A rising PSA despite ADT indicates risk for bone metastases and skeletal consequences1,2
Prostate cancer progression
Once patients on ADT become castration resistant, they are at a greater risk for the development of bone metastases and skeletal-related events (SREs).1-4
Metastases can go undetected and proactive screening is important in appropriate patients
A phase 3 study attempting to enroll patients with nonmetastatic castration-resistant prostate cancer (CRPC) recently reported that an unexpectedly high number of patients failed screening—32% of these patients had to be excluded because scans revealed they had metastatic CRPC5*
Of patients with metastatic CRPC, up to 90% have bone metastases6-8†
*Data from an analysis of all patients screened (N = 2,577) for a randomized, multicenter, placebo-controlled study of zibotentan in patients with nonmetastatic CRPC.
† Data from 3 separate studies analyzing the presence of bone metastases in patients with CRPC.
Given the prevalence of bone metastases in CRPC patients, it is important to identify patients early
Risk factors for metastasis to bone include:
|Risk factor||Rate of positive bone scan10‡|
|PSA >10 ng/mL9,10||>60%|
|PSA doubling time < 9 months10||>40%|
‡Data from a retrospective analysis of bone scans from 114 patients receiving ADT after biochemical recurrence following radical prostatectomy.