接受新型賀爾蒙治療的轉移性去勢敏感型前列腺癌患者之預後分析：回顧性研究

褚致維、羅浩倫

高雄長庚紀念醫院泌尿科

Prognostic factors of metastatic castration-sensitive prostate cancer(mCSPC) patients under novel hormonal agents (NHAs) treatment: A retrospective study

Chih-Wei Chu, Hao-Lun Luo

Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung

Purpose: Prognostic factors for metastatic castration-sensitive prostate cancer (mCSPC) patients receiving novel hormonal agents (NHAs) have been associated with their PSA nadir levels. The TITAN study showed that achieving an ultra-low PSA nadir (less than 0.2 ng/ml) after treatment is linked to improved progression-free survival in mCSPC patients. This study aims to analyze the characteristics of responders with ultra-low PSA nadir levels.
Materials and Methods: We collected data from 64 mCSPC patients treated with NHAs at Kaohsiung Chang-Gung Memorial Hospital since 2018 (IRB number: 20220111B0). Patients were divided into two groups based on their PSA nadir after treatment: group A (ultra-low PSA level ≤ 0.2 ng/mL) and group B (serum PSA level > 0.2 ng/mL). We conducted T-tests and chi-square tests to analyze differences in age, initial Gleason score, NHA group, baseline PSA, prior androgen deprivation therapy (ADT) response (before NHA treatment), metastasis (bone, lymph node, visceral), extent of disease (EOD), high risk, high volume, follow-up time (months), and adverse effects between the two groups.
Results: The study included 30 patients in group A and 34 patients in group B. Group A (ultra-low PSA level) was associated with younger age (p=0.035), lower initial Gleason score (p=0.028), and better prior ADT response (p<0.001). However, no significant differences were observed between the two groups in the other characteristics mentioned above.
Conclusions: Younger age, lower initial Gleason score (ISUP Gleason grade group less than 5), and better prior ADT response before NHAs treatment are associated with an ultra-low PSA response after NHA treatment in Taiwanese mCSPC patients. This finding suggests that patients with these characteristics might experience improved progression-free survival, as observed in the TITAN study. This information could aid physicians in selecting candidates for doublet or triplet therapy.