Prostate-specific antigen doubling time predicts the efficacy of site-directed therapy for oligoprogressive castration-resistant prostate cancer

Kawai, Taketo; Taguchi, Satoru; Nozaki, Keina; Kimura, Naoki; Oshina, Takahiro; Iwaki, Takuya; Matsui, Hotaka; Niimi, Aya; Kamei, Jun; Akiyama, Yoshiyuki; Yamada, Yuta; Sato, Yusuke; Yamada, Daisuke; Kaneko, Tomoyuki; Sawayanagi, Subaru; Nakayama, Hidetsugu; Minamimoto, Ryogo; Yamashita, Hideomi; Miyazaki, Hideyo; Fujimura, Tetsuya; Nakagawa, Tohru; Kume, Haruki

doi:10.1016/j.prnil.2023.10.002

Cited by 1 publication

(3 citation statements)

References 32 publications

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“…The predictive role of PSADT was also demonstrated in real-world data from Japan, including 59 patients with CRPC who received MDRT for oligo-progressive sites of the prostate or metastatic lesions. The majority of patient (61%) had received prior radical treatment for nmPCa, and a signi cantly longer PFS was shown in patients with PSADT < 6 months than that in those without (median: 15.0 vs. 5.0 months; P < 0.001) [21]. Here, one might argue for the clinical importance of such a difference of 10 months in PFS between the two PSADT groups shown in both the present and Japanese studies.…”

Section: Discussionsupporting

confidence: 49%

“…Therefore, the statistical association between better PFS and L-PSADT in the present study could be theoretically explained, especially given that the predictive role of PSADT for MDRT was also found in the present study, with no in uence of salvage hormone therapy. However, data on PSADT in the treatment with MDRT for OMPCa is exceedingly scarce when conference reports are excluded; thus, further studies are required to validate our proposed rationale [21].…”

Section: Discussionmentioning

confidence: 99%

“…In the treatment of metastatic CRPC, some studies have demonstrated better oncological outcomes following MDRT for oligo-progressive metastasis in patients with long PSADT [21]. This may be explained as follows: rst, as such lesions identi ed under castration resistance are deemed refractory to current systemic therapy, one of the subsequent treatment options can be radiotherapy; second, accumulating evidence of PSADT as an alternative marker for the progression of PCa was also established in non-metastatic CRPC, with an example of an association between PSADT < 8 months and a rapid increase in the risk of bone metastasis [22].…”

Section: Discussionmentioning

confidence: 99%

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Predictive Value of the Prostate-Specific Antigen Doubling Time for the Effectiveness of Metastasis-Directed Radiotherapy in Patients with Oligometastases after Radical Treatment for Non-metastatic Prostate Cancer: A Single Institution Retrospective Study

Koguchi,

Tabata,

Hirano

et al. 2024

Preprint

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Background: Data on metastasis-directed radiotherapy (MDRT) are limited, particularly regarding its association with the prostate-specific antigen (PSA) doubling time (PSADT). The present study aims to evaluate the oncological outcomes of MDRT on the basis of the PSADT in patients who developed oligometastases after radical treatment for non-metastatic prostate cancer. Methods: We retrospectively reviewed the clinical data of 35 MDRTs for 29 patients targeting oligometastatic prostate cancer developed after radical prostatectomy or radiotherapy for non-metastatic prostate cancer. Thirty-five MDRTs were classified into the PSADT > 3 months (n = 25) or PSADT ≤ 3 months group (n = 10). Statistical analyses were performed to compare associations between the two PSADT groups and the oncological outcomes such as progression-free survival (PFS) and PSA response after MDRT. Results: There were no significant differences between the groups in terms of age, PSA level, Gleason score, or TNM stage. Kaplan–Meier analysis showed that PFS was significantly better in the PSADT > 3 months group than in the PSADT ≤ 3 months group (median: 13.3 versus [vs.] 2.6 months, P = 0.046). Regarding castration sensitivity, the predictive role of PSADT > 3 months was maintained in 21 patients who received MDRT without prior salvage hormone therapy (median PFS: 12.7 vs. 2.6 months, P = 0.024). In the castration-resistant setting (n = 14), the frequency of a decrease in serum PSA levels after MDRT by 90% was 54.5% (median PFS: 23.1 months). Conclusions: MDRT can provide benefit especially for patients with PSADT ≥ 3 months who had oligo-recurrence after the radical treatment for non-metastatic prostate cancer.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%