Factors associated with a shorter time interval to PSA failure

What factors are associated with a shorter time interval to prostate-specific antigen (PSA) failure in nonmetastatic unfavorable-risk prostate cancer?

The objective of this study was to evaluate the factors of a short time interval to PSA failure to identify patients for treatment escalation in randomized clinical trials.

In this secondary analysis of a phase-3 clinical trial with 350 participants, significant factors associated with shorter time to PSA failure were age younger than 70 years, a PSA of 10 ng/mL or more, and a Gleason score of 8 to 10. A high-risk group, defined by these 3 factors, had 43.8% risk of PSA failure at 3 years.

Males at very high-risk for early PSA failure, as defined by this study, may benefit from treatment escalation with androgen receptor signaling inhibitors (hormonal therapy) or cytotoxic chemotherapy and should consider being the subject of a prospective randomized clinical trial.