Web of Science: 13 citations, Scopus: 14 citations, Google Scholar: citations,
Definition of Castrate Resistant Prostate Cancer : New Insights
Morote Robles, Juan (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Aguilar, Adriana (Hospital Universitari Vall d'Hebron)
Planas, Jacques (Hospital Universitari Vall d'Hebron)
Trilla Herrera, Enrique (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Date: 2022
Abstract: The term castrate resistant prostate cancer (CRPC) was initially proposed by the Prostate Cancer Working Group 2 in 2008 to define the state of clinical and/or biochemical progression of prostate cancer (PCa) in an environment with very low serum testosterone concentration. Clinical progression is based on the radiological imaging proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) adapted to PCa. Biochemical progression is defined as an over 25% increase in serum prostate-specific antigen within two consecutive measurements separated by at least one week, and an absolute value above 2. 0 ng/mL. Finally, the castrate environment is usually defined as a serum testosterone concentration maintained below 50 ng/dL or 1. 7 nmol/dL. This definition does not incorporate the new and more accurate imaging modalities to assess clinical progression and the capability of the new biochemical measurements to assess the true castration environment. Ga-68-PSMA-11 PET CT/MRI and whole-body MRI are the new imaging modalities that should replace the classic thoracic CT scan, abdomino-pelvic CT scan, and technetium 99-m bone scintigraphy. In addition, Ga-68-PSMA-11 PET is the current basis for the new therapies targeting metastatic sites. Moreover, the current methods for measuring the very low serum testosterone concentrations in clinical laboratories are the widespread chemiluminescent assays, which are inappropriate, while LC-MSMS is the only method recommended to assess the castrate environment. In addition, recent research shows that serum luteinising hormone concentration associates better than serum testosterone with the castration environment, even when it is measured with LC-MSMS. In summary, the current definition of CRPC seems outdated. An extensive update to diagnose true CRPC is also needed to differentiate CRPC men with M0 (non-metastatic) from those with M1 (metastatic) CRPC. WC: 277.
Rights: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Language: Anglès
Document: Article ; recerca ; Versió publicada
Subject: Prostate cancer ; Castration-resistance ; PSMA-PET ; Testosterone ; Free-testosterone ; Luteinising-hormone
Published in: Biomedicines, Vol. 10 (march 2022) , ISSN 2227-9059

DOI: 10.3390/biomedicines10030689
PMID: 35327491


11 p, 622.0 KB

The record appears in these collections:
Articles > Research articles
Articles > Published articles

 Record created 2022-04-26, last modified 2023-10-01



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