Abstract
ObjectiveTo date, there are no useful markers for predicting the prognosis of metastatic hormone-sensitive prostate cancer (mHSPC). We evaluated the effect of early changes in prostate-specific antigen (PSA) levels after androgen deprivation therapy (ADT) on castration-resistant prostate cancer (CRPC) progression and overall survival (OS) in mHSPC patients.ResultsIn 71 primary mHSPC patients treated with ADT, the median times to CRPC and OS were 15 months and 92 months, respectively. In multivariate analysis, a Gleason score of ≥ 8 (p = 0.004), an extent of disease value (EOD) of ≥ 2 (p = 0.004), and a 3-month PSA level > 1% of the pretreatment level (p = 0.017) were independent predictors of shorter time to CRPC. The area under the receiver operating characteristic curve was feasible at 0.822. A 3-month PSA level > 1% of the pretreatment level was an independent predictor of OS (p = 0.004). Three factors were independent predictors of shorter time to CRPC. A 3-month PSA level > 1% of the pretreatment level correlated with a poor prognosis.
Highlights
Androgen deprivation therapy (ADT) has been the standard of care for metastatic hormone-sensitivity prostate cancer
Patients were considered to be on ADT if they were on any luteinizing hormone-releasing hormone (LHRH) agonists or LHRH antagonists, or had undergone surgical castration or combined androgen blockade (CAB)
In this study, we assessed the usefulness of early prostate-specific antigen (PSA) change after ADT administration as a predictive marker for metastatic hormone-sensitivity prostate cancer (mHSPC) patients
Summary
Androgen deprivation therapy (ADT) has been the standard of care for metastatic hormone-sensitivity prostate cancer (mHSPC). Abiraterone acetate has been administered in Japan since 2018 for high-risk cases of mHSPC (those that satisfy two or more of a Gleason score ≥ 8, visceral metastasis, and ≥ 3 bone metastases). In the group of PSA ≥ 1% after 3 months of ADT, the time to CRPC was significantly shorter (p = 0.027) (Additional file 3: Figure S3); the OS was significantly shorter (p = 0.01). Lymph node metastasis and visceral metastasis were not significant factors in either the time to CRPC or OS (Additional file 4: Table S1). In multivariate analysis using Cox proportional hazards regression, a Gleason score ≥ 8 (p = 0.004), EOD ≥ 2 (p = 0.004), and %PSA ≥ 1 (p = 0.017) were found to be independent predictors of shortening the time to CRPC.
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