loss is not a determinant of time to castration-resistance following androgen-deprivation therapy in prostate cancer: a study from Jordan.

Androgen deprivation therapy (ADT) remains the principal treatment of advanced prostate cancer. However, most patients eventually experience treatment failure, resulting in castrate-resistant prostate cancer (CRPC). Loss of the tumor suppressor gene phosphatase and tensin homolog () has been linked to poor survival in prostate cancer. We have recently shown that loss is evident in approximately 60% of prostate cancer cases in Jordan. However, the correlation between loss and response to ADT remains unclear. This study aimed to determine the relationship between loss and time to CRPC in Jordan. We conducted a retrospective analysis of confirmed CRPC cases at our institution from 2005 to 2019 (N=104). expression was assessed using immunohistochemistry. Time to CRPC was calculated from the initiation of ADT to the confirmed diagnosis of CRPC. Combination/sequential ADT was defined as the use of two or more classes of ADT concomitantly or switching from one class to another. We found that loss was evident in 60.6% of CRPC. Mean time to CRPC was not different between patients with loss (24.8 months) and those with intact (24.2 months; p=0.9). However, patients receiving combination/sequential ADT had a significantly delayed onset of CRPC compared to patients on monotherapy ADT (log-rank Mantel-Cox p=0.000). In conclusion, loss is not a major determinant of time to CRPC in Jordan. The use of combination/sequential ADT procures a significant therapeutic advantage over monotherapy regimens, delaying the onset of CRPC.