Increased Serum Levels Of Bone-specific Alkaline Phosphatase Correlate With Shorter Survival In Men With Hormone Refractory Prostate Cancer

Metastatic prostate cancer (CaP) is primarily characterized by osteoblastic bone lesions, although both osteoclasts and osteoblasts demonstrate increased activity. Specific markers associating bone progression with survival in CaP was reported by Dr. Cook and colleagues in the June 1, 2006 issue of Clinical Cancer Research.

The patients evaluated in this report include 643 men who participated in a multicenter trial of zoledronic acid for the treatment of metastatic CaP. Serum bone-specific alkaline phosphatase (BAP) and urinary N-telopeptide were assessed and associated with survival and each other. BAP is a marker of osteoblast activity and N-telopeptide is a marker of osteoclast activity.

In the cohort, 278 men (43%) had bone metastases at initial presentation and 396 men (62%) required analgesics for bone pain. As zoledronic acid significantly decreases urinare N-telopeptide production, the data analyzed was limited to baseline values to exclude the effect of treatment.

Serum BAP correlated significantly with N-telopeptide and in univariate analysis both were significantly associated with shorter overall survival. Serum BaP was also associated with overall shorter survival in multivariate analysis, while N-telopeptide was not.

By Christopher P. Evans, MD

Reference:
Clin Cancer Res 2006;11:3361-7
Link Here.
Cook RJ, Coleman R, Brown J, Lipton A, Major P, Hei YJ, Saad F, Smith MR

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