Conversion of nested reverse-transcriptase polymerase chain reaction from positive to negative status at peripheral blood during androgen ablation therapy is associated with long progression-free survival in stage D2 prostate cancer patients.
BACKGROUND
Nested reverse-transcriptase polymerase chain reaction (nested rt-PCR) for the detection of mRNA of prostate specific antigen (PSA) and prostate specific membrane antigen (PSMA) in peripheral blood samples (PB) and bone marrow biopsies (BM) can assess the extraprostatic growth of prostate cells.


METHODS
Nested rt-PCR for PSA and PSMA at PB and BM was performed (a) at diagnosis, (b) after 6 months from the initiation of combined androgen blockade [(CAB); triptorelin 3.75 mg, i.m., q28 days plus flutamide 250 mg, per os, tid] and, (c) at progression to androgen refractory stage in 28 patients with newly-diagnosed stage D2 prostate cancer.


RESULTS
At diagnosis, all patients were found to be rt-PCR positive for PSA and PSMA at BM while 7 (25%) were rt-PCR negative for PSA and PSMA at PB. Nine out of 21 patients with rt-PCR-positive status have converted to rt-PCR-negative status at PB during CAB while they remained rt-PCR-positive at BM. The rt-PCR-negative status at PB during CAB was associated with progression-free survival >12 months (p=0.029). At progression to androgen refractory stage all but 2 patients were rt-PCR-positive at PB for PSA and PSMA, among them 3 who were rt-PCR-negative at diagnosis.


CONCLUSIONS
Our data suggest that conversion to rt-PCR-negative status at PB for PSA and PSMA during objective clinical response to CAB is associated with long progression-free survival in stage D2 disease.
Sourla
A
A
Department of Experimental Physiology, Medical School, University of Athens, Greece.
Lembessis
P
P
Mitsiades
C
C
Dimopoulos
T
T
Skouteris
M
M
Metsinis
M
M
Ntounis
A
A
Ioannidis
A
A
Katsoulis
A
A
Kyragiannis
V
V
Lambou
T
T
Tsintavis
A
A
Koutsilieris
M
M
D000726:Androgen Antagonists / Q000627:therapeutic use*; D000954:Antigens, Surface; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D002268:Carboxypeptidases / Q000097:blood / Q000378:metabolism; D018572:Disease-Free Survival; D005485:Flutamide / Q000008:administration & dosage; D043425:Glutamate Carboxypeptidase II; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017329:Triptorelin Pamoate / Q000008:administration & dosage
D000726:Androgen Antagonists; D000954:Antigens, Surface; D018931:Antineoplastic Agents, Hormonal; D017329:Triptorelin Pamoate; D005485:Flutamide; D002268:Carboxypeptidases; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II; D017430:Prostate-Specific Antigen