Prognostic role of serum parathyroid hormone levels in advanced prostate cancer patients undergoing zoledronic acid administration

Alfredo Berruti, Richard Cook, Fred Saad, Consuelo Buttigliero, Allan Lipton, Marco Tampellini, Ker Ai Lee, Robert E. Coleman, Matthew R. Smith

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background. Secondary hyperparathyroidism is frequent in prostate cancer patients with bone metastases, and this condition is worsened by the administration of potent bisphosphonates. Serum parathyroid hormone (PTH) elevation can impair the efficacy of these drugs in terms of survival. Methods. The prognostic role of elevated serum PTH levels at baseline and after 3 months of zoledronic acid administration was assessed prospectively in 643 bone metastatic prostate cancer patients enrolled in a prospective randomized, placebo-controlled study. Results. On multivariate analysis, after adjusting for major prognostic factors and bone turnover markers, elevated baseline serum PTH level was negatively associated with overall survival (hazard ratio [HR], 1.448; 95% confidence interval [CI], 1.045-2.006; p <.03) in zoledronic acid-treated patients but not in placebo-treated patients. In patients with normal baseline PTH levels, there was a trend but insignificant association between zoledronic acid administration and a better survival outcome than with placebo (HR, 0.81; 95% CI, 0.65-1.01;p =.065), whereas a trend in the opposite direction was observed in patients with elevated PTH levels (HR, 1.45; 95% CI, 0.87-2.39; p =.151); interaction test, p =.040. Elevated serum PTH level after 3 months of zoledronic acid treatment was not significantly associated with survival outcome. Conclusions. Secondary hyperparathyroidism has a negative prognostic impact in metastatic prostate cancer patients undergoing zoledronic acid administration. Counteracting elevated PTH levels by adequate doses of vitamin D may improve the efficacy of this drug.

Original languageEnglish (US)
Pages (from-to)645-652
Number of pages8
JournalOncologist
Volume17
Issue number5
DOIs
StatePublished - Jun 4 2012

Fingerprint

zoledronic acid
Parathyroid Hormone
Prostatic Neoplasms
Serum
Secondary Hyperparathyroidism
Survival
Placebos
Confidence Intervals
Bone and Bones
Bone Remodeling
Diphosphonates
Vitamin D
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Berruti, Alfredo ; Cook, Richard ; Saad, Fred ; Buttigliero, Consuelo ; Lipton, Allan ; Tampellini, Marco ; Lee, Ker Ai ; Coleman, Robert E. ; Smith, Matthew R. / Prognostic role of serum parathyroid hormone levels in advanced prostate cancer patients undergoing zoledronic acid administration. In: Oncologist. 2012 ; Vol. 17, No. 5. pp. 645-652.
@article{007f446884a840debba10b8fdc29d9a7,
title = "Prognostic role of serum parathyroid hormone levels in advanced prostate cancer patients undergoing zoledronic acid administration",
abstract = "Background. Secondary hyperparathyroidism is frequent in prostate cancer patients with bone metastases, and this condition is worsened by the administration of potent bisphosphonates. Serum parathyroid hormone (PTH) elevation can impair the efficacy of these drugs in terms of survival. Methods. The prognostic role of elevated serum PTH levels at baseline and after 3 months of zoledronic acid administration was assessed prospectively in 643 bone metastatic prostate cancer patients enrolled in a prospective randomized, placebo-controlled study. Results. On multivariate analysis, after adjusting for major prognostic factors and bone turnover markers, elevated baseline serum PTH level was negatively associated with overall survival (hazard ratio [HR], 1.448; 95{\%} confidence interval [CI], 1.045-2.006; p <.03) in zoledronic acid-treated patients but not in placebo-treated patients. In patients with normal baseline PTH levels, there was a trend but insignificant association between zoledronic acid administration and a better survival outcome than with placebo (HR, 0.81; 95{\%} CI, 0.65-1.01;p =.065), whereas a trend in the opposite direction was observed in patients with elevated PTH levels (HR, 1.45; 95{\%} CI, 0.87-2.39; p =.151); interaction test, p =.040. Elevated serum PTH level after 3 months of zoledronic acid treatment was not significantly associated with survival outcome. Conclusions. Secondary hyperparathyroidism has a negative prognostic impact in metastatic prostate cancer patients undergoing zoledronic acid administration. Counteracting elevated PTH levels by adequate doses of vitamin D may improve the efficacy of this drug.",
author = "Alfredo Berruti and Richard Cook and Fred Saad and Consuelo Buttigliero and Allan Lipton and Marco Tampellini and Lee, {Ker Ai} and Coleman, {Robert E.} and Smith, {Matthew R.}",
year = "2012",
month = "6",
day = "4",
doi = "10.1634/theoncologist.2011-0448",
language = "English (US)",
volume = "17",
pages = "645--652",
journal = "Oncologist",
issn = "1083-7159",
publisher = "AlphaMed Press",
number = "5",

}

Berruti, A, Cook, R, Saad, F, Buttigliero, C, Lipton, A, Tampellini, M, Lee, KA, Coleman, RE & Smith, MR 2012, 'Prognostic role of serum parathyroid hormone levels in advanced prostate cancer patients undergoing zoledronic acid administration', Oncologist, vol. 17, no. 5, pp. 645-652. https://doi.org/10.1634/theoncologist.2011-0448

Prognostic role of serum parathyroid hormone levels in advanced prostate cancer patients undergoing zoledronic acid administration. / Berruti, Alfredo; Cook, Richard; Saad, Fred; Buttigliero, Consuelo; Lipton, Allan; Tampellini, Marco; Lee, Ker Ai; Coleman, Robert E.; Smith, Matthew R.

In: Oncologist, Vol. 17, No. 5, 04.06.2012, p. 645-652.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic role of serum parathyroid hormone levels in advanced prostate cancer patients undergoing zoledronic acid administration

AU - Berruti, Alfredo

AU - Cook, Richard

AU - Saad, Fred

AU - Buttigliero, Consuelo

AU - Lipton, Allan

AU - Tampellini, Marco

AU - Lee, Ker Ai

AU - Coleman, Robert E.

AU - Smith, Matthew R.

PY - 2012/6/4

Y1 - 2012/6/4

N2 - Background. Secondary hyperparathyroidism is frequent in prostate cancer patients with bone metastases, and this condition is worsened by the administration of potent bisphosphonates. Serum parathyroid hormone (PTH) elevation can impair the efficacy of these drugs in terms of survival. Methods. The prognostic role of elevated serum PTH levels at baseline and after 3 months of zoledronic acid administration was assessed prospectively in 643 bone metastatic prostate cancer patients enrolled in a prospective randomized, placebo-controlled study. Results. On multivariate analysis, after adjusting for major prognostic factors and bone turnover markers, elevated baseline serum PTH level was negatively associated with overall survival (hazard ratio [HR], 1.448; 95% confidence interval [CI], 1.045-2.006; p <.03) in zoledronic acid-treated patients but not in placebo-treated patients. In patients with normal baseline PTH levels, there was a trend but insignificant association between zoledronic acid administration and a better survival outcome than with placebo (HR, 0.81; 95% CI, 0.65-1.01;p =.065), whereas a trend in the opposite direction was observed in patients with elevated PTH levels (HR, 1.45; 95% CI, 0.87-2.39; p =.151); interaction test, p =.040. Elevated serum PTH level after 3 months of zoledronic acid treatment was not significantly associated with survival outcome. Conclusions. Secondary hyperparathyroidism has a negative prognostic impact in metastatic prostate cancer patients undergoing zoledronic acid administration. Counteracting elevated PTH levels by adequate doses of vitamin D may improve the efficacy of this drug.

AB - Background. Secondary hyperparathyroidism is frequent in prostate cancer patients with bone metastases, and this condition is worsened by the administration of potent bisphosphonates. Serum parathyroid hormone (PTH) elevation can impair the efficacy of these drugs in terms of survival. Methods. The prognostic role of elevated serum PTH levels at baseline and after 3 months of zoledronic acid administration was assessed prospectively in 643 bone metastatic prostate cancer patients enrolled in a prospective randomized, placebo-controlled study. Results. On multivariate analysis, after adjusting for major prognostic factors and bone turnover markers, elevated baseline serum PTH level was negatively associated with overall survival (hazard ratio [HR], 1.448; 95% confidence interval [CI], 1.045-2.006; p <.03) in zoledronic acid-treated patients but not in placebo-treated patients. In patients with normal baseline PTH levels, there was a trend but insignificant association between zoledronic acid administration and a better survival outcome than with placebo (HR, 0.81; 95% CI, 0.65-1.01;p =.065), whereas a trend in the opposite direction was observed in patients with elevated PTH levels (HR, 1.45; 95% CI, 0.87-2.39; p =.151); interaction test, p =.040. Elevated serum PTH level after 3 months of zoledronic acid treatment was not significantly associated with survival outcome. Conclusions. Secondary hyperparathyroidism has a negative prognostic impact in metastatic prostate cancer patients undergoing zoledronic acid administration. Counteracting elevated PTH levels by adequate doses of vitamin D may improve the efficacy of this drug.

UR - http://www.scopus.com/inward/record.url?scp=84861608587&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861608587&partnerID=8YFLogxK

U2 - 10.1634/theoncologist.2011-0448

DO - 10.1634/theoncologist.2011-0448

M3 - Article

C2 - 22523198

AN - SCOPUS:84861608587

VL - 17

SP - 645

EP - 652

JO - Oncologist

JF - Oncologist

SN - 1083-7159

IS - 5

ER -