A new study published in Nature Communications provides a framework for researching whether earlier, model-guided treatment intensification can meaningfully improve survival for patients with aggressive disease.

“Early decline in prostate-specific antigen (PSA) to very low levels is one of the strongest predictors of long-term survival in metastatic prostate cancer. However, clinicians currently have to wait up to six months after starting therapy to see whether a patient achieves this favorable response. For patients who do not respond well, this delay may allow the cancer to progress and become more resistant to treatment,” said Soumyajit Roy, MD, a radiation oncologist at UH Seidman Cancer Center and first author of the study.

Because existing clinical risk stratification tools—such as disease volume or metastatic burden—are relatively imprecise, there has been an unmet need for a reliable, easy-to-use tool that can risk stratify patients earlier, before that critical six-month window closes. Researchers wanted to determine whether it is possible to predict early treatment response at the time of diagnosis for men with metastatic hormone-sensitive prostate cancer (mHSPC) who are treated with modern androgen receptor pathway inhibitors (ARPIs), which are now standard of care worldwide.