title: Palliative treatment of bone metastases in hormone-refractory prostate cancer: effects of pamidronate on the carboxyterminal telopeptide of type-I collagen level in patients with increasing prostate-specific antigen levels.
abstract: OBJECTIVE
  Bisphosphonates have been reported to be effective in reducing bone pain and skeletal-related events associated with bone metastases in hormone-refractory prostate cancer (HRPC). However, whether bone resorption is reduced primarily by these particular drugs is difficult to evaluate because patients with HRPC are usually treated with secondary or tertiary hormonal manipulations including second-line antiandrogens, high-dose diethylstilbestrol, or low-dose dexamethasone therapies, some of which may also be effective. Thus, we assessed changes in the level of the carboxyterminal telopeptide of type-I collagen (ICTP), a bone resorption marker, before and after pamidronate administration in HRPC patients with increasing prostate-specific antigen (PSA) levels.
  
  
  METHODS
  Twenty-one HRPC patients with bone metastases and increasing PSA levels were intravenously treated with pamidronate at a dose of 30 mg either every 2 or every 4 weeks. Pamidronate administration was started immediately after confirmation of three consecutive increases in the PSA level.
  
  
  RESULTS
  In 14 patients (67%), the ICTP levels decreased after the administration of pamidronate, despite increasing PSA levels. In 7 of these cases, the ICTP levels were lower than those recorded for 6 months or longer before the start of pamidronate administration. The characteristics of the responders were compared with those of the non-responders.
  
  
  CONCLUSIONS
  In 67% of the HRPC patients with increasing PSA levels, pamidronate reduced the accelerated turnover of bone metabolism caused by metastases of prostate cancer.
authors.affiliation: Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan. hidenori@msic.med.osaka-cu.ac.jp
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kawashima
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kuratsukuri
authors.forename: Junji
authors.initials: J
authors.lastname: Uchida
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Sugimura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tamada
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Nishisaka
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kumata
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Iwai
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ikemoto
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Ezaki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakatani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D024042:Collagen Type I / Q000187:drug effects*; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D000077268:Pamidronate; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D017430:Prostate-Specific Antigen; D000077268:Pamidronate