Fiala Ondřej, Hošek Petr, Korunková Hana, Tkadlecová Michaela, Hora Milan, Šiková Dominika, Stránský Petr, Fínek Jindřich, Kučera Radek, Windrichová Jindra, Topolčan Ondřej
Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic;
Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
In Vivo. 2025 Mar-Apr;39(2):859-869. doi: 10.21873/invivo.13889.
BACKGROUND/AIM: New generation androgen receptor-targeting agents (ARTA) have been in the spotlight for their efficacy in metastatic castration-resistant prostate cancer (mCRPC). Prostate-specific antigen (PSA) represents one of the most commonly used serum cancer biomarkers worldwide. The present retrospective study focused on the prognostic role of serum PSA isoforms and their early dynamics in mCRPC patients treated with abiraterone acetate (ABI) or enzalutamide (ENZ).
The association between outcomes of 334 mCRPC patients treated with ABI or ENZ and the levels of serum total PSA (tPSA), free PSA (fPSA), [-2]proPSA and the Prostate Health Index (PHI) at baseline and one month after treatment initiation was analyzed retrospectively.
In the multivariable Cox proportional hazards models, baseline tPSA>50 μg/l (<0.001), and [-2]proPSA>300 ng/l (=0.017) remained independent significant factors associated with inferior OS, while baseline fPSA>1.75 μg/l (=0.050) and Δ [-2]proPSA >-50% approached statistical significance (=0.062). The results of ROC analyses assessing the ability of baseline tPSA, fPSA, and [-2]proPSA to predict mortality within two years showed area under the curve (AUC) values of 0.709, 0.685, and 0.740, respectively. Among the subgroup with baseline tPSA≤20.0 μg/l, the results of ROC analyses for baseline tPSA, fPSA and [-2]proPSA showed AUC values of 0.441, 0.682, and 0.688, respectively.
Our results suggest a significant correlation between pretreatment serum levels of tPSA and [-2]proPSA with OS in mCRPC patients receiving ARTA.
背景/目的：新一代雄激素受体靶向药物（ARTA）因其在转移性去势抵抗性前列腺癌（mCRPC）中的疗效而备受关注。前列腺特异性抗原（PSA）是全球最常用的血清癌症生物标志物之一。本回顾性研究聚焦于血清PSA异构体及其早期动态变化在接受醋酸阿比特龙（ABI）或恩杂鲁胺（ENZ）治疗的mCRPC患者中的预后作用。
回顾性分析334例接受ABI或ENZ治疗的mCRPC患者的治疗结局与基线及治疗开始后1个月时血清总PSA（tPSA）、游离PSA（fPSA）、[-2]proPSA和前列腺健康指数（PHI）水平之间的关联。
在多变量Cox比例风险模型中，基线tPSA>50μg/l（<0.001）和[-2]proPSA>300ng/l（=0.017）仍然是与较差总生存期相关的独立显著因素，而基线fPSA>1.75μg/l（=0.050）和Δ[-2]proPSA>-50%接近统计学意义（=0.062）。评估基线tPSA、fPSA和[-2]proPSA预测两年内死亡率能力的ROC分析结果显示，曲线下面积（AUC）值分别为0.709、0.685和0.740。在基线tPSA≤20.0μg/l的亚组中，基线tPSA、fPSA和[-2]proPSA的ROC分析结果显示AUC值分别为0.441、0.682和0.688。
我们的结果表明，接受ARTA治疗的mCRPC患者治疗前血清tPSA和[-2]proPSA水平与总生存期之间存在显著相关性。
