1913 NANO-PSA IN PATIENTS WITH ADVERSE PATHOLOGICAL FEATURES

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You have accessJournal of UrologyProstate Cancer: Detection and Screening1 Apr 20111913 NANO-PSA IN PATIENTS WITH ADVERSE PATHOLOGICAL FEATURES Dae Y. Kim, Barry B. McGuire, Lee C. Zhao, Stacy Loeb, Brian Le, Shilajit Kundu, Phillip R. Cooper, Jessica A. Banks, C. Shad Thaxton, Chad A. Mirkin, and William J. Catalona Dae Y. KimDae Y. Kim Chicago, IL More articles by this author , Barry B. McGuireBarry B. McGuire Chicago, IL More articles by this author , Lee C. ZhaoLee C. Zhao Chicago, IL More articles by this author , Stacy LoebStacy Loeb Baltimore, MD More articles by this author , Brian LeBrian Le Chicago, IL More articles by this author , Shilajit KunduShilajit Kundu Chicago, IL More articles by this author , Phillip R. CooperPhillip R. Cooper Chicago, IL More articles by this author , Jessica A. BanksJessica A. Banks Chicago, IL More articles by this author , C. Shad ThaxtonC. Shad Thaxton Chicago, IL More articles by this author , Chad A. MirkinChad A. Mirkin Chicago, IL More articles by this author , and William J. CatalonaWilliam J. Catalona Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2051AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Following radical prostatectomy (RP) for prostate cancer (CaP), treatment success is defined by post-RP measurements of serum PSA. In most cases, conventional PSA assays (cPSA) with clinical limits of detection at 0.1 ng/mL fail to return detectable PSA values post-RP. Patients with adverse pathological features are those most in need of accurate post-RP PSA monitoring in order to rapidly identify CaP recurrence and to initiate early secondary treatment (Trock et al., JAMA 2008; 299:2760). By using a more sensitive PSA assay, the opportunity exists to measure PSA values < 0.1 ng/mL in patients with adverse pathological features to expedite risk stratification. METHODS Our study population consisted of 416 men with CaP treated by RP with conventional PSA (cPSA) values measured post-operatively. Using banked serum samples obtained at similar time points, serum PSA values were measured using a research use only nanoPSA assay (nPSA, Verisens™ PSA, Nanosphere, Inc.) that is two orders of magnitude more sensitive for PSA than the cPSA assays. In all cases, the first nPSA value following RP was used for analysis, and measured at a time point when cPSA values were undetectable. Median nPSA values were obtained for patients with favorable pathological features, adverse pathological features, and patients with CaP recurrence (cPSA >0.2 and/or secondary XRT or HT). RESULTS The median nPSA for patients with favorable (n= 90) vs adverse pathological features (n= 49) was 4.4 and 2.8 pg/ml, respectively (p = 0.06). The median nPSA for patients with CaP recurrence (n=21) was 28.7 pg/ml (p = 0.21 vs favorable). All values are shown in the Figure. The median nPSA values were obtained for patients with the following adverse features: Gleason 8–10 (2.8 pg/ml, n=19, p = 0.22 vs favorable), stage > T2 (4.1 pg/ml, N= 64, p = 0.51 vs favorable), positive surgical margins (6.1 pg/ml, N= 27, p = 0.82 vs favorable), ECE (3.3 pg/ml,n=54, p = 0.53 vs favorable). CONCLUSIONS We describe the initial nPSA values measured in men with favorable and adverse pathology, and in men with CaP recurrence at early time points when the cPSA values are undetectable. Data demonstrates that the first nPSA obtained after RP correlates with CaP recurrence. The first nPSA values obtained after RP in patients with adverse pathological features, but without recurrence, are not significantly different from those with favorable pathology. This result could be due to primary treatment success in those patients with adverse pathological features who did not undergo immediate secondary treatment or demonstrate CaP recurrence. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e765 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dae Y. Kim Chicago, IL More articles by this author Barry B. McGuire Chicago, IL More articles by this author Lee C. Zhao Chicago, IL More articles by this author Stacy Loeb Baltimore, MD More articles by this author Brian Le Chicago, IL More articles by this author Shilajit Kundu Chicago, IL More articles by this author Phillip R. Cooper Chicago, IL More articles by this author Jessica A. Banks Chicago, IL More articles by this author C. Shad Thaxton Chicago, IL More articles by this author Chad A. Mirkin Chicago, IL More articles by this author William J. Catalona Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...