Impact of PSA nadir, PSA response and time to PSA nadir on overall survival in real‐world setting of metastatic hormone‐sensitive prostate cancer patients

Background To evaluate the impact of prostate‐specific antigen (PSA) nadir, PSA response and time to PSA nadir (TTN) in metastatic hormone‐sensitive prostate cancer (mHSPC) patients on overall survival (OS) in the era of combination therapies. Methods Different PSA nadir cut‐offs (including ultra‐low PSA) were tested for OS analyses. Additionally, PSA response ≥99% was evaluated, as well as TTN categorized as 12 months. Multivariable Cox regression models predicted the value of PSA nadir cut‐offs, PSA response and TTN on OS. Sensitivity analyses were performed in de novo and high volume mHSPC patients. Results Of 238 eligible patients, PSA cut‐offs of 4.0 ng/mL differed significantly regarding median OS (96 vs. 56 vs. 44 months, p