Prognostic value of urinary N-telopeptide (uNTx) in patients (pts) with castration-resistant prostate cancer (CRPC) and bone metastases

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Abstract
5138 Background: Several prognostic models predicting for survival have been developed in men with CRPC (J Clin Oncol 2002,20:3972–82, J Clin Oncol 2003,21:1232–7). In pts with bone metastases from CRPC not pretreated by a bisphosphonate, elevated uNTx level, a marker of bone resorption, predicts for skeletal-related events (SRE) (J Clin Oncol 2005, 23: 4925–35). We assessed the prognostic value of uNTx in a population of CRPC pts with bone metastases receiving zoledronic acid. Methods: From 2004 to 2007, 94 pts with bone metastases from CRPC receiving zoledronic acid for at least 2 months were prospectively screened for uNTx. The last zoledronic acid injection was given within 4 weeks before screening. Overall survival (OS) and SRE occurrence were evaluated and analysed by using the Cox regression model. Results: The median age was 66 (46–88) years. Median PSA was 66 ng/ml (0–3984) and median uNTx was 19 nmol/mmol creatinine (3–489). 38 patients (40%) presented an SRE. Censoring death, the median time to SRE was 29 months. The median (95% CI) OS was 20 months (15–24). In univariate analysis, uNTx > 20 nmol/mmol creatinine (p 70 ng/ml (p 20 nmol/mmol creatinine and in those with uNTx < 20 nmol/mmol creatinine, respectively. A nomogram integrating uNTx together with other known prognostic factors was developed. Conclusion: An elevated uNTx level is a strong and independent prognostic factor of OS in pts with bone metastases from CRPC. No significant financial relationships to disclose.

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