present a unique case of cavitary nodular prostate metastases to the lung without osseous involvement and a normal PSA. A brief discussion of cavitary lung lesions is also covered.

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Progression of Prostate Cancer Despite an Extremely Low Serum Level of Prostate-Specific Antigen

Cited by 21 publications

References 8 publications

Prostate-specific antigen dynamics predict individual responses to intermittent androgen deprivation

Prostate-specific antigen dynamics predict individual responses to intermittent androgen deprivation

Advanced Prostate Cancer: A Case Report

A Cavitary Conundrum

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