Akash Maniam: How Best to De-Escalate Excellent Responders and Intensify Those Who Don’t
Dr. Akash Maniam, Medical Oncologist at University Hospitals Portsmouth NHS Trust, shared post by Diego Lopez Macias, Clinical Oncologist at Hospital Angeles Acoxpa, on LinkedIn:
“This makes counselling patients far easier. The next step is determining how best to de-escalate excellent responders and intensify those who don’t.”
Qouting Diego Lopez Macias‘s post:
“PSA Response as a Prognostic Marker
A recent systematic review and meta-analysis published in European Urology Focus confirms that early prostate-specific antigen (PSA) response is strongly associated with overall survival in patients treated with androgen receptor pathway inhibitors (ARPI) across all advanced prostate cancer stages.
Key Findings (n = 8,883 patients across 14 studies):
• In metastatic hormone-sensitive prostate cancer (mHSPC), achieving undetectable PSA was linked to a 67% reduction in mortality (HR 0.33; 95% CI: 0.23–0.49).
• In non-metastatic CRPC, a ≥90% PSA decline showed a 61% reduction in death risk (HR 0.39; CI: 0.28–0.52).
• In metastatic CRPC, a ≥90% PSA decline corresponded to a 78% reduction in mortality (HR 0.22; CI: 0.14–0.34).
These data support the use of PSA response as an early efficacy signal and potential surrogate marker in clinical trials.”
Title: Prostate-specific Antigen Response as a Prognostic Factor for Overall
Survival in Patients with Prostate Cancer Treated with Androgen
Receptor Pathway Inhibitors: A Systematic Review and Meta-analysis
Authors: Marcin Miszczyk, Tamás Fazekas, Paweł Rajwa, Akihiro Matsukawa, Ichiro Tsuboi, Michael S. Leapman, Gero Kramer, Maha Hussain, Axel Merseburger, Alberto Briganti, Anthony V. D’Amico, Silke Gillessen, Fred Saad, Shahrokh F. Shariat
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