Prostate-Specific Antigen Response after Abiraterone Treatment in mCRPC: PSA as a Predictor of Overall Survival

In this dual-institutional study with the collaboration of the Urology and Oncology departments, we managed to evaluate the prognostic value of early PSA response after abiraterone treatment. In fact, with the newer pharmacotherapeutic drugs and intensification treatments for hormone sensitive metastatic prostate cancer, metastatic castration-resistant prostate cancer (mCRPC) has been less studied in the last couple of years.

Nevertheless, these are the patients with higher mortality rates and we still need biomarkers to predict therapeutical outcomes. Our aim was to prove that early PSA response can be used as a prognostic marker in this setting and particularly after abiraterone acetate treatment, in which there are very few studies that report its clinical impact in the first 3 months. It is clear from our results that a > 30% or > 50% prostate-specific antigen decline at 60 and 90 days provide an important clinical tool to predict subsequent events in mCRPC patients treated with abiraterone and they should be used in clinical practice to determine which patients will have a better clinical response.

In fact, a positive response is correlated with longer overall survival for these patients. In conclusion, early PSA response is a meaningful biomarker and should not be underused, at least until more powerful data regarding other molecular biomarkers are validated.

Written by: Alexandre Mendonça Macedo, Rita Gameiro Marques, Margarida Cunha André, Nuno Silva Figueira, Miguel Leal Carvalho

Urology Department, Hospital Garcia de Orta EPE, Almada, Portugal; 2 Oncology Department, Centro Hospitalar Barreiro Montijo,. Oncology Department, Centro Hospitalar Barreiro Montijo, Barreiro. Urology Department, Hospital Garcia de Orta EPE, Almada. Urology Department, Hospital Garcia de Orta EPE, Almada. Urology Department, Hospital Garcia de Orta EPE, Almada.

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