Clinical value of prostate-specific antigen halving time as a predictor of response to first-line systemic treatment for synchronous metastatic castration-sensitive prostate cancer.

Authors

Takanari Kambe, Takayuki Sumiyoshi, Hiroshi Fujiwara, Takeru Fujimoto, Toshifumi Takahashi, Kei Mizuno, Masashi Kubota, Toshinari Yamasaki, Koji Yoshimura, Masahiro Tamaki, Yoshiyuki Nagumo, Hiroaki Kawanishi, Yu Miyazaki, Hiroki Oshiro, Ryoma Kurahashi, Norihiko Masuda, Yuki Makino, Go Kobori, Shusuke Akamatsu, Satoshi Morita, Takashi Kobayashi, Takayuki Goto

Published in

International journal of clinical oncology. Aug 25, 2026. Epub Aug 25, 2026.

Abstract

To address the challenge of early predicting systemic treatment response in metastatic castration-sensitive prostate cancer (mCSPC), this study evaluated the predictive value of prostate-specific antigen halving time (PSAHT) as a biomarker.
We retrospectively analyzed data for 719 patients with de novo mCSPC, of whom 495 received androgen deprivation therapy alone or combined androgen blockade (the ADT/CAB cohort) and 224 received ADT combined with an androgen receptor signaling inhibitor or docetaxel (the upfront cohort). PSAHT was estimated using log-transformed PSA values at baseline and 1 and 3 months later using a linear mixed-effects model. Individual slopes were used to calculate PSAHT, defined as log(2)/|slope|. Each cohort was divided into short and long PSAHT groups based on the median PSAHT. The primary endpoint was time to castration-resistant prostate cancer (CRPC). A multivariable Cox proportional hazards model was used to assess PSAHT as a predictive biomarker.
Log-transformed PSA decreased in a linear manner for up to 3 months post-treatment initiation and then plateaued. Median PSAHT was 0.47 months in the ADT/CAB cohort and 0.41 months in the upfront cohort. CRPC-free survival was more favorable in the short PSAHT group in both cohorts (ADT/CAB, 21.7 months vs. 15.9 months, P = 0.03; upfront, not reached vs. 27.1 months, P < 0.01). In multivariable Cox proportional hazards analysis, PSAHT was associated with time to CRPC in both cohorts.
PSAHT may have modest prognostic value in de novo mCSPC, although further validation is required.

PMID:
42640376
Bibliographic data and abstract were imported from PubMed on 26 Aug 2026.

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