High levels linked to three times higher death risk in men with androgen-independent malignancy


CHICAGO —Elevated plasma levels of C-reactive protein (CRP) predict worse survival in patients with androgen-independent prostate cancer (AIPC) receiving docetaxel-based therapy, a study found.

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The finding suggests that a readily available blood test can provide doctors and patients with prognostic in-formation that could be used in clinical decision-making, said researcher Tomasz Beer, MD, director of the prostate cancer research program and associate professor of medicine at the Oregon Health & Science University Cancer Institute in Portland. He presented findings here at the American Society of Clinical Oncology annual meeting.


He and his colleagues analyzed baseline plasma samples from 160 patients who were enrolled in the ASCENT trial, a large Phase II clinical trial that evaluated treatment docetaxel and DN-101 (a high-dose formulation of calcitriol) or doce-taxel with placebo. ASCENT results were published earlier this year in the Journal of Clinical Oncology (2007;25:669-674), and the most significant finding was the favorable impact of DN-101 (Asentar) used in combin-ation with docetaxel (Taxotere) on survival. The combination was associated with an estimated 49% improved survival while reducing the frequency of serious adverse events by 34% compared with docetaxel alone.


Dr. Beer’s group analyzed how CRP and other baseline variables (such as PSA, hemoglobin, lactate dehydrogenase, alkaline phosphatase, ECOG performance status, Gleason scores, and age) predicted overall survival and survival free of skeletal-related events (SRE). Only elevated CRP significantly predicted reductions in both. Compared with patients with normal CRP levels

(8 mg/L or below), those with elevated CRP levels (above 8 mg/L) were three times more likely to die from any cause, 30% more likely to die with SRE, and 26% less likely to have a PSA response to treatment.


“This is the first such analysis so it will have to be confirmed,” Dr. Beer said. “But any new marker we can find to help us better understand who is going to respond to therapy and who isn’t will help us spare patients unnecessary chemotherapy and help us direct those patients to effective therapy as soon as possible.”