Serial Markers of Bone Turnover in Men with Metastatic Prostate Cancer Treated with Zoledronic Acid for Detection of Bone Metastases Progression

• Published in: European urology Vol. 52; no. 5; pp. 1381 - 1387
• Main Authors: Lein, Michael, Wirth, Manfred, Miller, Kurt, Eickenberg, Hans-Udo, Weißbach, Lothar, Schmidt, Katja, Haus, Ulrike, Stephan, Carsten, Meissner, Sven, Loening, Stefan A, Jung, Klaus
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier 01.11.2007
• Subjects: Aged; Alkaline Phosphatase - blood; Biological and medical sciences; Biomarkers, Tumor - blood; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - therapeutic use; Bone Neoplasms - blood; Bone Neoplasms - drug therapy; Bone Neoplasms - secondary; Collagen Type I - blood; Diphosphonates - administration & dosage; Diphosphonates - therapeutic use; Disease Progression; Diseases of the osteoarticular system; Dose-Response Relationship, Drug; Enzyme-Linked Immunosorbent Assay; Follow-Up Studies; Humans; Imidazoles - administration & dosage; Imidazoles - therapeutic use; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Peptide Fragments - blood; Peptides - blood; Procollagen - blood; Prognosis; Prospective Studies; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - pathology; Tumors of striated muscle and skeleton; Tumors of the urinary system; Urinary tract. Prostate gland; Urology; Bisphosphonate treatment; Bone markers; Prostate cancer; Bone metastases; Nephrology; Prognosis; Prostate disease; Diseases of the osteoarticular system; Biological marker; Diphosphonic acid derivatives; Male; Bisphosphonates; Urology; Osteoarticular system; Turnover; Zoledronic acid; Adult; Evolution; Advanced stage; Diagnosis; Male genital diseases; Human; Urinary system disease; Biological indicator; Malignant tumor; Bone metastasis; Treatment; Bisphosphonate treatment,Bone markers,Bone metastases,Prostate cancer; Metastatic; Bone
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2007.02.033

Abstract Objectives This study assessed the usefulness of serial measurements of bone turnover markers in men with metastatic prostate cancer treated with zoledronic acid to detect disease progression. Methods Serum measurements of total alkaline phosphatase (tALP), bone-specific alkaline phosphatase (bALP), cross-linked N-terminal (NTx) and cross-linked C-terminal (CTx) telopeptides of type I collagen, amino-terminal procollagen propeptides of type I collagen (PINP), C-terminal telopeptides of type I collagen (ICTP), and prostate-specific antigen (PSA) were performed in 77 prostate cancer patients suffering from bone metastases and treated with zoledronic acid up to 15 mo. Fifty patients were with and 27 patients without objective evidence of metastatic bone progression during the administration of zoledronic acid. Results The baseline bone marker concentrations were not significantly different between the groups. After administration of zoledronic acid all bone markers except of ICTP decreased compared with baseline. CTx showed the greatest decrease. In patients with metastatic bone progression PINP, tALP, bALP, and ICTP were significantly higher at weeks 24, 36, 48, and 60 after starting treatment with zoledronic acid compared with patients without progression. In addition to the information of prostate-specific antigen as a monitoring parameter, the bone formation marker showed a better distinction between patients with and without disease progression. Conclusions Selected bone turnover markers provide valuable information regarding progression of bone metastasis in men with metastatic prostate cancer under bisphosphonate therapy. The clinical impact should be confirmed in prospective randomised studies.