The following is a summary of “Pretreatment plasma osteopontin level as a marker of response to curative radiotherapy and hormonal treatment for prostate cancer,” published in the August 2024 issue of Oncology by Smolska-Ciszewska et al.

Osteopontin (OPN) is a well-established marker of tumor hypoxia, which plays a crucial role in determining the outcome of radiotherapy. This study aimed to evaluate the potential of plasma OPN levels as a predictive marker of treatment response in patients with prostate cancer undergoing radiotherapy (RT) with or without androgen deprivation therapy (ADT). Between 2012 and 2014, 274 patients with prostate cancer eligible for RT were enrolled in the study. Among them, 34.3% received short-course ADT (SCADT), and 46.3% received long-course ADT (LCADT). The median plasma OPN concentration was 83.9 ng/mL, and patients were stratified into two groups based on this median: Group A with OPN levels below and Group B with OPN levels above the median.

Significant differences in OPN levels were observed across various clinical parameters, including Gleason score (p = 0.005), D’Amico risk classification (p = 0.002), ADT status (p < 0.001), and RT modality (p = 0.019). A positive correlation between OPN levels and clinical stage (p = 0.042) was also identified. However, OPN levels did not significantly impact biochemical recurrence-free survival (bRFS), relapse-free survival (RFS), or metastasis-free survival (MFS). Notably, the 10-year overall survival (OS) rate was significantly higher in Group A (81%) compared to Group B (60%) (p < 0.001). Cox proportional hazards analysis revealed that lower OPN levels (p < 0.001), younger age (p = 0.002), and lower Gleason score (p = 0.038) were independently associated with improved OS. The prognostic impact of OPN on survival diminished with the increasing duration of ADT, showing the strongest effect when RT alone was administered (hazard ratio [HR] = 3.93), a moderate effect with SCADT (HR = 2.48), and the weakest effect with LCADT (HR = 2.09).

In conclusion, pre-treatment OPN levels may serve as an independent prognostic marker for overall survival in patients with prostate cancer treated with radiotherapy, either alone or in combination with ADT. These findings suggest that OPN could be a valuable biomarker for guiding treatment decisions and improving clinical outcomes in this patient population.

Source: sciencedirect.com/science/article/abs/pii/S0167814024034960