AI Article Synopsis
- - The study investigates the impact of prostate-specific antigen doubling time (PSADT) on patients with biochemical recurrence (BCR) of nonmetastatic castration-sensitive prostate cancer (nmCSPC), analyzing data from the Veterans Health Administration between 2006 and 2020.
- - Patients were grouped based on rapid (≤9 months) and less rapid (>9 to ≤15 months) PSADT; rapid PSADT correlated with significantly shorter times to first treatment and worse outcomes in terms of metastasis, metastasis-free survival, and overall survival.
- - The findings suggest that patients with rapid PSADT typically started secondary treatment within a year of BCR, and early treatment appears to yield better outcomes compared to historical data
Article Abstract
Background: The natural history of biochemical recurrence (BCR) managed with delayed hormonal therapy is well documented by data from Johns Hopkins. However, as many patients receive treatment prior to metastasis, we evaluated the natural history and role of prostate-specific antigen doubling time (PSADT) in a more contemporary cohort of BCR patients with nonmetastatic castration-sensitive prostate cancer (nmCSPC).
Methods: Patients in the Veterans Health Administration (VHA; 01/01/06 to 06/22/20) with nmCSPC and BCR were divided into rapid ( ≤9 months) and less rapid ( >9 to ≤15 months) PSADT cohorts. Patients with PSADT >15 months were excluded as outcomes, even with delayed treatment, are excellent. Outcomes included time to first antineoplastic therapy after BCR, metastasis, metastasis-free survival (MFS), and overall survival (OS). Cox models adjusted for baseline demographics and clinical characteristics.
Results: Overall, 781 patients with BCR were identified (502 rapid; 279 less rapid PSADT). Rapid PSADT was associated with shorter time to first systemic antineoplastic therapy (median 11.4 vs. 28.3 months, adjusted hazard ratio [95% confidence interval] 2.17 [1.83-2.57]), metastasis (102.4 months vs. not reached, 1.79 [1.33-2.40]), MFS (76.1 vs. 106.3 months, 1.73 [1.33-2.24]), and OS (120.5 vs. 140.5 months, 1.76 [1.22-2.54]) versus less rapid PSADT.
Conclusion: Most patients with rapid PSADT underwent secondary treatment within 1 year after BCR. More contemporary patients treated with early secondary treatment had better outcomes than historical data from patients who had delayed treatment. Whether these results reflect the benefits of early secondary treatment or overall improvements in prostate cancer outcomes over time requires further study.
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| http://dx.doi.org/10.1038/s41391-024-00894-0 | DOI Listing |
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