Early (but not too early) PSA drop is a predictor of ADT efficacy (+ apalutamide)

[Maxone73]

Early PSA response at 6 months is both a predictor and a causal mediator of treatment efficacy for ADT plus apalutamide in men with mHSPC. While patients who achieve an early PSA response experience a significant survival benefit with the addition of apalutamide, those who don't have poor outcomes regardless of treatment. Longer time to early PSA response is unexpectedly associated with better outcomes, and this may be due to rapid androgen receptor ablation leading to treatment resistance. These findings suggest that early PSA response could be a valuable tool for guiding treatment decisions in mHSPC.

prostatewarriors.com/2024/1...

[dhccpa]

Your second to last sentence seems to conflict with the rest. Or did I read that wrong?

[Maxone73 in reply to dhccpa]

It's tricky. If you reach <0.2 within 6 months it's better than if you reach it within 3 months. That's the unexpected part.

[dhccpa in reply to Maxone73]

Yes. That is confusing, but I was just seeing that in the actual article. I hit my nadir of 0.5 in April 2021, 17 months after starting ADT (Lupron only), BUT I had a 0.6 reading as early as Oct 2019. In between it went as high as 1.3 and 1.4. I do still have my prostate and I've never had anything but Lupron until I had Provenge in September. PSA a week ago was 2.42 at the 6-year mark on ADT.

[Maxone73 in reply to dhccpa]

Not bad after 6 years

[dhccpa in reply to Maxone73]

Yes. We're getting ready to start prostate and pelvic radiation as a result of my PSMA scan.

[Maxone73 in reply to dhccpa]

Good luck! I hope you can keep it at bay!

[dhccpa in reply to Maxone73]

Thanks!