945 - Bone turnover markers and potential correlation with outcomes in patients with genitourinary cancer (prostate) and bone metastasis (results of TUGAM...
|Date||28 September 2012|
|Event||ESMO Congress 2012|
|Topics|| Prostate Cancer
J. Bellmunt1, C. De La Piedra2, A. Gómez Caamaño3, M.J. Ribal4, F. Vázquez5, U. Anido6, E. Solsona7, P. Samper8, E. Esteban9, J. Morote10
Levels of bone turnover markers (BTM) might be correlated with outcome in terms of skeletal related events (SRE), disease progression and death. The aim of this study was to determine the possible correlation between BTM, disease progression, SREs and death in patients with genitourinary cancer and bone metastases (BM) treated with zoledronic acid (ZA).Methods
Observational, prospective, multicenter study. Patients with genitourinary cancer (prostate, renal, bladder) and BM were included. BTM determined were: carboxiterminal telopeptide of type I collagen (�-CTX) and bone specific alkaline phosphatase (BALP) by ELISA (immunoenzymatic assay, IDS UK), and aminoterminal propeptide of type I collagen (P1NP) by automatised assays (Elecsys, Roche). All BTM were determined at baseline (V0) and every 3 mo of treatment until Month 18 (V6). All patients started treatment with ZA 4 mg IV every 3-4 weeks at the beginning of the study.Results
Data of 168 patients with genitourinary cancer were analyzed. In this work data of prostate cancer patients (n = 95) are presented. Population basal characteristics [35 new, without previous treatment (N) / 60 pre-treated, with anti-hormonal treatment (P)]: mean age (years): 72.1; median time from tumor diagnosis (months): 7.6 (N) / 11.6 (P); ECOG 0-1: 90% (N) / 87.5% (P). Patients with pathologic baseline levels were: 47.1% �-CTX, 64.7% BALP and 57.1% P1NP (N) and 48.3% �-CTX, 80.7% BALP and 60% P1NP (P). After 6 mo.: 28%, 48% and 32% (N) and 32%, 59.4% and 31.3% (P) presented pathologic values of �-CTX, BALP and P1NP respectively. Normalized levels remained steady throughout 18 mo follow-up. Reductions from baseline to month 3 in BALP levels correlated with lower risk of death (p = 0.0219) (Cox regression analysis).Conclusions
Elevation of baseline BTM levels is frequently present in advanced prostate cancer with bone metastasis. Addition of AZ to standard systemic therapy reduces BTM levels, even though in those highly hormone sensitive ones. A significant association was observed between elevated levels of BALP and death throughout follow-up.Disclosure
All authors have declared no conflicts of interest.