Salvatore L Burgio1, Vincenza Conteduca1, Britt Rudnas2, Francesco Carrozza3, Enrico Campadelli4, Emanuela Bianchi1, Paolo Fabbri5, Marco Montanari6, Elisa Carretta2, Cecilia Menna1, Ugo De Giorgi7. 1. Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy. 2. Biostatistic and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy. 3. Oncology Unit, City Hospital, Faenza, Italy. 4. Oncology Unit, Umberto I Hospital, Lugo di Romagna, Italy. 5. Oncology Unit, Cervesi Hospital, Cattolica, Italy. 6. Oncology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy. 7. Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy. Electronic address: ugo.degiorgi@irst.emr.it.
Abstract
BACKGROUND: The aim of this study was to assess early serum prostate-specific antigen (PSA) changes in patients treated with abiraterone and to correlate those changes with clinical outcome. PATIENTS AND METHODS: We retrospectively evaluated 103 patients with castrate-resistant prostate cancer (CRPC) treated with compassionate use of abiraterone in Romagna, Italy. In these patients, serum PSA levels were monitored every 4 weeks, and a time course of serum PSA levels was obtained. The PSA flare phenomenon was evaluated. The log-rank test was applied to compare survival between groups of patients according to early PSA level changes. RESULTS: Of 103 patients, 43 (41.7%) had an immediate PSA response, whereas 9 (8.7%) had an initial PSA flare. Of the 9 patients with PSA flare, 5 attained a subsequent PSA response. The temporary PSA flare exceeded baseline values by a median of 19.7% (range, 5%-62.9%). The median PFS of the 9 patients in the PSA-flare group was higher compared with patients without the PSA flare (10.5 vs. 6.4 months; P = .0999) but was similar to the subgroup of patients with immediate PSA response (10.5 vs. 10.7 months; P = .7019). In the multivariate analysis, only the PSA response remained as a predictor of progression-free survival (PFS) (P < .0001) and overall survival (OS) (P = .0003), respectively. CONCLUSION: PSA flare occurs not infrequently in patients with CRPC who respond to abiraterone. Patients should be informed of this possible PSA flare phenomenon.
BACKGROUND: The aim of this study was to assess early serum prostate-specific antigen (PSA) changes in patients treated with abiraterone and to correlate those changes with clinical outcome. PATIENTS AND METHODS: We retrospectively evaluated 103 patients with castrate-resistant prostate cancer (CRPC) treated with compassionate use of abiraterone in Romagna, Italy. In these patients, serum PSA levels were monitored every 4 weeks, and a time course of serum PSA levels was obtained. The PSA flare phenomenon was evaluated. The log-rank test was applied to compare survival between groups of patients according to early PSA level changes. RESULTS: Of 103 patients, 43 (41.7%) had an immediate PSA response, whereas 9 (8.7%) had an initial PSA flare. Of the 9 patients with PSA flare, 5 attained a subsequent PSA response. The temporary PSA flare exceeded baseline values by a median of 19.7% (range, 5%-62.9%). The median PFS of the 9 patients in the PSA-flare group was higher compared with patients without the PSA flare (10.5 vs. 6.4 months; P = .0999) but was similar to the subgroup of patients with immediate PSA response (10.5 vs. 10.7 months; P = .7019). In the multivariate analysis, only the PSA response remained as a predictor of progression-free survival (PFS) (P < .0001) and overall survival (OS) (P = .0003), respectively. CONCLUSION:PSA flare occurs not infrequently in patients with CRPC who respond to abiraterone. Patients should be informed of this possible PSA flare phenomenon.
Authors: Kambiz Rahbar; Martin Bögeman; Anna Yordanova; Maria Eveslage; Michael Schäfers; Markus Essler; Hojjat Ahmadzadehfar Journal: Eur J Nucl Med Mol Imaging Date: 2017-11-13 Impact factor: 9.236
Authors: Francesco Ceci; Ken Herrmann; Boris Hadaschik; Paolo Castellucci; Stefano Fanti Journal: Eur J Nucl Med Mol Imaging Date: 2017-05-25 Impact factor: 9.236
Authors: S Gillessen; A Omlin; G Attard; J S de Bono; E Efstathiou; K Fizazi; S Halabi; P S Nelson; O Sartor; M R Smith; H R Soule; H Akaza; T M Beer; H Beltran; A M Chinnaiyan; G Daugaard; I D Davis; M De Santis; C G Drake; R A Eeles; S Fanti; M E Gleave; A Heidenreich; M Hussain; N D James; F E Lecouvet; C J Logothetis; K Mastris; S Nilsson; W K Oh; D Olmos; A R Padhani; C Parker; M A Rubin; J A Schalken; H I Scher; A Sella; N D Shore; E J Small; C N Sternberg; H Suzuki; C J Sweeney; I F Tannock; B Tombal Journal: Ann Oncol Date: 2015-06-03 Impact factor: 32.976