Bone scan index: A quantitative treatment response biomarker for castration-resistant metastatic prostate cancer Journal Article


Authors: Dennis, E. R.; Jia, X.; Mezheritskiy, I. S.; Stephenson, R. D.; Schoder, H.; Fox, J. J.; Heller, G.; Scher, H. I.; Larson, S. M.; Morris, M. J.
Article Title: Bone scan index: A quantitative treatment response biomarker for castration-resistant metastatic prostate cancer
Abstract: Purpose: There is currently no imaging biomarker for metastatic prostate cancer. The bone scan index (BSI) is a promising candidate, being a reproducible, quantitative expression of tumor burden seen on bone scintigraphy. Prior studies have shown the prognostic value of a baseline BSI. This study tested whether treatment-related changes in BSI are prognostic for survival and compared BSI to prostate-specific antigen (PSA) as an outcome measure. Patients and Methods: We retrospectively examined serial bone scans from patients with castration-resistant metastatic prostate cancer (CRMPC) enrolled in four clinical trials. We calculated BSI at baseline and at 3 and 6 months on treatment and performed univariate and bivariate analyses of PSA, BSI, and survival. Results: Eighty-eight patients were scanned, 81 of whom have died. In the univariate analysis, the log percent change in BSI from baseline to 3 and 6 months on treatment prognosticated for survival (hazard ratio [HR], 2.44; P = .0089 and HR, 2.54; P < .001, respectively). A doubling in BSI resulted in a 1.9-fold increase in risk of death. Log percent change in PSA at 6 months on treatment was also associated with survival (HR, 1.298; P = .013). In the bivariate analysis, change in BSI while adjusting for PSA was prognostic at 3 and 6 months on treatment (HR, 2.368; P = .012 and HR, 2.226; P = .002, respectively), but while adjusting for BSI, PSA was not prognostic. Conclusion: These data furnish early evidence that on-treatment changes in BSI are a response indicator and support further exploration of bone scintigraphy as an imaging biomarker in CRMPC. © 2012 by American Society of Clinical Oncology.
Keywords: adult; cancer survival; treatment response; aged; major clinical study; bone metastasis; prostate specific antigen; tumor volume; mathematical model; bone scintiscanning; castration resistant prostate cancer; bone scan index; musculoskeletal system parameters
Journal Title: Journal of Clinical Oncology
Volume: 30
Issue: 5
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2012-02-10
Start Page: 519
End Page: 524
Language: English
DOI: 10.1200/jco.2011.36.5791
PROVIDER: scopus
PMCID: PMC3295554
PUBMED: 22231045
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 2 April 2012" - "CODEN: JCOND" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Josef J Fox
    45 Fox
  2. Glenn Heller
    303 Heller
  3. Michael Morris
    280 Morris
  4. Xiaoyu Jia
    44 Jia
  5. Heiko Schoder
    289 Schoder
  6. Steven M Larson
    779 Larson
  7. Howard Scher
    835 Scher
  8. Elizabeth Rose Dennis
    5 Dennis