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C-reactive protein doubling adds 10.6% to risk


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Editorial - C-reactive protein as an adverse prognostic marker for men with castration-resistant prostate cancer (CRPC): Confirmatory results Show Comments PDF Print E-mail

Written by Christopher P. Evans, MD

Monday, 19 April 2010

BERKELEY, CA (UroToday.com) - In the online version of Urologic Oncology, Dr. Renee Prins and colleagues from Oregon Health and Science University validate C-reactive protein (CRP) as an adverse marker in men with castration-resistant prostate cancer (CRPC).

The story begins with inflammation and its role in disease to protect tissues and repair damage while eliminating pathogens. However, a chronic state of inflammation can generate carcinogens by cell injury with DNA damage, generation of free radicals and increased cell proliferation. The authors point to numerous states of chronic infection that are linked to the development of cancer, such as chronic hepatitis and hepatocellular carcinoma. In prostate cancer, the link between chronic prostatitis and cancer development has been suggested and the use of anti-inflammatory drugs decreases the incidence of prostate cancer. CRP is a marker of acute-phase inflammation and its elevation is associated with shortened survival in numerous cancers. This study sought to validate increased CRP levels with worse survival in men with CRPC.

The study cohort included patients with CRPC treated in 6 different phase II clinical trials. No patient had received standard docetaxel and prednisone. Blood samples from 119 patients prior to study initiation were correlated with overall survival (OS). Over 90% had bone metastasis at entry and the remainder had rising PSA levels with CRPC. The risk of death increased as the log of CRP increased. In multivariable analysis assessing age, alkaline phosphatase, performance status, hemoglobin, PSA and CRP, CRP remained an independent predictor of shorter survival demonstrating a 10.6% increase in risk for every doubling of CRP. Hemoglobin was inversely correlated with OS and alkaline phosphatase positively associated with OS (a two-fold increased risk of death for a baseline level >238). PSA, age and performance status were not associated with OS.

Prins RC, Rademacher BL, Mongoue-Tchokote S, Alumkal JJ, Graff JN, Eilers KM, Beer TM

Urol Oncol. 2010 Mar 5. Epub ahead of print.

10.1016/j.urolonc.2009.11.012

PubMed Abstract

PMID: 20207556 Forum: Castrate Resistant Prostate Cancer Title: C-reactive protein doubling adds 10.6% to risk

This extract can be found on http://PubMed.com, and is in the public domain.

On PubMed.com there will be a link to the full paper (often $30, sometimes free).

Any highlighting (except the title) is not by the author, but by Jim Marshall.

Jim is not a doctor.

This page was found on the Advanced Prostate Cancer Community for Australian men at http://advancedprost...lia.ipbhost.com.

The link is hard to remember.

An easier way to find it is to go to JimJimJimJim.com and click on Prostate.

That's the word Jim four times, no spaces, followed by .com.

If you need other help - to perhaps find someone to talk to or a local support group:

Click on the Contact Jim button at http://JimJimJimJim.com.

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