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Identifying Prostate Cancer Patients at High Death Risk
JAMA Oncol; ePub 2017 Jan 12; Royce, Chen, et al
A prostate-specific antigen (PSA) base value >0.5 ng/mL after radiation and androgen deprivation therapy appeared to identify men prior to PSA failure who were at high risk for death, according to a secondary analysis of a randomized trial involving 206 men.
Participants with unfavorable-risk prostate cancer were randomized to radiation therapy alone or radiation followed by 6 months of androgen deprivation therapy. Investigators followed them for a median of ~17 years, and looked at a subgroup of 157 men with minimal or no comorbidities.
3 metrics were tested:
- PSA base value >0.5 ng/mL.
- PSA doubling time <9 months.
- Interval to PSA failure <30 months.
For these 3 successful surrogates, the proportion of treatment effect values were 104%, 43%, and 41%, respectively.
Royce T, Chen M, Wu J, et al. Surrogate end points for all-cause mortality in men with localized unfavorable-risk prostate cancer treated with radiation therapy vs radiation therapy plus androgen deprivation therapy: A secondary analysis of a randomized clinical trial. [Published online ahead of print January 12, 2017]. JAMA Oncol. doi:10.1001/jamaoncol.2016.5983.