The Lowest PSA Level Achieved Before CRPC Predicts Abiraterone Response But Not Enzalutamide Response in Metastatic CRPC.
Kohei Hashimoto, Kouji Izumi, Takashi Shima et al.
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In 30 seconds
This multicenter randomized controlled trial investigated the impact of the lowest prostate-specific antigen (PSA) level before castration-resistant prostate cancer (CRPC) on the efficacy of abiraterone (ABI) and enzalutamide (ENZ) in metastatic CRPC. The study found that lower PSA levels were associated with improved docetaxel-free survival (DFS) in the ABI group (median 29.0 vs. 15.2 months, p=0.0209), but no significant differences were observed in the ENZ group.
Key findings
- In the ABI arm, median DFS was 29.0 months for low PSA vs. 14.0 months for high PSA (p=0.0106).
- Median time to PSA progression was undefined in the low PSA group vs. 4.7 months in the high PSA group (p=0.0443).
- Radiographic progression-free survival was 39.5 months for low PSA vs. 9.8 months for high PSA (p=0.0243).
- No significant differences in outcomes were found in the ENZ treatment arm.
Why it matters
Understanding the relationship between PSA levels and treatment outcomes can help clinicians better predict responses to therapies in metastatic CRPC, potentially guiding treatment decisions and patient management strategies.