Stable PSA Periods After adiation Therapy May Predict Disease-Free Survival

Publication
Article
OncologyONCOLOGY Vol 13 No 6
Volume 13
Issue 6

Like pretreatment prostate-specific antigen (PSA), post-treatment PSA nadirs may have prognostic significance in patients with prostate carcinoma, according to data presented by Timothy S. Boyd, MD, Robert C. Orth, BS, Wolfgang A. Tomé,

Like pretreatment prostate-specific antigen (PSA), post-treatment PSA nadirs may have prognostic significance in patients with prostate carcinoma, according to data presented by Timothy S. Boyd, MD, Robert C. Orth, BS, Wolfgang A. Tomé, PhD, and Mark A. Ritter, MD, PhD, of the Department of Human Oncology at the University of Wisconsin at the American Society for Therapeutic Radiology and Oncology (ASTRO) meeting.

Assuming that a stable PSA period occurring many years after treatment equates with cure, the investigators focused on the extent to which the probability of long-term cure decreased as the time between treatment and the observed stable PSA interval decreased.

The Wisconsin researchers reviewed the PSA records of 296 patients with prostate cancer initially treated with radiation therapy over a 9-year period. The final selection criteria for the study included definitive treatment with irradiation, no post-treatment use of antiandrogen therapy, and at least a 1-year period of stable PSA values (defined two or more values below 1.0 or 0.5 ng/mL).

Any subsequent deviation from these criteria was defined as the onset of biochemical failure. Clinical failures were defined by physical examination and biopsy or imaging. From the time of completion of each of the stable PSA periods, actuarial biochemical disease-free survival was then calculated.

Study Findings

Patients with stable PSA periods below 1.0 ng/mL beginning 1 to 2 years after radiation therapy had a 5-year postinterval control rate of 69%, increasing to 100% for stable PSA periods beginning 3 to 4 years after treatment. Patients with stable PSA periods below 0.5 ng/mL beginning 1 to 2 years after therapy had a 5-year postinterval control rate of 92%, increasing to 100% for stable PSA periods beginning 2 to 3 years after treatment. Patients in the nadir cohort achieved a 5-year post nadir control rate of only 72% for nadirs £ 1.0 ng/mL and a control rate of 73% for nadirs £ 0.5 ng/mL.

Therefore, the investigators concluded that PSA stability after radiation is prognostically significant and may be useful as a study end point and in counseling patients.

Related Videos
Anemia in patients who receive talazoparib plus enzalutamide for metastatic castration-resistant prostate cancer appears to be manageable without any compromises in patient-reported outcomes and quality of life.
Artificial intelligence models may be “seamlessly incorporated” into clinical workflow in the management of prostate cancer, says Eric Li, MD.
Robust genetic testing guidelines in the prostate cancer space must be supported by strong clinical research before they can be properly implemented, says William J. Catalona, MD.
Financial constraints and a lack of education among some patients and providers must be addressed to improve the real-world use of certain prostate cancer therapies, says Neeraj Agarwal, MD.
Novel anti-PSMA monoclonal antibody rosopatamab is capable of carrying a bigger payload of radiation particles, which may potentially reduce doses for patients with prostate cancer, says Neeraj Agarwal, MD.
Findings from recent studies support the use of artificial intelligence-based tools in the context of radiation therapy for patients with localized prostate cancer, according to Neeraj Agarwal, MD.
Germline testing may elucidate important mutations in patients with metastatic prostate cancer who may be eligible to receive treatment with PARP inhibitors, according to Neeraj Agarwal, MD.
In this September edition of Snap Recap, we share our highlights from Prostate Cancer Awareness Month, news in the breast cancer space, and the latest FDA updates.
Artificial intelligence programs may help introduce new care strategies that minimize the risk of adverse effects in patients with prostate cancer, according to Wayne G. Brisbane, MD.
Related Content