Editorial comment on: Platelet microparticles: a potential predictive factor of survival in hormone-refractory prostate cancer patients treated with docetaxel-based chemotherapy.

摘要

Platelet activation results in the production of platelet microparticles (PMPs) and has been found to be increased in several types of cancer. PMPs are suggested to be useful in a number of basic and preclinical papers. The study by Helley et al [1] found that hormone refractory prostate cancer patients treated with docetaxel showing PMP levels above the median had a significantly lower overall survival. PMPs presumably reflect microthrombosis, a finding that seems to be commonly seen in prostate cancer. Although the topic of this report is of interest to urologists and scientists who work in the field of prostate cancer research, there is no "major impact on treatment", and the study shows a biologic association resulting in a negative study since PMPs were not independently associated with overall survival in multivariate analysis. In addition, the study series is of value because it is prospective, but limited in size because it includes only 43 cases recruited over a period of 5 years. This represents a major limitation, and the paper should be considered as a preliminary data report. Adding more cases to the reported series would thus add strength to the paper in terms of clinical value. Finally, although the authors suggest that therapies targeting PMPs may be useful, it is not clear whether they contribute to disease progression or are only a marker of disease extension and ongoing thrombosis. In summary, this study represents a limited advance that is consistent with previous data and suggests that PMPs or other markers of ongoing thrombosis might be indicators of disease burden; nonetheless, the potential value of PMP as an independent marker remains unclear. The data reported by Helley et al [1] underscore the need for more studies with appropriate sample size confirming the suggested clinical potential of PMP formation in hormone refractory prostate cancer patients.