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Is time to castration resistant prostate cancer a potential intermediate end-point for time to metastasis among men initiating androgen deprivation therapy for non-metastatic prostate cancer with rapid PSA doubling time (<9 months)?

Publication ,  Journal Article
Klaassen, Z; Howard, L; Wallis, CJD; Janes, JL; De Hoedt, A; Aronson, WJ; Polascik, TJ; Amling, CJ; Kane, CJ; Cooperberg, MR; Terris, MK ...
Published in: Prostate Cancer Prostatic Dis
March 2023

PURPOSE: Metastasis-free survival (MFS) is a surrogate for overall survival (OS) in men with non-metastatic castration-resistant prostate cancer (CRPC), but this endpoint may take years to develop in men with non-metastatic castrate-sensitive disease. The study objective was to examine whether progression to CRPC is a potential intermediate endpoint for developing metastatic disease in patients with biochemical recurrence (BCR) after radical prostatectomy (RP). MATERIALS AND METHODS: Men with BCR following RP who had PSA doubling times (PSADT) < 9 months and no metastasis at the time of initiating androgen deprivation therapy (ADT) (n = 210) were included. The primary objective was to assess the correlation between CRPC-free survival (CRPC-FS) and MFS, and the secondary objective was to assess the correlation between time to metastasis and time to CRPC. Kendall's Tau was used to test the correlation for the primary and secondary outcomes. RESULTS: The median MFS was 104 months (95% CI: 83-114) and median CRPC-FS was 100 months (95% CI: 80-114). Based on the Kaplan-Meier curve, the greatest difference in time to MFS and CRPC-FS was around 70% free survival, which was reached at 61.2 months for MFS and 49.6 months for CRPC-FS. Kendall's Tau for the correlation between CRPC-FS and MFS and between time to CRPC and time to metastasis was 0.867 (95% CI: 0.765-0.968) and 0.764 (95% CI: 0.644-0.884), respectively. CONCLUSIONS: Given the high correlation between CRPC-FS and MFS, after validation, CRPC-FS may serve as a potential intermediate endpoint in trials for men with BCR initiating ADT following local therapy.

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Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

March 2023

Volume

26

Issue

1

Start / End Page

151 / 155

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Retrospective Studies
  • Prostatic Neoplasms, Castration-Resistant
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Male
  • Humans
  • Androgens
  • Androgen Antagonists
  • 3211 Oncology and carcinogenesis
 

Citation

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Klaassen, Z., Howard, L., Wallis, C. J. D., Janes, J. L., De Hoedt, A., Aronson, W. J., … Freedland, S. J. (2023). Is time to castration resistant prostate cancer a potential intermediate end-point for time to metastasis among men initiating androgen deprivation therapy for non-metastatic prostate cancer with rapid PSA doubling time (<9 months)? Prostate Cancer Prostatic Dis, 26(1), 151–155. https://doi.org/10.1038/s41391-022-00585-8
Klaassen, Zachary, Lauren Howard, Christopher J. D. Wallis, Jessica L. Janes, Amanda De Hoedt, William J. Aronson, Thomas J. Polascik, et al. “Is time to castration resistant prostate cancer a potential intermediate end-point for time to metastasis among men initiating androgen deprivation therapy for non-metastatic prostate cancer with rapid PSA doubling time (<9 months)?Prostate Cancer Prostatic Dis 26, no. 1 (March 2023): 151–55. https://doi.org/10.1038/s41391-022-00585-8.
Klaassen Z, Howard L, Wallis CJD, Janes JL, De Hoedt A, Aronson WJ, Polascik TJ, Amling CJ, Kane CJ, Cooperberg MR, Terris MK, Wu Y, Freedland SJ. Is time to castration resistant prostate cancer a potential intermediate end-point for time to metastasis among men initiating androgen deprivation therapy for non-metastatic prostate cancer with rapid PSA doubling time (<9 months)? Prostate Cancer Prostatic Dis. 2023 Mar;26(1):151–155.

Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

March 2023

Volume

26

Issue

1

Start / End Page

151 / 155

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Retrospective Studies
  • Prostatic Neoplasms, Castration-Resistant
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Male
  • Humans
  • Androgens
  • Androgen Antagonists
  • 3211 Oncology and carcinogenesis