Health
Response to prostate cancer treatment
Bobby Riau, MD: We usually evaluate the effectiveness of prostate cancer treatment in three ways: symptoms, PSA. [prostate-specific antigen tests], And imaging. I usually repeat this for patients from time to time. This is to remind patients that many of the conversations we make during our visit are not really just lazy jokes. This is to investigate symptoms that may be worried that something is happening to the prostate cancer, or to see if the clinical symptoms caused by the disease are beginning to improve with treatment. Designed for. And, of course, to figure out if there are any side effects we need to pick up. However, PSA remains a major challenge in defining effectiveness. Our application for prostate cancer has been and is still a very important biomarker.
Although not many studies have used PSA decline as a primary endpoint these days, we feel that PSA dynamics provide a lot of valuable clinical data.In fact, the AUA recently had some summaries. [American Urological Association] Meeting like GUASCO [ASCO Genitourinary Cancers Symposium] This year, I’ll try to look a little at the decline in PSA, the lowest point of PSA, and the depth of reaction of PSA. There was a very good summary looking at the lowest PSA and the percentage of patients who achieved a PSA reduction of over 90% with appartamide. This analysis focused on patients who participated in the TITAN and SPARTAN studies.The research is actually a combination of appartamide and ADT [androgen deprivation therapy] It was associated with a high PSA reduction rate of over 90% at both 3 and 12 months. In fact, there was a decrease of over 90% at 12 months compared to 3 months. In fact, the 12-month TITAN survey was 71%, and the SPARTAN survey was 61% in 12 months. This indicates that PSA continues to decline over time. We also showed that the moderate time to the PSA lowest point was about 5.5 months for TITAN patients and 7.36 months for SPARTAN patients. Now, PSA response and kinetics are important in that they provide measurements of patient prognostic data, so I think it’s important to keep some of these in mind.
I would like to talk about a paper published by Hussainetal in 2006 that found that the lowest PSA point in patients with metastatic prostate cancer was a strong predictor of survival. That particular study was a study of more than 1,000 newly diagnosed metastatic prostate cancer patients who underwent ADT for 7 months. It showed that the PSA had a lowest point of less than 0.2 and the median survival time for the group of patients was 75 months. They had a median survival time of 44 months compared to those that had a lowest point in the range 0.2-4.0. Again, compared to them, the nadir was greater than 4 for PSA. The median survival time was only 13 months.
You can see PSA nadir actually start to provide us with a lot of information about how these people behave in the long run. Now, this particular study by Hussein et al. Was done solely at ADT. There is not exactly the same level of definitive data in the context of the use of inhibitors directed at the combined AR pathway, in the context of methods or standard of care that are pervasive in today’s era, but much data is still beginning to emerge. It suggests that the rate of decline in PSA and the lowest point of PSA still retains some of its prognostic value.
I edited the transcript for clarity.
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