Post-therapy serum prostate-specific antigen level and survival in patients with androgen-independent prostate cancer.
Publication/Presentation Date
2-3-1999
Abstract
BACKGROUND: With an hypothesis that post-chemotherapy changes in serum prostate-specific antigen (PSA) levels might serve as a surrogate marker for assessing prostate cancer outcome (i.e., survival), we studied the relationship between pretherapy and post-therapy prognostic factors and survival in patients with androgen-independent prostate cancer.
METHODS: A prognostic model for survival based on pretherapy and post-therapy parameters was developed from the clinical data on 254 patients with androgen-independent prostate cancer treated with 11 different protocol therapies at Memorial Sloan-Kettering Cancer Center. The model was validated by use of an independent dataset of 541 patients enrolled in two randomized phase III trials.
RESULTS: In multivariate analysis, a post-therapy decline in PSA levels of 50% achieved in 12 weeks was a statistically significant factor associated with survival (two-sided P = .0012). A similar outcome was obtained with the use of an 8-week time frame. Elevated pretherapy level of serum lactate dehydrogenase (two-sided P = .0001), lower pretherapy level of hemoglobin (P = .0001), and younger age (two-sided P = .0430) had a statistically significant negative impact on outcome. Median survival times were 23, 17, and 9 months for low-, intermediate-, and high-risk groups of patients defined by the prognostic model, respectively.
CONCLUSION: This study confirms the prognostic value of a post-therapy decline in PSA of 50% or greater from baseline in relation to survival in patients with androgen-independent prostate cancer treated with a variety of therapies. Two consecutive determinations at 4-week intervals can be used as an end point for efficacy in phase II trials of therapies in this disease.
Volume
91
Issue
3
First Page
244
Last Page
251
ISSN
0027-8874
Published In/Presented At
Scher, H. I., Kelly, W. M., Zhang, Z. F., Ouyang, P., Sun, M., Schwartz, M., Ding, C., Wang, W., Horak, I. D., & Kremer, A. B. (1999). Post-therapy serum prostate-specific antigen level and survival in patients with androgen-independent prostate cancer. Journal of the National Cancer Institute, 91(3), 244–251. https://doi.org/10.1093/jnci/91.3.244
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
10037102
Department(s)
Administration and Leadership
Document Type
Article