A novel ultra-low 6-month PSA cutoff for radiographic PFS stratification in high-volume mHSPC.

Abstract

In metastatic hormone-sensitive prostate cancer (mHSPC), a 6-month PSA nadir ≤0.2 ng/mL is commonly applied as an early prognostic benchmark. Moreover, routine PSA reporting is often truncated at low values (e.g., 0.07 ng/mL was associated with higher risk of radiographic progression (HR 14.27; 95% CI 3.51–58.05; p 0.07 ng/mL identifies a population at imminent risk of radiographic progression. This deeper PSA response provides a pragmatic candidate threshold for assessing treatment efficacy and for risk stratification in high-volume disease, warranting validation in larger, well-designed studies.