Three-month prostate-specific antigen level after androgen deprivation therapy predicts survival in patients with metastatic castration-sensitive prostate cancer

Background/Aim: Although upfront combination therapies with androgen deprivation are recommended for patients with castration-sensitive prostate cancer (CSPC), combination therapies may be excessive for some patients. The aim of this study was to identify patients with favorable outcome under androgen deprivation therapy (ADT) alone. Patients and Methods: This study consisted of 242 patients with CSPC who received ADT alone. The association between 3-month prostate-specific antigen (PSA) value after ADT and survival was analyzed. Results: The median overall survival for men with high-volume and/or high-risk cancer and those with low-volume low-risk cancer were 48.0 months and 103.0 months, respectively (p≤0.0001). Notably, in patients with low-volume low-risk cancer, the median overall survival for patients who achieved PSA ≤2 ng/ml at 3 months after ADT initiation was quite long at 112.0 months. Conclusion: Conventional ADT may be sufficient and upfront combination therapy may be excessive for those patients with favorable outcome.