PSA nadir and time to PSA nadir during initial androgen deprivation therapy as prognostic factors in metastatic castration‐resistance prostate cancer patients treated with docetaxel

Shi, Xinyu; Pei, Xinqi; Fan, Jia; Liu, Tianjie; Zhang, Dize; Yang, Tao; Wu, Kaijie; He, Dalin; Li, Lei

doi:10.1111/and.13916

Cited by 3 publications

(8 citation statements)

References 34 publications

(33 reference statements)

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“…The present multicenter retrospective case review approach revealed a significant association between nPSA levels < 0.2 ng/mL of nPSA and better median bPFS outcomes, relative to patients with nPSA levels ≥ 0.2 ng/mL of nPSA(27.6 vs 13.5 months, respectively), with these patients showing an overall 67.7% lower progression risk (HR, 0.323). Other studies have similarly reported lower nPSA levels to be related to a better prognosis (9,22), although the actual cut-off values for nPSA have varied among studies (8,9,(22)(23)(24). Several studies have used a cut-off value of 0.2 ng/mL (8,23,25), although some reports suggest that an undetectable nPSA level is related to better prognostic outcomes (26) and other reports have used a higher cut-off of 4.0 ng/mL (22).…”

Section: Discussionmentioning

confidence: 99%

“…After the initiation of ADT in patients with prostate cancer, the PSA levels undergo dynamic changes and monitoring these changes can provide insight into the patient outcomes. However, the actual prognostic value of parameters such as the nadir PSA (nPSA) and time to nPSA (TTN) levels remains the subject of substantial debate and further clinical analyses will be critical to fully clarify the relevance of these variables in different patient cohorts (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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Dynamic changes in PSA levels predict prognostic outcomes in prostate cancer patients undergoing androgen -deprivation therapy: A multicenter retrospective analysis

Mao²,

Chen³

et al. 2023

Front. Oncol.

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BackgroundAndrogen-deprivation therapy (ADT) is used for the treatment of prostate cancer. However, the specific risk factors for the development of castration-resistant disease are still unclear. The present study sought to identify predictors of patient prognostic outcomes through analyses of clinical findings in large numbers of prostate cancer patients following ADT treatment.MethodsData pertaining to 163 prostate cancer patients treated at the Second Affiliated Hospital of Bengbu Medical University and Maoming People’s Hospital from January 1, 2015, to December 30, 2020, were retrospectively analyzed. Dynamic changes in prostate-specific antigen (PSA) levels were regularly assessed, including both time to nadir (TTN) and nadir PSA (nPSA). Univariate and multivariate analyses were performed with Cox risk proportional regression models, while differences in biochemical progression-free survival (bPFS) were compared among groups with Kaplan-Meier curves and log-rank tests.ResultsThe bPFS values over the median 43.5-month follow-up period differed significantly between patients with nPSA levels < 0.2 ng/mL and ≥ 0.2 ng/mL, being 27.6 months and 13.5 months, respectively (log-rank P < 0.001). A significant difference in median bPFS was also observed when comparing patients with a TTN ≥ 9 months (27.8 months) to those with a TTN < 9 months (13.5 months) (log-rank P < 0.001).ConclusionsTTN and nPSA are valuable predictors of prognosis in prostate cancer patients after ADT treatment, with better outcomes evident in patients with nPSA < 0.2 ng/mL and TTN > 9 months.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dynamic changes in PSA levels predict prognostic outcomes in prostate cancer patients undergoing androgen -deprivation therapy: A multicenter retrospective analysis

Mao²,

Chen³

et al. 2023

Front. Oncol.

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“…The role of the posttreatment PSA (higher PSA nadir or shorter time to PSA nadir) in predicting the progression to CRPC or the overall survival has been demonstrated in many reports. 13 , 22 - 26 However, the exact mechanism remains unclear. The possible reason is that the rapid decrease in the PSA level after ADT is due to the suppression of the expression of PSA mediated by the androgen receptor in hormone-sensitive prostate cancer cells.…”

Section: Discussionmentioning

confidence: 99%

Nomogram Incorporating Contrast-Enhanced Ultrasonography Predicting Time to the Development of Castration-Resistant Prostate Cancer

Zhao

Sun

Wang

et al. 2021

Clin Med Insights Oncol

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Background: It is valuable to predict the time to the development of castration-resistant prostate cancer (CRPC) in patients with advanced prostate cancer (PCa). This study aimed to build and validate a nomogram incorporating the clinicopathologic characteristics and the parameters of contrast-enhanced ultrasonography (CEUS) to predict the time to CRPC after androgen deprivation therapy (ADT). Methods: Patients with PCa were divided into the training (n = 183) and validation cohorts (n = 37) for nomogram construction and validation. The clinicopathologic characteristics and CEUS parameters were analyzed to determine the independent prognosis factors and serve as the basis of the nomogram to estimate the risk of 1-, 2-, and 3-year progress to CRPC. Results: T stage, distant metastasis, Gleason score, area under the curve (AUC), prostate-specific antigen (PSA) nadir, and time to PSA nadir were the independent predictors of CRPC (all P < 0.05). Three nomograms were built to predict the time to CRPC. Owing to the inclusion of CEUS parameter, the discrimination of the established nomogram (C-index: 0.825 and 0.797 for training and validation datasets) was improved compared with the traditional prediction model (C-index: 0.825 and 0.797), and when it excluded posttreatment PSA, it still obtained an acceptable discrimination (C-index: 0.825 and 0.797). Conclusions: The established nomogram including regular prognostic indicators and CEUS obtained an improved accuracy for the prediction of the time to CRPC. It was also applicable for early prediction of CRPC when it excluded posttreatment PSA, which might be helpful for individualized diagnosis and treatment.

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“…Similar ndings have been con rmed in previous studies, [6,10] in which the lower the PSA nadir, the better the prognosis; however, the nadir cut-off values reported in different studies vary slightly. [5,6,10−13] Most studies concluded a cut-off value of 0.2 ng/ml, [5,10,11,13] and some suggest that PSA nadir should be as low as unmeasurable so that patients have a better prognosis, [14] or somewhat higher, 4.0 ng/ml. [12] These differences may be explained by different study populations and follow-up methods.…”

Section: Discussionmentioning

confidence: 99%

“…[3] After androgen deprivation therapy for prostate cancer, a series of dynamic changes in serum PSA levels occur, and various factors affected by these changes may provide important prognostic information. However, considerable controversy persists regarding the utility of PSA nadir (nPSA) values, time to nadir PSA (TTN), and halving time after androgen deprivation therapy for prostate cancer in the prognostic determination of prostate cancer, [4][5][6] and need to be analyzed in more clinical studies.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Changes in Prostate-Specific Antigen After Androgen Deprivation Therapy for Prostate Cancer are Strongly Associated with Biochemical Progression-Free Survival: A Multicenter Retrospective Analysis

Hu¹,

Mao

Zhang³

et al. 2021

Preprint

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Objectives: The risk factors for prostate cancer to progress to castration-resistant prostate cancer after androgen deprivation treatment (ADT) are still not to be well defined. We conducted this investigation in an attempt to determine factors that predicted the prognosis in a series of patients with prostate cancer after ADT. Methods: We retrospectively analyzed the database of patients treated with androgen deprivation prostate cancer who were hospitalized in the Second Affiliated Hospital of Bengbu Medical College and Maoming People's Hospital from 2015.1.1 to 2020.12.30. PSA dynamic changes, including nadir PSA (nPSA), time to nadir PSA (TTN), were examined regularly. Cox risk proportional regression model was used for univariate and multivariate analysis; Kaplan-Meier survival curve and Log-rank test were used to compare and analyze differences in biochemical progression-free survival (bPFS) between groups. Results: During the follow-up with a median time of 43.5 months, a total of 163 men were included in the study. The median bPFS of the two groups with nPSA lower than 0.2ng/ml and ≥0.2ng/ml were 27.6 months and 13.5, respectively, with significant differences between the groups (Log-rank p<0.001); The median bPFS of the two groups with TTN ≥9 months and less than 9 were 27.8 months and 13.5 months, respectively, with significant differences between the groups (Log rank p<0.001). Conclusions: PSA dynamic changes after androgen deprivation treatment of prostate cancer can be used as prognostic indicators for bPFS. The lower the nadir PSA value and the longer the time to nadir, the longer the bPFS of patients with prostatic cancer after androgen deprivation treatment.

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PSA nadir and time to PSA nadir during initial androgen deprivation therapy as prognostic factors in metastatic castration‐resistance prostate cancer patients treated with docetaxel

Cited by 3 publications

References 34 publications

Dynamic changes in PSA levels predict prognostic outcomes in prostate cancer patients undergoing androgen -deprivation therapy: A multicenter retrospective analysis

Dynamic changes in PSA levels predict prognostic outcomes in prostate cancer patients undergoing androgen -deprivation therapy: A multicenter retrospective analysis

Nomogram Incorporating Contrast-Enhanced Ultrasonography Predicting Time to the Development of Castration-Resistant Prostate Cancer

Dynamic Changes in Prostate-Specific Antigen After Androgen Deprivation Therapy for Prostate Cancer are Strongly Associated with Biochemical Progression-Free Survival: A Multicenter Retrospective Analysis

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