Combined androgen blockade therapy can convert RT-PCR detection of prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) transcripts from positive to negative in the peripheral blood of patients with clinically localized prostate cancer and increase biochemical failure-free survival after curative therapy.
BACKGROUND
The clinical relevance of positive molecular staging as defined by reverse transcriptase-polymerase chain reaction (RT-PCR) detections of both prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) transcripts in the peripheral blood (PB) of patients with prostate cancer is still debatable.


METHODS
We analyzed the biochemical failure-free survival (bFFS) of prostate cancer patients with positive molecular staging who underwent immediate curative therapy (Group I, n=39) compared to prostate cancer patients who did convert their positive molecular staging by the administration of combined androgen blockade (CAB) for 12 months prior to curative treatment (Group II, n=15).


RESULTS
The median bFFS for Group I was 9 months (95% CI 5-13 months) and was significantly lower compared to Group II (>36 months, p<0.001). In Group I, the median time for PSA values of >2.0 ng/mL was 18 months (95% CI 12-21 months, range 12-36 months). Notably, only one patient from Group II reached PSA values>2.0 ng/mL at 36 months post-curative treatment.


CONCLUSIONS
In patients with clinically localized prostate cancer and positive RT-PCR detection of PSA and PSMA transcripts in PB, CAB can convert positive molecular staging status to negative and by doing so it modifies the post-curative therapy bFFS of patients with clinically localized prostate cancer.
Lembessis
Peter
P
Department of Experimental Physiology, National and Kapodistrian University of Athens, Athens, Greece.
Msaouel
Pavlos
P
Halapas
Antonis
A
Sourla
Antigone
A
Panteleakou
Zacharoula
Z
Pissimissis
Nikolaos
N
Milathianakis
Constantine
C
Bogdanos
John
J
Papaioannou
Andreas
A
Maragoudakis
Evangelos
E
Dardoufas
Constantine
C
Dimopoulos
Theodoros
T
Koutsilieris
Michael
M
D000368:Aged; D000726:Androgen Antagonists / Q000494:pharmacology*; D000954:Antigens, Surface; D018572:Disease-Free Survival; D043425:Glutamate Carboxypeptidase II; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000235:genetics*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000628:therapy; D012333:RNA, Messenger / Q000097:blood / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*
D000726:Androgen Antagonists; D000954:Antigens, Surface; D012333:RNA, Messenger; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II; D017430:Prostate-Specific Antigen