https://doi.org/10.4081/aiua.2023.11052

Prostate-specific antigen response after Abiraterone treatment in mCRPC: PSA as a predictor of overall survival

Vol. 95 No. 1 (2023)
Submitted: December 2, 2022
Accepted: December 31, 2022
Published: February 22, 2023
Abiraterone, mCRPC, PSA, Overall survival, Progression free survival
Abstract Views: 1006
PDF: 596
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Authors

Alexandre Mendonça Macedo
alex.m.macedo89@gmail.com
https://orcid.org/0000-0003-3907-7753
Urology Department, Hospital Garcia de Orta EPE, Almada; Oncology Department, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal.
Rita Gameiro Marques
https://orcid.org/0000-0002-4292-6552
Oncology Department, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal.
Margarida Cunha André
https://orcid.org/0000-0002-5918-8621
Urology Department, Hospital Garcia de Orta EPE, Almada, Portugal.
Nuno Silva Figueira
Urology Department, Hospital Garcia de Orta EPE, Almada, Portugal.
Miguel Leal Carvalho
https://orcid.org/0000-0001-9087-2109
Urology Department, Hospital Garcia de Orta EPE, Almada, Portugal.

Objectives: Abiraterone Acetate (AA) is an important agent in the treatment of advanced prostate cancer. It was primarily approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC) after failure of androgen deprivation therapy. There is still no available strong data regarding the impact of early decline of prostate-specific antigen (PSA) in the overall survival. The aim of this study was to evaluate the clinical efficacy of an early prostate-specific antigen response as a predictor of overall survival (OS) in metastatic castration-resistant prostate cancer when treated with Abiraterone Acetate.

Materials and methods: A dual center, retrospective, cohort study on patients diagnosed with mCRPC treated with abiraterone between 2013 and 2020 was performed. Primary end-point was to demonstrate the efficacy of AA, with the analysis of PSA decline, and the correlation with overall survival.

Results: The cohort analysis consisted of 84 patients with a median age of 71 ± 9 years. A PSA response of > 30% and > 50% at 60 and 90 days was associated with improved OS. Multivariate analysis revealed that a 60 day PSA decline of > 30% was predictive of overall survival. Median OS of diag-nosed mCRPC patients was 28 months. Docetaxel pre-treatment was not associated with longer OS. The median duration of drug exposure for patients submitted to AA was found to be 14 months.

Conclusions: Early PSA response rate can offer clinically meaningful information and can be considered a surrogate of longer OS. A > 30% or > 50% prostate-specific antigen decline at 60 and 90 days provided an important low-cost clinical tool to predict subsequent events in mCRPC patients treated with abiraterone.

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How to Cite

Mendonça Macedo, A., Gameiro Marques, R., Cunha André, M., Silva Figueira, N., & Leal Carvalho, M. (2023). Prostate-specific antigen response after Abiraterone treatment in mCRPC: PSA as a predictor of overall survival. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.11052
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