861 SERUM ALKALINE PHOSPHATASE AS A BIOMARKER FOR DIFFERENTIATING PROSTATE-SPECIFIC ANTIGEN SURGE PHENOMENON FROM PROGRESSION IN PATIENTS WITH ANDROGEN-INDEPENDENT PROSTATE CANCER RECEIVING SYSTEMIC CHEMOTHERAPY (2010)

You have accessJournal of UrologyProstate Cancer: Advanced III1 Apr 2010861 SERUM ALKALINE PHOSPHATASE AS A BIOMARKER FOR DIFFERENTIATING PROSTATE-SPECIFIC ANTIGEN SURGE PHENOMENON FROM PROGRESSION IN PATIENTS WITH ANDROGEN-INDEPENDENT PROSTATE CANCER RECEIVING SYSTEMIC CHEMOTHERAPY Kyung Seok Han, Won Sik Ham, Young Hoon Lee, Woong Kyu Han, Koon Ho Rha, Young Deuk Choi, Seung Choul Yang, and Sung Joon Hong Kyung Seok HanKyung Seok Han More articles by this author , Won Sik HamWon Sik Ham More articles by this author , Young Hoon LeeYoung Hoon Lee More articles by this author , Woong Kyu HanWoong Kyu Han More articles by this author , Koon Ho RhaKoon Ho Rha More articles by this author , Young Deuk ChoiYoung Deuk Choi More articles by this author , Seung Choul YangSeung Choul Yang More articles by this author , and Sung Joon HongSung Joon Hong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1617AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Early transient rise in prostate-specific antigen (PSA) after the initiation of chemotherapy in castration resistant prostate cancer (CRPC), called postchemotherapy PSA surge syndrome, has been reported. However, investigators could not find predictive factors for PSA surge. We investigated whether bone-related serum markers can differentiate PSA surge from PSA progression in patients with CRPC. METHODS This study enrolled 83 patients with CRPC who received systemic chemotherapy between 2002 and 2008. Patients in whom pre- or post-treatment PSA levels could not be obtained were excluded from this study. The baseline levels and serial changes in the PSA and alkaline phosphatase (ALP) were assessed. The pretreatment baseline and follow-up data were evaluated, including age, performance score, PSA, Gleason score, ALP, calcium level, and hemoglobin. Pretreatment baseline and serum parameters after the first cycle of chemotherapy were included in univariate and multivariate analyses. RESULTS At the first response evaluation after chemotherapy, PSA was increased in 38 patients (45.8%). There were distinct patterns in the sequential PSA changes. The PSA increased continuously or did not decrease to a stable level until the third evaluation in 21 (55.3%) patients, while the PSA decreased to a stable level before the third evaluation in 17 (44.7%). Overall, a PSA surge occurred in 17 patients (20.5%). Univariate analysis showed that no baseline parameters were significantly associated with the PSA surge, while an initial decrease in ALP (p=0.001), change in the ALP ratio (p=0.008), and the median calcium level (p=0.012) were significantly associated with a PSA surge. Multivariate logistic regression analysis showed that the change in the ALP level was an independent predictor of a PSA surge (p=0.017). CONCLUSIONS A significant portion of patients with CRPC experience an increase and subsequent decrease in PSA after initiating chemotherapy. The initial changes in the serum ALP after chemotherapy can differentiate PSA progression from PSA surge in CRPC patients with increases in PSA at the first response evaluation after chemotherapy. Seoul, Republic of Korea© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e336 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Metrics Author Information Kyung Seok Han More articles by this author Won Sik Ham More articles by this author Young Hoon Lee More articles by this author Woong Kyu Han More articles by this author Koon Ho Rha More articles by this author Young Deuk Choi More articles by this author Seung Choul Yang More articles by this author Sung Joon Hong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...