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dc.contributor.authorBryce, AH
dc.contributor.authorAlumkal, JJ
dc.contributor.authorArmstrong, A
dc.contributor.authorHigano, CS
dc.contributor.authorIversen, P
dc.contributor.authorSternberg, CN
dc.contributor.authorRathkopf, D
dc.contributor.authorLoriot, Y
dc.contributor.authorde Bono, J
dc.contributor.authorTombal, B
dc.contributor.authorAbhyankar, S
dc.contributor.authorLin, P
dc.contributor.authorKrivoshik, A
dc.contributor.authorPhung, D
dc.contributor.authorBeer, TM
dc.date.accessioned2017-03-01T12:14:37Z
dc.date.issued2017-06
dc.identifier.citationProstate cancer and prostatic diseases, 2017, 20 (2), pp. 221 - 227
dc.identifier.issn1365-7852
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/439
dc.identifier.eissn1476-5608
dc.identifier.doi10.1038/pcan.2016.71
dc.description.abstractBackground Advanced prostate cancer is a phenotypically diverse disease that evolves through multiple clinical courses. PSA level is the most widely used parameter for disease monitoring, but it has well-recognized limitations. Unlike in clinical trials, in practice, clinicians may rely on PSA monitoring alone to determine disease status on therapy. This approach has not been adequately tested.Methods Chemotherapy-naive asymptomatic or mildly symptomatic men (n=872) with metastatic castration-resistant prostate cancer (mCRPC) who were treated with the androgen receptor inhibitor enzalutamide in the PREVAIL study were analyzed post hoc for rising versus nonrising PSA (empirically defined as >1.05 vs ⩽1.05 times the PSA level from 3 months earlier) at the time of radiographic progression. Clinical characteristics and disease outcomes were compared between the rising and nonrising PSA groups.Results Of 265 PREVAIL patients with radiographic progression and evaluable PSA levels on the enzalutamide arm, nearly one-quarter had a nonrising PSA. Median progression-free survival in this cohort was 8.3 months versus 11.1 months in the rising PSA cohort (hazard ratio 1.68; 95% confidence interval 1.26-2.23); overall survival was similar between the two groups, although less than half of patients in either group were still at risk at 24 months. Baseline clinical characteristics of the two groups were similar.Conclusions Non-rising PSA at radiographic progression is a common phenomenon in mCRPC patients treated with enzalutamide. As restaging in advanced prostate cancer patients is often guided by increases in PSA levels, our results demonstrate that disease progression on enzalutamide can occur without rising PSA levels. Therefore, a disease monitoring strategy that includes imaging not entirely reliant on serial serum PSA measurement may more accurately identify disease progression.
dc.formatPrint-Electronic
dc.format.extent221 - 227
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectDisease Progression
dc.subjectPhenylthiohydantoin
dc.subjectProstate-Specific Antigen
dc.subjectAntineoplastic Agents
dc.subjectDisease-Free Survival
dc.subjectTreatment Outcome
dc.subjectProportional Hazards Models
dc.subjectDrug Resistance, Neoplasm
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectProstatic Neoplasms, Castration-Resistant
dc.titleRadiographic progression with nonrising PSA in metastatic castration-resistant prostate cancer: post hoc analysis of PREVAIL.
dc.typeJournal Article
dcterms.dateAccepted2016-11-29
rioxxterms.versionofrecord10.1038/pcan.2016.71
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-sa/4.0
rioxxterms.licenseref.startdate2017-06
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfProstate cancer and prostatic diseases
pubs.issue2
pubs.notesNo embargo
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Prostate Cancer Targeted Therapy Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Prostate Cancer Targeted Therapy Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume20
pubs.embargo.termsNo embargo
icr.researchteamProstate Cancer Targeted Therapy Groupen_US
dc.contributor.icrauthorDe Bono, Johannen
dc.contributor.icrauthorMarsden,en


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