This retrospective modeling and validation study developed mechanism-based mathematical biomarkers—derived from first-cycle PSA kinetics—to predict time to progression (TTP), mean daily dose, and overall survival (OS) under adaptive therapy in two independent cohorts: 40 patients with castrate-sensitive prostate cancer (CSPC) receiving intermittent androgen deprivation therapy, and 13 patients with metastatic castrate-resistant prostate cancer (mCRPC) receiving adaptive abiraterone acetate.
In the CSPC cohort (n=40), the adaptive therapy score was strongly prognostic for TTP (HR 0.49; 95% CI 0.31–0.76; P=.002). In the mCRPC cohort (n=13), it correlated with TTP (Spearman ρ=0.76; P=.002) and was associated with prolonged OS—while standard PSA metrics (nadir, time to nadir, doubling time) showed no association with OS.
- Very small mCRPC cohort (n=13) limits statistical power and generalizability. - Retrospective, nonrandomized design from historical trial data (enrollment as early as 1996) may not reflect current treatment practices. - Full text was not accessible; conclusions rely on abstract and results sections only.
First-cycle PSA kinetics can be used to compute a mathematically derived adaptive therapy score that outperforms standard PSA metrics in predicting TTP and survival under adaptive therapy—consider this as a decision-support tool when personalizing adaptive treatment schedules for prostate cancer patients.
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