Prostate-specific Antigen at 3 Months as a Predictor of Radiologic Progression-free Survival in Metastatic Hormone-sensitive Prostate Cancer Treated with Apalutamide: Analysis of 633 Patients in a Real-world Database.

Autor:	Hassi Roman M; Hospital DIPRECA, Santiago, 7550000, Chile., Mate K; Péterfy Sándor Utcai Hospital Clinic and Trauma Centre, Budapest, Hungary., De Pablos-Rodriguez P; Instituto Valenciano de Oncología, Valencia, Spain., Horcajada ÁZ; Hospital Palencia, Palencia, Spain., Cascales AG; Hospital Universitario Fundación de Alcorcón, Madrid, Spain., Bonet ÁS; Hospital Príncipe de Asturias, Madrid, Spain., Vilaseca A; Hospital Clínic de Barcelona, Barcelona, Spain., Vázquez-Martul Pazos D; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain., Espinós EL; Hospital Universitario La Paz, Madrid, Spain., Rodríguez JM; Hospital Parc Taulí, Sabadell, Spain., de la Morena Gallego JM; Hospital Universitario Infanta Sofía, Madrid, Spain., Alemán JR; Hospital Verge de la Cinta de Tortosa, Tortosa, Spain., Rivas JG; Hospital Clínico San Carlos, Madrid, Spain., Formisano L; Department of Clinical Medicine and Surgery, University Federico II, Napoli, Italy., Juan Fita MJ; Instituto Valenciano de Oncología, Valencia, Spain., Planells MC; Hospital Vall d'Hebrón, Barcelona, Spain., Esteban MD; Hospital Universitario Marqués de Valdecilla, Santander, Spain., Márquez MP; Consorci Sanitari de Terrassa, Barcelona, Spain., Sanz MG; Hospital León, León, Spain., Expósito NG; ICO Hospitalet, Barcelona, Spain., Picola N; Hospital Universitari de Bellvitge, Barcelona, Spain., Vives PS; Hospital Universitari Germans Trias i Pujol, Barcelona, Spain., Sutil RS; Hospital Universitario 12 de Octubre, Madrid, Spain., Climent Durán MA; Instituto Valenciano de Oncología, Valencia, Spain., Backhaus MR; Instituto Valenciano de Oncología, Valencia, Spain.
Jazyk:	angličtina
Zdroj:	European urology open science [Eur Urol Open Sci] 2024 Oct 17; Vol. 70, pp. 58-63. Date of Electronic Publication: 2024 Oct 17 (Print Publication: 2024).
DOI:	10.1016/j.euros.2024.10.001
Abstrakt:	Background and Objective: The depth of the prostate-specific antigen (PSA) decline after androgen receptor pathway inhibitor (ARPI) treatment combined with androgen deprivation therapy for patients with metastatic hormone-sensitive prostate cancer (mHSPC) may affect prognosis. The primary objective in our study was the correlation between the PSA response at 3 mo and radiologic progression-free survival (rPFS) at 24 mo. Three groups were defined according to the PSA decline: complete response (PSA ≤0.02 ng/ml), partial response (PSA >0.02 and ≤0.2 ng/ml), and incomplete response (PSA >0.2 ng/ml). Secondary objectives were correlation between the PSA response at 3 mo and overall survival, and the development of a model predicting complete PSA response. Methods: We conducted a retrospective multicenter study of patients with mHSPC treated with apalutamide from May 2018 to September 2023 registered in the Real-World Evidence APA registry across 20 centers. Key Findings and Limitations: We included 633 patients with mHSPC. The median age at diagnosis was 68 yr (interquartile range [IQR] 63-75) and median PSA was 16 ng/ml (IQR 7.5-64). Some 63% of the short had low-volume disease, 51% had de novo disease, 48% had recurrent disease. At 3 mo, 27% had a complete response, 42% a partial response, and 31% an incomplete response, with corresponding rRFS rates at 24 mo of 92%, 86%, and 63%. According to the predictive model, a complete PSA response at 3 mo was associated with the use of next-generation imaging and PSA <50 ng/ml at diagnosis. Study limitations include heterogeneity among the groups and variations in data quality and assessment methods. Conclusions and Clinical Implications: Patients with a complete PSA response after 3 mo of apalutamide treatment face a very low risk of progression within 2 yr. Conversely, nearly 50% of patients with an incomplete PSA response will experience disease progression. Patient Summary: For patients with metastatic prostate cancer that is still responsive to hormone therapy, a complete response after treatment with a drug called apalutamide is associated with a very low risk of progression within 2 years. However, nearly half of patients with an incomplete response to apalutamide will experience progression of their cancer. (© 2024 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu