These plots show the linear relationship between median PSA-Nadir and median Testosterone-Nadir, pointing towards the Origin (i.e., 0 PSA-Nadir at 0 T-Nadir.). N= 38 men. The upper to graphs compare median PSA-nadir and median T-Nadir for Non-CRPC and CPRC groups (CPRC = Castrate Resistant Prostate Cancer).
Non-CRPC men have roughly about 1/2 the median PSA-Nadir and 1/2 the median T-nadir values compared to CRPC men, which makes sense because non-CRPC men are still hormone sensitive to ADT and, hence, have lower amounts of prostate cancer in their bodies.
I'm not sure I understand your question completely...
These are two different groups (populations) of men with PCa. Some have HSPC and some have CRPC. Each group has their own individual median values of PSA-nadir and T-nadir. The point of the plot is that the data points from the two different groups lie on a straight line that goes through the origin at (0,0) [or, close to it]. I'm always looking for straight lines in data plots, to indicate a linear relationship.
But, yes, I think I see your point. As you move from initially being Hormone Sensitive to Castrate Resistant, the median values of PSA increases. That make sense because men that have CRPC generally have more cancer in their body, which makes more PSA , on average.
The plot also says that as you reduce the testosterone level in your body, that the PSA level will drop proportionately. That's the basis of doing ADT in the linear regime below about T = 150 ng/dL. Ideally, you want to try to get your testosterone < 5 ng/dL, at which point the PSA will be < 0.5 ng/mL. That may require a combination of drugs to get that low, however.
As best as I understand it, Lupron and Estrogen are interchangeable. They both have the exact same mechanism of action (suppression of LH and FSH causing low testosterone). SO, adding darolutamide to Estrogen should give similar results to darolutamide + Lupron ADT.
I don't think there are any trials or studies that cover your idea, however.
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