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Related Experiment Videos

Response criteria in prostatic carcinoma.

N A Dawson1

  • 1Hematology-Oncology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.

Seminars in Oncology
|December 22, 1999
PubMed
Summary

Assessing advanced prostate cancer response is challenging due to bone-only disease. New methods focus on separate reporting of prostate-specific antigen (PSA) levels, measurable disease, and quality of life for better treatment evaluation.

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Area of Science:

  • Oncology
  • Clinical Trials
  • Biochemical Markers

Background:

  • Advanced prostate cancer often presents as nonmeasurable bone-only disease, complicating response assessment.
  • Bone scans are limited in evaluating tumor regression, necessitating alternative methods.
  • Prostate-specific antigen (PSA) is a common surrogate endpoint, but lacks standardized response definitions and doesn't always correlate with tumor shrinkage.

Purpose of the Study:

  • To explore improved methods for assessing treatment response in advanced prostate cancer.
  • To address the limitations of traditional response assessment in bone-predominant disease.
  • To highlight the emerging trend of independent reporting of multiple outcome parameters.

Main Methods:

  • Review of current practices in advanced prostate cancer clinical trials.
  • Analysis of the utility of prostate-specific antigen (PSA) as a response marker.
  • Evaluation of quality of life as a clinically relevant endpoint.
  • Discussion of the trend towards separate reporting of biochemical markers, measurable disease, bone-only disease, and quality of life.

Main Results:

  • Traditional "complete" or "partial" response categories are insufficient for advanced prostate cancer.
  • PSA changes are best used as initial indicators of drug potential, not definitive benefit validation.
  • Quality of life is a crucial endpoint, especially in hormone-refractory disease.
  • Independent reporting of PSA, measurable disease, bone-only disease, and quality of life offers a more accurate therapeutic benefit picture.

Conclusions:

  • A shift towards independent reporting of multiple outcome parameters (PSA, measurable disease, bone-only disease, quality of life) provides a more accurate assessment of treatment efficacy in advanced prostate cancer.
  • This approach facilitates more informed clinical decision-making for physicians and patients.
  • Standardized definitions for PSA response remain an unmet need.

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