Post-therapy serum prostate-specific antigen level and survival in patients with androgen-independent prostate cancer Journal Article


Authors: Scher, H. I.; Kelly, W. M. K.; Zhang, Z. F.; Ouyang, P.; Sun, M.; Schwartz, M.; Ding, C.; Wang, W.; Horak, I. D.; Kremer, A. B.
Article Title: Post-therapy serum prostate-specific antigen level and survival in patients with androgen-independent prostate cancer
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.
Keywords: cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; major clinical study; androgen; prednisone; drug efficacy; validation process; disease marker; alpha interferon; prostate specific antigen; reproducibility of results; risk factors; tumor marker; age; prostate cancer; prostate-specific antigen; prostatic neoplasms; survival time; outcomes research; lactate dehydrogenase; multivariate analysis; high risk population; bicalutamide; cyproterone acetate; isotretinoin; retinoic acid; lactate dehydrogenase blood level; suramin; hemoglobin determination; edatrexate; humans; prognosis; human; male; priority journal; article; liarozole
Journal Title: JNCI: Journal of the National Cancer Institute
Volume: 91
Issue: 3
ISSN: 0027-8874
Publisher: Oxford University Press  
Date Published: 1999-02-03
Start Page: 244
End Page: 251
Language: English
PUBMED: 10037102
PROVIDER: scopus
DOI: 10.1093/jnci/91.3.244
DOI/URL:
Notes: Source: Scopus
Altmetric Score
MSK Authors
  1. William K Kelly
    110 Kelly
  2. Howard Scher
    837 Scher
  3. Zuo-Feng Zhang
    96 Zhang
  4. Ming Sun
    19 Sun