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Combined androgen blockade therapy can convert RT-PCR detection of prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) transcripts from positive to negative in the peripheral blood of patients with clinically localized prostate cancer and increase biochemical failure-free survival after curative therapy
Published/Copyright:
October 31, 2007
Abstract
Background: The clinical relevance of positive molecular staging as defined by reverse transcriptase-polymerase chain reaction (RT-PCR) detections of both prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) transcripts in the peripheral blood (PB) of patients with prostate cancer is still debatable.
Methods: We analyzed the biochemical failure-free survival (bFFS) of prostate cancer patients with positive molecular staging who underwent immediate curative therapy (Group I, n=39) compared to prostate cancer patients who did convert their positive molecular staging by the administration of combined androgen blockade (CAB) for 12 months prior to curative treatment (Group II, n=15).
Results: The median bFFS for Group I was 9 months (95% CI 5–13 months) and was significantly lower compared to Group II (>36 months, p<0.001). In Group I, the median time for PSA values of >2.0 ng/mL was 18 months (95% CI 12–21 months, range 12–36 months). Notably, only one patient from Group II reached PSA values >2.0 ng/mL at 36 months post-curative treatment.
Conclusions: In patients with clinically localized prostate cancer and positive RT-PCR detection of PSA and PSMA transcripts in PB, CAB can convert positive molecular staging status to negative and by doing so it modifies the post-curative therapy bFFS of patients with clinically localized prostate cancer.
Clin Chem Leb Med 2007;45:1488–94.
Keywords: combined androgen blockade; pre-operative risk stratification; prostate cancer; prostate-specific antigen (PSA); prostate-specific membrane antigen (PSMA); reverse transcriptase-polymerase chain reaction (RT-PCR)
Received: 2007-3-29
Accepted: 2007-6-29
Published Online: 2007-10-31
Published in Print: 2007-11-01
©2007 by Walter de Gruyter Berlin New York
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