Therapeutic Options in Metastatic Castration-Resistant Prostate Cancer
Therapeutic Options in Metastatic Castration-Resistant Prostate Cancer
Prostate-specific antigen (PSA) is a protein, the transcription of which is positively regulated by the androgen receptor (AR). PSA may be elevated for various reasons, including infection of the prostate gland (prostatitis), benign prostatic hypertrophy, inflammation, or prostate cancer. In 1979, Wang et al published data suggesting the potential significance of PSA in the serum as a marker in the detection of prostate cancer. In the 1980s, further investigation through the National Cancer Institute–sponsored National Prostatic Cancer Project detected the prognostic value of PSA. PSA as a tumor marker to monitor men with prostate cancer was approved by the US Food and Drug Administration (FDA) in 1986. PSA can be used to detect biochemical recurrence, which is defined as increasing PSA in men who have undergone definitive treatment for prostate cancer. It is important to consider that PSA values may be affected by treatments such as 5-α reductase inhibitors, which can decrease PSA secretion from benign and malignant tissue, leading to a reduction in serum PSA levels without an effect on cell growth. In addition, in patients who receive radiation therapy for the treatment of prostate cancer, a phenomenon known as PSA bounce has been documented whereby temporary increases in PSA are seen as the result of a possible delayed radiation effect or bacterial prostatitis, which do not correlate with tumor growth. Understanding the role of PSA is an important consideration in the treatment of men with mCPRC.
Prostate-specific Antigen
Prostate-specific antigen (PSA) is a protein, the transcription of which is positively regulated by the androgen receptor (AR). PSA may be elevated for various reasons, including infection of the prostate gland (prostatitis), benign prostatic hypertrophy, inflammation, or prostate cancer. In 1979, Wang et al published data suggesting the potential significance of PSA in the serum as a marker in the detection of prostate cancer. In the 1980s, further investigation through the National Cancer Institute–sponsored National Prostatic Cancer Project detected the prognostic value of PSA. PSA as a tumor marker to monitor men with prostate cancer was approved by the US Food and Drug Administration (FDA) in 1986. PSA can be used to detect biochemical recurrence, which is defined as increasing PSA in men who have undergone definitive treatment for prostate cancer. It is important to consider that PSA values may be affected by treatments such as 5-α reductase inhibitors, which can decrease PSA secretion from benign and malignant tissue, leading to a reduction in serum PSA levels without an effect on cell growth. In addition, in patients who receive radiation therapy for the treatment of prostate cancer, a phenomenon known as PSA bounce has been documented whereby temporary increases in PSA are seen as the result of a possible delayed radiation effect or bacterial prostatitis, which do not correlate with tumor growth. Understanding the role of PSA is an important consideration in the treatment of men with mCPRC.
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