Prostate-Specific Antigen Kinetics Effects on Outcomes of Low-Volume Metastatic Prostate Cancer Patients Receiving Androgen Deprivation Therapy

Abstract

Background. The present study aimed to analyse factors influencing the effects of androgen deprivation therapy (ADT) in patients with newly diagnosed metastatic castration-naïve prostate cancer (mCNPC), especially in low-volume disease (LVD), according to subclassification of metastatic prostate cancer established by the CHAARTED trial. Materials and Methods. We reviewed 648 patients with newly diagnosed mCNPC receiving ADT at Chang Gung Memorial Hospital from January 2007 to December 2016. Basic characteristics and PSA kinetics profile were subsequently evaluated. Results. 48.3% of LVD patients progressed to castration-resistant prostate cancer (mCRPC). Among them, CRPC group had significantly shorter time to PSA nadir (TTN) and faster time from PSA nadir to CRPC (TFNTC) ( p < 0.001) compared to non-CRPC group. PSA doubling time (PSADT) < 4 months tended to be associated with faster disease progression and shorter overall survival (OS). Among all patients with metastatic prostate cancer, those with shorter TTN <9 months, higher nadir PSA level ≥1 ng/mL, and shorter PSADT <3 months had increased tendency for biochemical progression. Conclusions. PSADT is an effective clinical predictor for disease progression and survival in LVD. Other PSA kinetics including TTN and TFNTC, though not the major predictors for disease progression or OS in LVD, might be the predictors for disease control status.

The slope associated with nadir prostate‐specific antigen is prognostically significant in men with hormone‐sensitive prostate cancer after primary androgen deprivation therapy

“…We investigated the prognostic significance of the slope associated with nadir PSA in patients treated with PADT. In accordance with previous reports, 12 , 15 , 17 our results also showed that nPSA‐DS, nPSA‐LS, and nPSA‐PDS were associated with PFS and OS in the univariate analysis. Moreover, we found that nadir PSA and nPSA‐DS following PADT were independently associated with PFS and OS, even after adjusting for other factors.…”

“…Akbay et al 15 used a formula for assessing the PSA decline pattern to calculate the declining slope to nadir PSA (ds‐nPSA), and they found that patients with ds‐nPSA> − 0.507 had prolonged PFS in the univariate analysis. Lin et al 17 calculated the PSA reduction rate (PSARR) according to the formula PSARR = (100* (iPSA‐nPSA/iPSA)/TTPN). In the univariate analysis, the PSARR was a statistically significant indicator for disease progression and OS, but no statistical significance was found in the multivariate analysis.…”

“…However, the roles of the slope associated with nadir PSA based on initial PSA, PSA nadir, and TTPN in evaluating the prognosis of prostate cancer patients after treatment have been reported in very few studies. Therefore, we obtained the slope associated with nadir PSA according to different calculation methods 12,15,17 . These methods included the nPSA declining slope (nPSA‐DS), nPSA percentage declining slope (nPSA‐PDS), and nPSA line slope (nPSA‐LS), which were defined as the slope associated with nadir PSA from a mathematical point of view according to the calculation formula.…”

“…Therefore, we obtained the slope associated with nadir PSA according to different calculation methods. 12 , 15 , 17 These methods included the nPSA declining slope (nPSA‐DS), nPSA percentage declining slope (nPSA‐PDS), and nPSA line slope (nPSA‐LS), which were defined as the slope associated with nadir PSA from a mathematical point of view according to the calculation formula. Then, we investigated whether the slope associated with nadir PSA could be utilized as a prognostic indicator in men with prostate cancer undergoing ADT.…”

Three Members of Transmembrane-4-Superfamily, TM4SF1, TM4SF4, and TM4SF5, as Emerging Anticancer Molecular Targets against Cancer Phenotypes and Chemoresistance

“…PRC is the second most commonly diagnosed cancer in men worldwide [ 78 ]. For patients with metastatic PRC, androgen deprivation therapy (ADT) has been the gold standard [ 79 ]. Androgens control the proliferation and survival of prostate epithelial cells by binding to the AR, which is also involved in the development of PRC and regulates specific target genes [ 80 , 81 ].…”