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Serum procollagen 1 amino‐terminal propeptide ( P 1 NP ) in prostate cancer: Pitfalls of its use as an early surrogate marker for bone metastasis
Author(s) -
Moseshvili Eka,
Joseph David J,
Spry Nigel A,
Cohen Ronald J,
Abreu Alberta,
Kautto Allison,
Denham James W
Publication year - 2014
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12134
Subject(s) - medicine , prostate cancer , androgen deprivation therapy , bone metastasis , bone remodeling , pca3 , procollagen peptidase , cancer , metastasis , oncology , prostate , prostate specific antigen , endocrinology , gastroenterology
Abstract Introduction Procollagen 1 amino‐terminal propeptide ( P 1 NP ) is a bone formation marker and has been shown to have a strong association with the extent of bone metastases ( BM ) in patients with advanced prostate cancer. More recently, its levels were found to be affected by androgen deprivation therapies and bisphosphonates. We investigated the role of P 1 NP as a surrogate marker of sub‐radiological skeletal metastases in prostate cancer patients with biochemical failure ( BF ). Methods BePrepared is a prospective longitudinal substudy of RADAR trial in which serial P 1 NP s were collected at regular intervals for 123 patients who had completed RADAR protocol treatment. Results There was no trend identified in P 1 NP levels prior to diagnosis of BM . We found that there was no difference in P 1 NP concentrations at the time of diagnosis of BM in the group that developed BM compared with P 1 NP levels in groups with only nodal metastases or BF . In the group of patients who did not experience BF , P 1 NP was affected by previous luteinizing hormone‐releasing hormone‐agonist and bisphosphonate therapy. Hence, patients who received an 18‐month course of androgen deprivation without bisphosphonates had significantly higher P 1 NP values than patients with shorter androgen deprivation therapy ( ADT ) course combined with a course of bisphosphonates. Conclusion P 1 NP is not a sensitive serum marker of early BM in high‐risk prostate cancer patients with BF and low prostate‐specific antigen levels as its levels are affected by prior history of bone remodelling therapies such as ADT and bisphosphonates.