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oai:recercat.cat:11351/123622025-10-24T10:26:17Zcom_2072_378070com_2072_378040col_2072_378092

Prostate-specific Antigen at 3 Months as a Predictor of Radiologic Progression-free Survival in Metastatic Hormone-sensitive Prostate Cancer Treated with Apalutamide: Analysis of 633 Patients in a Real-world Database Hassi Roman, Mario Mate, Kinga de Pablos-Rodriguez, Pedro Zamora Horcajada, Álvaro Guijarro Cascales, Ana Sanchis-Bonet, Angeles Costa Planells, Marc Institut Català de la Salut [Hassi Roman M] Hospital DIPRECA, Santiago, Chile. [Mate K] Péterfy Sándor Utcai Hospital Clinic and Trauma Centre, Budapest, Hungary. [De Pablos-Rodriguez P] Instituto Valenciano de Oncología, Valencia, Spain. [Zamora Horcajada Á] Hospital Palencia, Palencia, Spain. [Guijarro Cascales A] Hospital Universitario Fundación de Alcorcón, Madrid, Spain. [Sanchís Bonet Á] Hospital Príncipe de Asturias, Madrid, Spain. [Costa Planells O] Vall d’Hebron Hospital Universitari, Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Pròstata - Càncer - Tractament Pròstata - Càncer - Prognosi Avaluació de resultats (Assistència sanitària) Antiandrògens - Ús terapèutic Antigen prostàtic específic DISEASES::Neoplasms::Neoplasms by Site::Urogenital Neoplasms::Genital Neoplasms, Male::Prostatic Neoplasms CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormone Antagonists::Androgen Antagonists ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome::Progression-Free Survival CHEMICALS AND DRUGS::Enzymes and Coenzymes::Enzymes::Hydrolases::Peptide Hydrolases::Endopeptidases::Serine Endopeptidases::Kallikreins::Prostate-Specific Antigen ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias urogenitales::neoplasias de los genitales masculinos::neoplasias de la próstata COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::hormonas, sustitutos de hormonas y antagonistas de hormonas::antagonistas de hormonas::antagonistas de andrógenos TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento::supervivencia libre de progresión COMPUESTOS QUÍMICOS Y DROGAS::enzimas y coenzimas::enzimas::hidrolasas::péptido hidrolasas::endopeptidasas::serina endopeptidasas::calicreínas::antígeno prostático específico Apalutamide; Prostate cancer; Prostate-specific antigen Apalutamida; Cáncer de próstata; Antígeno prostático específico Apalutamida; Càncer de pròstata; Antigen específic pròstatic Background and objective The depth of the prostate-specific antigen (PSA) decline after androgen receptor pathway inhibitor (ARPI) treatment combined with androgen deprivation therapy for patients with metastatic hormone-sensitive prostate cancer (mHSPC) may affect prognosis. The primary objective in our study was the correlation between the PSA response at 3 mo and radiologic progression-free survival (rPFS) at 24 mo. Three groups were defined according to the PSA decline: complete response (PSA ≤0.02 ng/ml), partial response (PSA >0.02 and ≤0.2 ng/ml), and incomplete response (PSA >0.2 ng/ml). Secondary objectives were correlation between the PSA response at 3 mo and overall survival, and the development of a model predicting complete PSA response. Methods We conducted a retrospective multicenter study of patients with mHSPC treated with apalutamide from May 2018 to September 2023 registered in the Real-World Evidence APA registry across 20 centers. Key findings and limitations We included 633 patients with mHSPC. The median age at diagnosis was 68 yr (interquartile range [IQR] 63–75) and median PSA was 16 ng/ml (IQR 7.5–64). Some 63% of the short had low-volume disease, 51% had de novo disease, 48% had recurrent disease. At 3 mo, 27% had a complete response, 42% a partial response, and 31% an incomplete response, with corresponding rRFS rates at 24 mo of 92%, 86%, and 63%. According to the predictive model, a complete PSA response at 3 mo was associated with the use of next-generation imaging and PSA <50 ng/ml at diagnosis. Study limitations include heterogeneity among the groups and variations in data quality and assessment methods. Conclusions and clinical implications Patients with a complete PSA response after 3 mo of apalutamide treatment face a very low risk of progression within 2 yr. Conversely, nearly 50% of patients with an incomplete PSA response will experience disease progression. Patient summary For patients with metastatic prostate cancer that is still responsive to hormone therapy, a complete response after treatment with a drug called apalutamide is associated with a very low risk of progression within 2 years. However, nearly half of patients with an incomplete response to apalutamide will experience progression of their cancer. 2024-12-30T11:42:59Z 2024-12-30T11:42:59Z 2024-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Hassi Roman M, Mate K, De Pablos-Rodriguez P, Zamaro Horcajada Á, Guijarro Cascales A, Sanchís Bonet Á, et al. Prostate-specific Antigen at 3 Months as a Predictor of Radiologic Progression-free Survival in Metastatic Hormone-sensitive Prostate Cancer Treated with Apalutamide: Analysis of 633 Patients in a Real-world Database. Eur Urol Open Sci. 2024 Dec;70:58–63. 2666-1683 https://hdl.handle.net/11351/12362 10.1016/j.euros.2024.10.001 39474116 001343349400001 http://hdl.handle.net/11351/12362 eng European Urology Open Science;70 https://doi.org/10.1016/j.euros.2024.10.001 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess application/pdf Elsevier Scientia