Prognostic value of prostate-specific antigen in advanced prostate cancer treated with androgen deprivation therapy and abiraterone WCRJ 2024; 11 : e2850
DOI: 10.32113/wcrj_202411_2850

  Topic: Genitourinary cancer     Category: Original article

Lou L. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Wei J. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Ma S. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Chen W. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Cao X.-L. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Sun F.-H. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
sunfanghao2020@163.com Abstract OBJECTIVE: Prostate-specific antigen (PSA) has been a cornerstone in diagnosing and monitoring prostate cancer. With the advent of advanced hormonal therapies, such as the combination of androgen deprivation therapy (ADT) and abiraterone acetate plus prednisone (AAP+ADT), understanding PSA's prognostic value in metastatic castration-sensitive prostate cancer (mCSPC) is crucial for optimizing treatment strategies. This study was designed to explore the prognostic value of prostate-specific antigen in advanced prostate cancer treated with AAP+ADT.

PATIENTS AND METHODS: This study is a prospective, randomized controlled trial (RCT) comparing the effectiveness of ADT alone vs. AAP+ADT in 236 patients with mCSPC. Participants were randomly assigned to one of the two treatment groups, focusing on evaluating PSA progression-free survival and overall survival. The Kaplan-Meier survival curves and Log-rank tests were used for survival comparisons, and the analysis included both univariate and multivariate Cox regression to identify prognostic factors.

RESULTS: In this RCT study, a total of 236 mCSPC patients were enrolled and 118 patients received AAP+ADT, while the other 118 patients were treated with ADT alone. Our findings revealed that treatment with AAP+ADT emerged as an independent predictor of favorable PSA trajectory (Hazard Ratio [HR]=0.412, 95% Confidence Interval [CI]: 0.288-0.535, p<0.001), especially pronounced in patients achieving a 50-90% reduction in PSA levels (HR=0.434, 95% CI: 0.173-0.625, p<0.001) and those in the PSA90 reduction category (HR=0.183, 95% CI: 0.103-0.363, p<0.001).

CONCLUSIONS: The degree of PSA reduction following AAP+ADT therapy was a robust independent prognostic marker for patients with mCSPC.

To cite this article Lou L. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Wei J. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Ma S. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Chen W. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Cao X.-L. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China , Sun F.-H. Department of Urology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
sunfanghao2020@163.com Prognostic value of prostate-specific antigen in advanced prostate cancer treated with androgen deprivation therapy and abiraterone

WCRJ 2024; 11 : e2850
DOI: 10.32113/wcrj_202411_2850

Publication History

Submission date: 06 Apr 2024

Revised on: 19 Jun 2024

Accepted on: 22 Oct 2024

Published online: 25 Nov 2024

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