A new study highlights that sustained testosterone suppression plays a key role in predicting outcomes for patients with advanced hormone-sensitive prostate cancer (aHSPC).
Study findings
Researchers examined how long-term testosterone suppression influences tumor progression and survival. The analysis revealed a median time to progression (TTP) of 18 months and a median overall survival of 6.17 years across the cohort.
Patients who achieved sustained testosterone suppression experienced markedly better outcomes than those who did not. Median survival in the sustained-response group reached 7.58 years, compared with just 3.00 years for the non-sustained group (P<0.001). Similarly, time to progression was longer—23.70 months versus 13.68 months (P<0.001).
The study also found inverse correlations between testosterone levels and disease progression. Lower minimum testosterone levels were linked with longer TTP (r=-0.238, P<0.001), as were lower average testosterone levels (r=-0.220, P<0.001).
Risk factors and prognosis
Multivariate analysis identified visceral metastases (OR 0.45, 95% CI 0.21-0.98; P=0.043) and high tumor burden (OR 0.53, 95% CI 0.33-0.85; P=0.008) as significant negative predictors of sustained testosterone suppression.
Importantly, patients in the sustained-response group showed a reduced risk of death (HR 0.605, 95% CI 0.369-0.990; P=0.045). Conversely, higher minimum testosterone levels were associated with increased mortality risk (HR 1.358, 95% CI 1.116-1.654; P=0.002).
Conclusion
The findings suggest that monitoring sustained testosterone suppression offers a practical tool for evaluating treatment effectiveness and forecasting prognosis in aHSPC.
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