Autori: Helley D, Banu E, Bouziane A, Banu A, Oudard S, Fischer A.M

Editorial: The XXIst Congress of the International Society on Thrombosis and Haemostasis, Geneva, 6-12 July, 2007:2411, PS 525, 2007.

Rezumat:

Introduction: Several studies suggest a causal relationship between platelets activation and cancer metastasis. Activated platelets release platelet microparticles (PMP), VEGF (vascular endothelial growth factor) and bFGF (basic fibroblast growth factor) which could play a role in patient outcome. Methods: Eligible chemonaive hormone-refractory prostate cancer (HRPC) patients (pts) were required to have: European Cooperation Oncology Group performance status (ECOG PS) < 2, and progressive disease after antiandrogen withdrawal. Before chemotherapy, we quantified PMP in whole blood by flow cytometry using an anti-CD41. As primary endpoint, we evaluated the impact of PMP on overall survival (OS) by Cox regression. Secondary, we studied the correlation between PMP and platelets, and their relationship with OS, incorporating an interaction term in the modeling (PMP and platelets).Results: Forty-four HRPC pts were treated by chemotherapy [docetaxel (91%), mitoxantrone] in our center. Median age was 69 years (range 52-85), with median values of hemoglobin 12.5 g/dL, baseline prostate-specific antigen (PSA) 37.7 ng/mL, PMP 6 867/μL (range 3319-12439), VEGF 22.4 pg/mL, and bFGF 2.9 pg/mL. Significant correlations were observed between PMP, ECOG PS and platelets. There were 33 deaths (75%) with a median follow-up of 22.5 months. Median OS was significantly lower in pts with high PMP values (> 6867/μL), compared to low PMP pts: 16.7 months (95% CI, 4.8-28.5) vs 25.2 months (95% CI, 19.9-30.6), P=0.027 (unstratified), P=0.046 (stratified analysis according chemotherapy regimen). Univariate analysis by Cox regression showed a significant relationship between OS and PMP level. PMP kept their significance after adjusting by multivariate analysis for baseline hemoglobin, number of metastatic sites, and PSA doubling-time (P=0.01). An interaction term (PMP and platelets) was also predictive on OS (P=0.009). Conclusions: PMP and their interaction term with platelets were a predictive factor of OS in HRPC pts.

Cuvinte cheie: cancer de prostata hormorefractar, microparticule plachetare, supravietuirea // hormone-refractory prostate cancer, plateles microparticles, survival

URL: http://itinerary.abstractsondemand.com/showabstract.php?congress=isth2007&id=1005