MONDAY, March 6, 2023 (HealthDay News) — Greater depth of prostate-specific antigen (PSA) decline is associated with improved clinical outcomes among men treated with enzalutamide for nonmetastatic castration-resistant prostate cancer, according to a study published in the March issue of The Journal of Urology.

Maha Hussain, M.D., from the Robert H. Lurie Comprehensive Cancer Center at Northwestern University in Chicago, and colleagues conducted a post hoc analysis of PROSPER to evaluate the relationship between depth of PSA decline and clinical outcomes in 905 enzalutamide-treated men with nonmetastatic castration-resistant prostate cancer.

The researchers found that PSA declines of <50 percent, ≥50 percent to <90 percent, ≥90 percent with nadir ≥0.2 ng/mL, and ≥90 percent with nadir <0.2 ng/mL were associated with median metastasis-free survival of 22.1 months, 34.2 months, 36.6 months, and not reached yet, respectively. Overall survival for each PSA decline subgroup was 40.8 months, 54.4 months, 64.3 months, and not reached yet, respectively.

“Our analysis of data from the PROSPER study shows a previously unappreciated relationship between changes in PSA levels and clinical outcomes in men with nonmetastatic castration-resistant prostate cancer,” Hussain said in a statement. “The findings may help us to make personalized decisions regarding clinical follow-up and imaging studies for a group of patients at high risk of prostate cancer metastases.”

Several authors disclosed financial ties to pharmaceutical companies, including Pfizer and Astellas Pharma, which manufacture enzalutamide and funded the study.

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