Many doctors believe that increased levels of C-reactive protein (CRP) is associated with adverse outcomes in men with castration-resistant prostate cancer (CRPC) treated with docetaxel.

C-reactive protein is a protein found in the blood, the levels of which rise in response to inflammation in any part of the body. Traditionally measuring levels of c-reactive protein is useful in the diagnosis and treatment of inflammatory bowel disease, some forms of arthritis and autoimmune diseases, pelvic inflammatory disease, coronary heart disease (CHD) and cardiovascular disease.

In an attempt to confirm the possible role of c-reactive protein in castration-resistant prostate cancer (CRPC) a study was Presented by R. Prins, MD, at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO).

Baseline serum samples from 119 CRPC patients enrolled in 6 phase I or II clinical trials were retrospectively analyzed. Ninety-one percent (91%) of patients had metastases and sixteen percent (16%) had prior chemotherapy exposure. Median follow-up was 19.7 months and 89% of the subjects had died. In a multivariate model CRP (HR 1.09, p=0.036) was independently associated with survival. The role of CRP as a prognostic measure for the risk of death confirmed. It was estimated that there was an increase of the chance for death of 8.7% for every doubling of the CRP.

This study clearly confirms that CRPC patients with higher baseline CRP have worse survival. This information can be useful for future prognostic models and may help stratify those of us who should consider enrolling into clinical trials. Additionally, it would be beneficial to see if this relationship between CRP and survival extends to men with prostate cancer that is not yet hormone resistant.

Joel T Nowak MA, MSW