Opinion|Videos|October 1, 2025
Redefining Response in mHSPC: Ultralow PSA, Treatment Nuance, and the Call for More Equitable Care
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Jack R. Andrews, MD; Alicia Morgans, MD, MPH; and Murilo de Almeida Luz, MD, discuss how ultralow prostate-specific antigen thresholds (below 0.02) serve as important prognostic biomarkers in metastatic hormone-sensitive prostate cancer, with recent post hoc analyses from the ARANOTE trial showing that patients achieving these ultralow levels with combination androgen deprivation therapy plus darolutamide therapy have significantly better radiographic progression-free survival and time to castration-resistant disease compared with those who don't reach these thresholds.
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Timecodes:
ARANOTE trial- 43:32-48:08
Rationale of using ultra-low PSA thresholds- 48:08-51:25
Understanding the prognostic value of ultra-low PSA results- 51:25-55:20
Ultralow PSA levels in the TITAN trial- 55:20-58:24
Ultralow PSA as a clinical benchmark- 58:24-1:00:48
Benefits of monitoring response with PSA- 1:00:48-1:01:32
Implications of suboptimal PSA response- 1:01:32-1:05:41
Selection of AR-targeted therapies- 1:05:41-1:07:30
Disparities in trial outcomes- 1:07:30-1:10:48
Improving disparities through changes in practice- 1:10:48-1:13:32
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