Abstract
BackgroundProstate specific antigen (PSA) is an important biomarker to monitor the response to the treatment, but has not been fully utilized as a whole sequence. We used a longitudinal biomarker PSA to discover a new prognostic pattern that predicts castration-resistant prostate cancer (CRPC) after androgen deprivation therapy.MethodsWe transformed the longitudinal PSA into a discrete sequence, used frequent sequential pattern mining to find candidate patterns from the sequences, and selected the most predictive and informative pattern among the candidates.ResultsPatients were less likely to be CRPC if, after PSA values reach nadir, the PSA decreases more than 0.048 ng/ml during a month, and the decrease occurs again. This pattern significantly increased the accuracy of predicting CRPC by supplementing information provided by existing PSA patterns such as pretreatment PSA.ConclusionsThis result can help clinicians to stratify men by the risk of CRPC and to determine the patient that needs intensive follow-up.
Highlights
Prostate specific antigen (PSA) is an important biomarker to monitor the response to the treatment, but has not been fully utilized as a whole sequence
Some patients proceed to castration-resistant prostate cancer (CRPC), whereas others retain hormone-sensitive prostate cancer (HSPC)
Predictive pattern selection To select the predictive patterns among the candidates set that were generated from frequent sequential pattern mining (FSPM), we evaluated the accuracy by measuring the area under the receiver-operating characteristic curve (AUC) and Harrell’s concordance index (C-index) [24]
Summary
Prostate specific antigen (PSA) is an important biomarker to monitor the response to the treatment, but has not been fully utilized as a whole sequence. We used a longitudinal biomarker PSA to discover a new prognostic pattern that predicts castration-resistant prostate cancer (CRPC) after androgen deprivation therapy. Androgen deprivation therapy (ADT) is the primary treatment of metastatic prostate cancer. ADT is conducted by suppressing androgens by castration, inhibiting the action of androgen using competing compounds known as anti-androgens, or by combining these treatments. Some patients proceed to castration-resistant prostate cancer (CRPC), whereas others retain hormone-sensitive prostate cancer (HSPC). For those who will be possibly endangered to CRPC, intensive follow-up and additional systematic therapies are required. Clinicians must assess the risk of progression to CRPC
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