Review Article

Beyond PSA: Managing Modern Therapeutic Options in Metastatic Castration-Resistant Prostate Cancer

Authors: Fatima H. Karzai, MD, Ravi A. Madan, MD, William D. Figg, PharmD

Abstract

Prostate cancer remains a significant cause of cancer-related deaths in men in the United States. Significant advances in the treatment of metastatic castration-resistant prostate cancer have been made in recent years with the arrival of new therapeutic targets and options. The definition of progression of disease must be thought of in the context of clinical symptoms and radiographic evidence rather than as changes in prostate-specific antigen (PSA). Ultimately, the use of PSA criteria alone should not be used to determine the progression of disease; instead, PSA should be evaluated in combination with other clinical data.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Siegel R, Ma J, Zou Z, et al. Cancer statistics, 2014. CA Cancer J Clin 2014;64:9-29.
 
2. Han M, Partin AW, Pound CR, et al. Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15-year Johns Hopkins experience. Urol Clin North Am 2001;28:555-565.
 
3. Mohler ML, Coss CC, Duke CB 3rd, et al. Androgen receptor antagonists: a patent review (2008-2011). Expert Opin Ther Pat 2012;22:541-565.
 
4. Papalia MA, Davis SR. What it the rationale for androgen therapy for women? Treat Endocrinol 2003;2:77-84.
 
5. Balk SP, Ko YJ, Bubley GJ. Biology of prostate-specific antigen. J Clin Oncol 2003;21:383-391.
 
6. Haythorn MR, Ablin RJ. Prostate-specific antigen testing across the spectrum of prostate cancer. Biomark Med 2011;5:515-526.
 
7. Wang MC, Valenzuela LA, Murphy TM, et al. Purification of a human prostate specific antigen. Invest Urol 1979;17:159-163.
 
8. Chu TM. Prostate specific antigen (PSA): the historical perspective. http://www.medicine.mcgill.ca/mjm/v02n02/psa.html. Published 1996. Accessed July 3, 2014.
 
9. Kuriyama M, Wang MC, Lee CI, et al. Use of human prostate-specific antigen in monitoring prostate cancer. Cancer Res 1981;41:3874-3876.
 
10. Marberger M, Freedland SJ, Andriole GL, et al. Usefulness of prostate-specific antigen (PSA) rise as a marker of prostate cancer in men treated with dutasteride: lessons from the REDUCE study. BJU Int 2012;109:1162-1169.
 
11. Naghavi AO, Strom TJ, Nethers K, et al. Clinical implications of a prostate-specific antigen bounce after radiation therapy for prostate cancer. Int J Clin Oncol 2014 Sep 6 [Epub ahead of print] .
 
12. Tannock IF, de Wit R, Berry WR, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004;351:1502-1512.
 
13. Roessner M, de Wit R, Tannock IF, et al. Prostate-specific antigen (PSA) response as a surrogate endpoint for overall survival (OS): analysis of TAX327 study comparing docetaxel plus prednisone with mitoxantrone plus prednisone in advanced prostate cancer. 2005 ASCO Annual Meeting Proceedings. J Clin Oncol 2005;23(Suppl 4554) .
 
14. Olbert PJ, Hegele A, Kraeuter P, et al. Clinical significance of a prostate-specific antigen flare phenomenon in patients with hormone-refractory prostate cancer receiving docetaxel. Anticancer Drugs 2006;17:993-996.
 
15. Ning YM, Gulley JL, Arlen PM, et al. Phase II trial of bevacizumab, thalidomide, docetaxel, and prednisone in patients with metastatic castration-resistant prostate cancer. J Clin Oncol 2010;28:2070-2076.
 
16. Dahut WL, Scripture C, Posadas E, et al. A phase II clinical trial of sorafenib in androgen-independent prostate cancer. Clin Cancer Res 2008;14:209-214.
 
17. Bubley GJ, Carducci M, Dahut W, et al. Eligibility and response guidelines for phase II clinical trials in androgen-independent prostate cancer: recommendations from the Prostate-Specific Antigen Working Group. J Clin Oncol 1999;17:3461-3467.
 
18. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92:205-216.
 
19. Scher HI, Halabi S, Tannock I, et al. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol 2008;26:1148-1159.
 
20. Scher HI, Morris MJ, Kelly WK, et al. Prostate cancer clinical trial endpoints: ‘‘RECIST’’ing a step backwards. Clin Cancer Res 2005;11:5223-5232.
 
21. Halabi S, Small EJ, Kantoff PW, et al. Prognostic model for predicting survival in men with hormone-refractory metastatic prostate cancer. J Clin Oncol 2003;21:1232-1237.
 
22. Levenson RM, Sauerbrunn BJ, Bates HR, et al. Comparative value of bone scintigraphy and radiology in monitoring tumor response in systemically treated prostate carcinoma. Radiology 1983;146:513-518.
 
23. Cook GJ, Venkitaraman R, Sohaib AS, et al. The diagnostic utility of the flare phenomenon on bone scintigraphy in staging prostate cancer. Eur J Nucl Med Mol Imag 2011;38:7-13.
 
24. Gillespie PJ, Alexander JL, Edelstyn GA. Changes in 87mSR concentrations in skeletal metastases in patients responding to cyclical combination chemotherapy for advanced breast cancer. J Nucl Med 1975;16:191-193.
 
25. Alexander J, Gillespie PJ, Edelstyn GA. Serial bone scanning using technetium 99 m diphosphonate in patients undergoing cyclical combination chemotherapy for advanced breast cancer. Clin Nucl Med 1976;1:13-17.
 
26. Rossleigh MA, Lovegrove FT, Reynolds PM, et al. The assessment of response to therapy in bone metastases in breast cancer. Aust N Z J Med 1984;14:19-22.
 
27. Fleming MT, Morris MJ, Heller G, et al. Post-therapy changes in PSA as an outcome measure in prostate cancer clinical trials. Nat Clin Pract Oncol 2006;3:658-667.
 
28. Mukherji D, Pezaro CJ, De-Bono JS. MDV3100 for the treatment of prostate cancer. Expert Opin Investig Drugs 2012;21:227-233.
 
29. Figg WD, Ammerman K, Patronas N, et al. Lack of correlation between prostate-specific antigen and the presence of measurable soft tissue metastases in hormone-refractory prostate cancer. Cancer Invest 1996;14:513-517.
 
30. Gardner TA, Elzey BD, Hahn NM. Sipuleucel-T (Provenge) autologous vaccine approved for treatment of men with asymptomatic or minimally symptomatic castrate-resistant metastatic prostate cancer. Hum Vaccin Immunother 2012;8:534-539.
 
31. Kantoff PW, Higano CS, Shore ND, et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 2010;363:411-422.
 
32. Karan D, Holzbeierlein JM, Van Veldhuizen P, et al. Cancer immunotherapy: a paradigm shift for prostate cancer treatment. Nat Rev Urol 2012;9:376-385.
 
33. Nelson JB, Love W, Chin JL, et al. Phase 3, randomized, controlled trial of atrasentan in patients with nonmetastatic, hormone-refractory prostate cancer. Cancer 2008;113:2478-2487.
 
34. Dawson NA. Targeted therapy in prostate cancer--are we our own worst enemy? Cancer 2008;113:2376-2378.
 
35. Pezaro C, Woo HH, Davis ID. Prostate cancer: measuring PSA. Intern Med J 2014;44:433-440.
 
36. Crawford ED, Bennett CL, Andriole GL, et al. The utility of prostate-specific antigen in the management of advanced prostate cancer. BJU Int 2013;112:548-560.
 
37. Bonkhoff H, Berges R. From pathogenesis to prevention of castration resistant prostate cancer. Prostate 2010;70:100-112.
 
38. Grist E, de Bono JS, Attard G. Targeting extra-gonadal androgens in castration-resistant prostate cancer. J Steroid Biochem Mol Biol 2015;145:157-163.
 
39. Arlen PM, Bianco F, Dahut WL, et al. Prostate Specific Antigen Working Group guidelines on prostate specific antigen doubling time. J Urol 2008;179:2181-2185.
 
40. Colloca G. Prostate-specific antigen kinetics as a surrogate endpoint in clinical trials of metastatic castration-resistant prostate cancer: a review. Cancer Treat Rev 2012;38:1020-1026.