Reliability of prostate-specific antigen-marker in determining biochemical failure during the first 2 years after external beam radiation therapy and hormone therapy in patients with non-operated prostate cancer

Vigna‐Taglianti, Riccardo; Russi, Elvio; Attanasio, Roberto; Gianello, Luca; Denaro, Nerina; Lucio, Francesco; Arena, Giuseppe; Buglione, Michela; Pergolizzi, Stefano; Ricardi, Umberto; Magrini, Stefano Maria

doi:10.1016/j.urolonc.2012.10.011

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…The question of PSA bounce with high-dose regimens is particularly interesting because benign rises in PSA may lead to unnecessary intervention. 24 This phenomenon has been examined in patients treated with BRT alone or BRT in combination with EBRT, EBRT alone, and SBRT. [25][26][27][28][29] 31 At 8 years, the addition of a course of 6 months of neoadjuvant/concurrent ADT to a very high radiation dose did not confer a therapeutic advantage but added side effects and cost.…”

Section: Discussionmentioning

confidence: 99%

High-Dose Robotic Stereotactic Body Radiotherapy in the Treatment of Patients With Prostate Cancer

Pontoriero

Iatì

Mondello

et al. 2015

Technol Cancer Res Treat

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Background: Stereotactic body radiotherapy (SBRT) can emulate high dose rate brachytherapy (HDR-BRT) dose fractionation. We report our preliminary results using SBRT in monotherapy or pre-external-beam radiotherapy (EBRT) boost in patients with localized prostate cancer (LpC). The primary end point was the evaluation of both acute and late toxicities; secondary end point was the observation of prostate-specific antigen (PSA) nadir. Patients and Methods: Patients with LpC having prostate volume 90 cm 3 were enrolled in the present study. Patients were treated with SBRT alone or in combined modality (SBRT þ EBRT). SBRT was performed using a CyberKnife System (Accuray Incorporated, Sunnyvale, California) and fiducial tracking system. Results: From February 2008 to July 2013, 21 patients for monotherapy (38 Gy/4 fractions) and 5 for combined modality (9.5 Gy/2 fractions plus 46 Gy/23 fractions EBRT) were enrolled. Androgen deprivation therapy (ADT) was administered in 16 of the 26 patients. The median pretreatment PSA was 9.4 (range, 4.5-14.3) ng/mL. All patients completed the planned therapy. Acute Grade 1 toxicity was observed in 18 patients, genitourinary (GU) in 12 / 26 patients, and gastrointestinal (GI) in 6 / 26 patients. Acute Grade 2 GU toxicity was reported in 1 / 26 patients, and Grade 2 GI toxicity was observed in 2 / 26 patients. The median PSA nadir was 0.15 (range, 0.02 ¼ 1.4) ng/mL. Late toxicities were observed in 5 / 26 patients: Grade 1 GU (3 of 26), Grade 2 GU (1 of 26), and Grade 1 GI (1 of 26). Median follow-up was 21.5 (range, 8-65) months. Conclusions: Our preliminary results of SBRT ''simulating'' HDR for LpC confirm a minimal toxicity and an optimal PSA response. The PSA nadirs appear comparable with HDR-BRT.

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Section: Discussionmentioning

confidence: 99%

High-Dose Robotic Stereotactic Body Radiotherapy in the Treatment of Patients With Prostate Cancer

Pontoriero

Iatì

Mondello

et al. 2015

Technol Cancer Res Treat

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“…PSA is limited from release into the circulation (blood) by the normal basement membrane of prostatic ducts and acini as well as prostatic stroma. Although associated with PCa, increased PSA levels can also be caused by benign events such as prostatitis and BPH ( Figure 1 ) [ 23 ]. Furthermore, the level of PSA in blood, although correlated with long-term clinical outcomes at a population level, does not allow distinction between benign and aggressive PCa in individuals.…”

Section: Prostate Cancermentioning

confidence: 99%

“…Moreover, 80%–90% of patients who receive androgen ablation therapy develop castration-resistant tumors within 12–33 months, for which there is no cure [ 43 , 62 ]. The earliest indication of PCa recurrence (treatment failure) is termed ‘biochemical recurrence’ and is diagnosed following two successive PSA measurements 2 ng above the nadir—the nadir value being the baseline PSA measurement for a patient immediately following radical prostatectomy [ 23 , 29 , 63 ]. However, not all patients with detectable PSA post-surgery will manifest clinical progression and some patients may suffer cancer recurrence without a pre-emptive increase in serum PSA [ 29 ].…”

Section: Prostate Cancermentioning

confidence: 99%

The Role of Proteomics in Biomarker Development for Improved Patient Diagnosis and Clinical Decision Making in Prostate Cancer

et al. 2016

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Prostate Cancer (PCa) is the second most commonly diagnosed cancer in men worldwide. Although increased expression of prostate-specific antigen (PSA) is an effective indicator for the recurrence of PCa, its intended use as a screening marker for PCa is of considerable controversy. Recent research efforts in the field of PCa biomarkers have focused on the identification of tissue and fluid-based biomarkers that would be better able to stratify those individuals diagnosed with PCa who (i) might best receive no treatment (active surveillance of the disease); (ii) would benefit from existing treatments; or (iii) those who are likely to succumb to disease recurrence and/or have aggressive disease. The growing demand for better prostate cancer biomarkers has coincided with the development of improved discovery and evaluation technologies for multiplexed measurement of proteins in bio-fluids and tissues. This review aims to (i) provide an overview of these technologies as well as describe some of the candidate PCa protein biomarkers that have been discovered using them; (ii) address some of the general limitations in the clinical evaluation and validation of protein biomarkers; and (iii) make recommendations for strategies that could be adopted to improve the successful development of protein biomarkers to deliver improvements in personalized PCa patient decision making.

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“…In these patients, the earliest indication of treatment failure is termed biochemical recurrence (BR) and is recognized by two successive serum PSA measurements 2 ng/mL above the nadir, the nadir being defined as the lowest PSA levels following a patient’s treatment; however, PSA is considered to be a poor biomarker as a rise in PSA levels is not always associated with subsequent disease progression. Furthermore, treatment failure can occur without an increase in PSA levels. − It is evident, therefore, that there is a significant need for more reliable biomarkers to indicate, as early as possible, the likelihood of treatment failure and in this way to improve personalized patient care …”

Section: Introductionmentioning

confidence: 99%

Discovery and Longitudinal Evaluation of Candidate Protein Biomarkers for Disease Recurrence in Prostate Cancer

et al. 2015

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When compared with hormonal therapy alone, treatment with combined hormone and radiation therapy (CHRT) gives improved disease-specific survival outcomes for patients with prostate cancer; however, a significant number of CHRT patients still succumb to recurrent disease. The purpose of this study was to use longitudinal patient samples obtained as part of an ongoing noninterventional clinical trial (ICORG06-15) to identify and evaluate a potential serum protein signature of disease recurrence. Label-free LC-MS/MS based protein discovery was undertaken on depleted serum samples from CHRT patients who showed evidence of disease recurrence (n = 3) and time-matched patient controls (n = 3). A total of 104 proteins showed a significant change between these two groups. Multiple reaction monitoring (MRM) assays were designed for a subset of these proteins as part of a panel of putative prostate cancer biomarkers (41 proteins) for evaluation in longitudinal serum samples. These data revealed significant interpatient variability in individual protein expression between time of diagnosis, disease recurrence, and beyond and serve to highlight the importance of longitudinal patient samples for evaluating the use of candidate protein biomarkers in disease monitoring.

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Reliability of prostate-specific antigen-marker in determining biochemical failure during the first 2 years after external beam radiation therapy and hormone therapy in patients with non-operated prostate cancer

Cited by 6 publications

References 26 publications

High-Dose Robotic Stereotactic Body Radiotherapy in the Treatment of Patients With Prostate Cancer

High-Dose Robotic Stereotactic Body Radiotherapy in the Treatment of Patients With Prostate Cancer

The Role of Proteomics in Biomarker Development for Improved Patient Diagnosis and Clinical Decision Making in Prostate Cancer

Discovery and Longitudinal Evaluation of Candidate Protein Biomarkers for Disease Recurrence in Prostate Cancer

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