The bridge between bone biomarkers and prostate cancer prognosis
Newfound research has elucidated how the elevated presence of bone biomarkers has been associated with an increased risk of death and, therefore, influences overall survival in men with castration-resistant prostate cancer (CRPC).
In American men, prostate cancer ranks as the second most common cause of mortality, therefore it remains imperative to identify the influences that affect patient outcomes, for the improvement of treatment and survival rates.
The research team managed by the UC Davis Comprehensive Cancer Center (CA, USA), brought to light the link between bone metabolism biomarkers and survival rate, in men with recently diagnosed hormone-sensitive prostate cancer (HSPC) who had previously received androgen deprivation therapy (ADT).
The study published in the journal, European Urology, analyzed findings from a SWOG Cancer Research Network Phase 3 trial of nearly 1,000 patients who had received ADT. It was established that bone biomarkers for both bone formation and bone loss were present in HSPC patients enrolled in the clinical trial.
The researchers determined a correlation between elevated bone biomarkers and an increased risk of mortality. The impact of bone biomarkers on overall survival has been observed in men with CRPC, a form of prostate cancer that persists in its growth despite significantly reduced testosterone levels. However, the complete extent of bone biomarkers’ influence on HSPC has yet to have been fully established.
“Our findings show that high levels of bone turnover biomarkers are associated with a shorter lifespan in men newly diagnosed with metastatic HSPC,” UC Davis Comprehensive Cancer Center Director, Primo Lara Jr stated.“In the future, knowing one’s bone biomarker status could improve how we predict patient outcomes and enhance treatment considerations for men with HSPC.”
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Men with advanced prostate cancer frequently experience a fine balance between the cells that build bone and cells that destroy bone. This interplay becomes particularly prominent in the presence of skeletal metastasis, which commonly leads to bone pain and fractures, thereby impacting the overall survival of these individuals.
Coupled with this, men who have metastatic HSPC are usually treated with ADT, which is known to disrupt bone turnover and therefore promotes the development of bone diseases including osteopenia and osteoporosis. In the past, studies have displayed how elevated levels of blood-based biomarkers of bone turnover can be used to predict survival in men with CRPC. Bone-targeted therapy may therefore prove to be a promising avenue to treat patients with highly elevated markers.
“This study takes a similar look at bone turnover biomarkers in men with advanced or metastatic HSPC who are initiating ADT as part of a large phase 3 clinical trial,” commented co-author of the study and UC Davis Comprehensive Cancer Center Clinical Scientist, Mamta Parikh. “Ultimately, our findings add to the growing understanding of the complex interplay between cancer and bone metabolism, which will also help the design of future clinical trials.”
Sources: Lara Jr P N., Mayerson E, Gertz E, et al. Bone biomarkers and subsequent survival in men with hormone-sensitive prostate cancer: Results from the SWOG S1216 Phase 3 Trial of Androgen Deprivation Therapy with or Without Orteronel. European Urology (2023), doi: 10.1016/j.eururo.2023.03.036., Eurekalert press release, www.eurekalert.org/news-releases/988774
