Increasing PSA Levels in mCRPC Patients Are Unreliable Markers for Making Treatment Decisions

In an article in the Southern Medical Journal authored by Karzai et al, the role of PSA in evaluating patients with mCRPC is clarified. In early trials of prostate cancer therapies, rising PSA levels were used to define “progression” and therefore to allow discontinuation of treatment based on those rising levels. However, more recent studies have shown that PSA level responses can be delayed for various reasons, and many patients who were denied treatment in these early studies might have actually benefitted from additional treatment.

“As the landscape for treatment in mCRPC continues to evolve, it is important to realize that patients will benefit from multiple individual therapies sequentially, and that PSA should not be used as a marker to discontinue therapy in the absence of other criteria. Of note, in no other oncologic disease state is a marker such as serum PSA used alone to discontinue therapy.”