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Abstract

Volume 19, Issue 2 (March 2017) 19, 143–148; DOI:10.4103/1008-682X.179159

Understanding prostate-specific antigen dynamics in monitoring metastatic castration-resistant prostate cancer: implications for clinical practice

Atsushi Mizokami1, Kouji Izumi1, Hiroyuki Konaka1, Yasuhide Kitagawa1, Yoshifumi Kadono1, Kazutaka Narimoto1, Takahiro Nohara1, Amit K Bahl2, Mikio Namiki1

1 Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi Kanazawa, 920-8640, Japan
2 Bristol Haematology and Oncology Centre, University Hospitals Bristol, Bristol, BS2 8ED, United Kingdom

Correspondence: Dr. A Mizokami (mizokami@med.kanazawa-u.ac.jp)

Date of Submission 06-Aug-2015 Date of Decision 11-Oct-2015 Date of Acceptance 01-Mar-2016 Date of Web Publication 03-Jun-2016

Abstract

Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer (CRPC) has changed the outlook for this group of patients with improvements in progression-free survival and overall survival. Physicians often diagnose the progression of prostate cancer using serum prostate-specific antigen (PSA). However, serum PSA is not always correlated with the clinical status in CRPC. To evaluate the PSA dynamics with greater precision, understanding of the control of PSA and of the mechanisms of development of CRPC is needed. Moreover, it is necessary to use new hormonal therapies with an appropriate timing to optimally improve the prognosis and the QOL of the patients. In the present review, we ascertain the PSA dynamics and the mechanisms of the development of CRPC to assist in optimal utilization of the new treatments for mCRPC.

Keywords: castration-resistant prostate cancer; new hormonal therapy; prostate-specific antigen

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