"ECOG3805 is a randomized trial of testosterone suppression with or
without docetaxel for metastatic hormone-sensitive prostate cancer (mHSPC).
One in eight patients had clinical progression below a PSA
level of 2 ng/mL, and approximately 25% developed clinical progression in the
absence of confirmed PSA progression. Overall survival from randomization was
shorter in patients with clinical progression without confirmed PSA progression
than in patients with PSA progression alone as the first progression. Patient
demographics at study entry were not predictive of the pattern of progression.
Study limitations include its retrospective and post hoc nature.
Conclusions: Clinical progression prior to PSA rise or at low PSA levels is a
relatively frequent phenomenon in mHSPC and is associated with poorer overall
survival. Further biological and clinical studies of these patients are warranted."