Trimetrexate in prostatic cancer: Preliminary observations on the use of prostate-specific antigen and acid phosphatase as a marker in measurable hormone-refractory disease Journal Article

  

Authors:	Scher, H. I.; Curley, T.; Geller, N.; Engstrom, C.; Dershaw, D. D.; Lin, S. Y.; Fitzpatrick, K.; Nisselbaum, J.; Schwartz, M.; Bezirdjian, L.; Eisenberger, M.
Article Title:	Trimetrexate in prostatic cancer: Preliminary observations on the use of prostate-specific antigen and acid phosphatase as a marker in measurable hormone-refractory disease
Abstract:	Thirty-one patients with bidimensionally measurable hormone-refractory prostatic cancer received trimetrexate (TMTX). Serial values of prostate-specific antigen (PSA) and acid phosphatase (SAP) were correlated with response. Five patients (17%; 95% confidence interval, 3% to 30%) achieved a partial remission for a median of 3 months (range, 3 to 7.5 months). Marker levels showed large variations with no discernible patterns. Serial PSA and SAP in 19 patients with abnormal baseline values showed a correlation with measurable disease response in only 68% (13 of 19) and 47% (nine of 19) of patients, respectively. Values were then smoothed using an exploratory data analysis technique of running medians and averages. Trends in marker changes were much more apparent. Several "decision rules" were evaluated for use of markers as indices of disease progression. A 50% increase from the patient's minimum value in either PSA or SAP on two successive determinations correlated with progression in 90% of cases in this trial. TMTX has modest activity in prostatic cancer, and further trials are not warranted. Biochemical markers do not uniformly reflect disease activity in hormonerefractory disease, and changes in biochemical markers must be interpreted cautiously when used as the sole end point to assess efficacy in clinical trials. © 1990 by American Society of Clinical Oncology.
Keywords:	adult; clinical article; aged; antineoplastic agents; conference paper; prostate specific antigen; tumor markers, biological; time factors; prostate cancer; prostate-specific antigen; prostatic neoplasms; antigens, neoplasm; cancer epidemiology; quinazolines; intravenous drug administration; acid phosphatase; middle age; trimetrexate; acid phosphatase prostate isoenzyme; human; male; priority journal; support, non-u.s. gov't; support, u.s. gov't, p.h.s.
Journal Title:	Journal of Clinical Oncology
Volume:	8
Issue:	11
ISSN:	0732-183X
Publisher:	American Society of Clinical Oncology
Date Published:	1990-11-01
Start Page:	1830
End Page:	1838
Language:	English
DOI:	10.1200/jco.1990.8.11.1830
PUBMED:	1700078
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0025186406&doi=10.1200%2fJCO.1990.8.11.1830&partnerID=40&md5=1cd9f7e3c52d40488228b0c23a4cbdb7
Notes:	Article -- Export Date: 27 January 2020 -- Source: Scopus

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