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Advanced Prostate Cancer

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intermediate endpoints for overall survival correlation

maley2711 profile image
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practiceupdate.com/C/114754...

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The authors of this meta-analysis of 75 trials including over 50,000 patients evaluated the performance of intermediate clinical endpoints in randomised trials enrolling patients with localised prostate cancer. Metastasis-free survival correlated strongly with overall survival. Progression-free survival showed moderate correlation with overall survival. However, biochemical failure, biochemical failure–free survival, biochemical failure and clinical failure, and local failure all correlated poorly with overall survival.

Among patients with localised prostate cancer, only metastasis-free survival was validated as a surrogate endpoint for overall survival.

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maley2711 profile image
maley2711
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GP24 profile image
GP24

If metastasis-free survival is the most important endpoint correlated with overall survival, maybe zapping mets may turn out to provide benefit by extending overall survival.

maley2711 profile image
maley2711 in reply to GP24

zapping a few detectable mets is unlikely to do that...per what current studies have shown. But in many cases, would be harmless, and there is always hope!!!

GP24 profile image
GP24 in reply to maley2711

I meant detecting mets with a PSMA PET/CT. I had several of these. This will not result in zapping a few, it will destroy all mets down to a few millimeters in size.

In this study they mention:

Post hoc analysis of PFS (progression-free survival) based on extent of disease appreciable by PSMA-targeted PET-CT found significant PFS and distant metastasis–free survival advantages among men who received consolidation of all detectable disease.

jamanetwork.com/journals/ja...

So it is very likely to provide benefit.

maley2711 profile image
maley2711 in reply to GP24

You might venture over to Healthunlocked.com and find some commentary by TallAllen on this topic.....a forum to serve advanced PCa victims. Allen is a deep researcher!!

GP24 profile image
GP24

Using SBRT radiation I can become metastatic free for quite some time. If you are metastatic free without metastasis-directed therapy, new mets can appear any time. If you removed all mets with SBRT that is not much different then.

This is just a thought, I have no trial to prove this. I am free of detectable mets for two years after my last therapy now.

JRPnSD profile image
JRPnSD

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