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
Session Publication Only
Topics Prostate Cancer
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Joaquim Bellmunt
Authors J. Bellmunt1, C. De La Piedra2, A. Gómez Caamaño3, M.J. Ribal4, F. Vázquez5, U. Anido6, E. Solsona7, P. Samper8, E. Esteban9, J. Morote10
  • 1Medical Oncology Department, Hospital del Mar, 08003 - Barcelona/ES
  • 2Clinical Biochemistry Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid/ES
  • 3Radiation Oncology Department, Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña/ES
  • 4Urology Department, Hospital Clínic, 08036 - Barcelona/ES
  • 5Urology Department, Hospital Universitario Virgen de las Nieves, Granada/ES
  • 6Oncology Department, Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña/ES
  • 7Urology Department, Instituto Valenciano de Oncología, Valencia/ES
  • 8Urology Department, Hospital Central de la Defensa Gómez Ulla, Madrid/ES
  • 9Hospital Universitario Central de Asturias, Oviedo/ES
  • 10Urology Department, Hospital Vall d'Hebrón, Barcelona/ES



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).


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.


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).


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.


All authors have declared no conflicts of interest.