912P - Serum chromogranin a in metastatic carcinoma prostate - a prognostic marker for hormonal therapy

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Biomarkers
Prostate Cancer
Presenter Gouri Shankar Bhattacharyya
Authors G.S. Bhattacharyya1, H. Malhotra2, P.M. Parikh3, J.K. Singh4, G.B. Kanaka5, S. Basu6, M. Singh7, T. Shahid8, J. Biswas9, A.A. Ranade3
  • 1Medical Oncology & Hemato-oncology, FORTIS Hospital, Anandapur,, 700107 - KOLKATA/IN
  • 2Medicine & Medical Oncology, SMS Hospital, IN-302004 - Jaipur/IN
  • 3Medical Oncology & Hematology, Indian Co-operative Oncology NetworkICON ARO, IN-400028 - Mumbai/IN
  • 4Cancer Insuitut, Mahavir Cancer Sansthan, IN-801505 - Patna/IN
  • 5Medical Oncology, Kidwai Memorial Institute of Oncology, IN-560029 - Bangalore/IN
  • 6Radiotherapy, AMRI Hospital, IN-700029 - Kolkata/IN
  • 7Cancer Insuitute, Mahavir Cancer Sansthan, IN-801505 - Patna/IN
  • 8Radiotherapy, AMRI Hospital, 700029 - Kolkata/IN
  • 9Medical Director, Chittaranjan National Cancer Institute, 700 026 - Kolkata/IN

Abstract

Introduction

Treatment of metastatic carcinoma prostate is hormonal manipulation. Response to the hormone therapy is high but duration is variable. Attempt to develop a marker has clinical relevance and importance to such activity. Aim 1. To show that Serum Chromogranin-A (CgA) at baseline can define the risk population of metastatic Ca Prostate 2. Baseline Serum Chromogranin-A (CgA) may be able to choose patient who may require early non-hormonal interventions.

Method

Study was done in a period of 2005 to 2010. 160 patients of Metastatic Ca Prostate who had no chemotherapy or hormonal therapy were included. All patients were staged by Bone Scan, CT scan, and Trans Rectal Ultrasound. Routine biochemistry was done. Serum Chromogranin-A (CgA) was assayed by immune-fluorescence microscopy (IFM) and immuno chemiluminometer (ICMA). PSA was assayed by immuno chemiluminometer (ICMA). Gleason's score was obtained from biopsy report. All patients were serially followed up at three monthly intervals. Statistical analysis, descriptive analysis for population was used. Patients were stratified on the basis of Gleason's score >7 or <7 and PSA levels >10 or <10. Spearman's coefficient was used along with ANOVA non parametric tests. Primary end point of the study was PSA progression and was measured as from the time the patient was detected as metastatic

Results

Out of the 160 patients at the end of 3 years surveillance 59 had progressed; 8 patients with Gleason's score 7 out of 62 had progressed and 51 out of 96 patients with Gleason's score >7 had progressed. 14 patients out of 40 with PSA <10 progressed while 45 patients out of 120 progressed. 18 out of 100 patients with CgA <100 had progressed while 41 out of 60 had progressed. At the end of 5 years 25% of patients (40 patients) with CgA >100 are alive while 75% of patients (120 patients) with CgA <100 are alive.

Conclusion

a) CgA assay at metastatic presentation seems like an important marker for prognosis b) Needs to be validated in a larger study c) May be a marker in choosing early chemotherapy d) Neuroendocrine markers in early ca prostate should be studied and biopsy should be stratified in the presence or absence of neuroendocrine differentiation. Keywords Metastatic Ca Prostate; Serum Chromogranin-A; Disease progression

Disclosure

All authors have declared no conflicts of interest.