{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:28:38Z","timestamp":1787138918146,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,8,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple phase 3 metastatic castration\u2010sensitive prostate cancer (mCSPC) studies consistently show a prostate\u2010specific antigen (PSA) nadir of &lt;0.2 ng\/mL to be the preferred threshold for PSA response. However, in real\u2010world practice, physicians often use other metrics such as percentage of PSA decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis of Veterans Health Administration data (2006\u22122024) assessed the association between PSA response and overall survival (OS) in patients with mCSPC who initiated androgen deprivation therapy (ADT)\u00a0\u00b1\u00a0other treatments, using landmark analyses with adjusted Cox regressions. PSA response metrics included \u226590% PSA decline and a PSA of &lt;0.2 ng\/mL within 9 months of starting therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4890 patients, 44% reached a PSA of &lt;0.2 ng\/mL and 74% had \u226590% PSA decline. Patients with a PSA of &lt;0.2 ng\/mL within 9 months of ADT initiation had a reduced risk of death after this time point (adjusted hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.40\u22120.54) versus patients who did not. OS improvements with a PSA of &lt;0.2 ng\/mL were similar, regardless of \u226590% (adjusted HR, 0.43; 95% CI, 0.35\u22120.52) or &lt;90% PSA decline (adjusted HR, 0.36; 95% CI, 0.23\u22120.56). Achieving \u226590% PSA decline without a PSA of &lt;0.2 ng\/mL was unrelated to improved OS. Patients who initiated ADT plus androgen receptor pathway inhibitors versus ADT alone were more likely to achieve a PSA of &lt;0.2 ng\/mL during PSA follow\u2010up (adjusted HR, 1.71; 95% CI,\u00a01.55\u22121.88).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a real\u2010world mCSPC setting, achieving a PSA of &lt;0.2 ng\/mL (whether or not a PSA decline of 90% was reached) within 9 months of initiating ADT\u00a0\u00b1\u00a0other treatments was associated with improved OS, which supports a PSA nadir of\u00a0&lt;0.2 ng\/mL for optimizing mCSPC outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70494","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:01:26Z","timestamp":1786345286000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How low do you need to go? Association between various prostate\u2010specific antigen response measures and clinical outcomes in metastatic castration\u2010sensitive prostate cancer in the Veterans Health Administration data"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8104-6419","authenticated-orcid":false,"given":"Stephen J.","family":"Freedland","sequence":"first","affiliation":[{"name":"Department of Urology Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Durham VA Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Gao","sequence":"additional","affiliation":[{"name":"Analysis Group Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00eblys","family":"Touya","sequence":"additional","affiliation":[{"name":"Astellas Pharma Global Development  Northbrook Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbo","family":"Yang","sequence":"additional","affiliation":[{"name":"Analysis Group Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Russell","sequence":"additional","affiliation":[{"name":"Pfizer Inc.  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Chen","sequence":"additional","affiliation":[{"name":"Analysis Group Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Chen","sequence":"additional","affiliation":[{"name":"Analysis Group Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmina I.","family":"Ivanova","sequence":"additional","affiliation":[{"name":"Pfizer Inc.  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.04.010"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003452"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/mend.11.2.9883"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2025.03.019"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.8751"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2023.02.009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.036"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2024.03.001"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2006.06.4246"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.07.1493"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.5079"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0302\u20102838(22)00600\u20105"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16449"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.11.021"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2025.06.010"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.48707"},{"key":"e_1_2_9_18_1","unstructured":"U.S. Department of Veterans Affairs.About VHA. Accessed October 17 2025.https:\/\/www.va.gov\/health\/aboutvha.asp"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00799"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.00193"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO\u201024\u201001798"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903835"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.4_suppl.TPS236"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.TPS5118"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.4_suppl.TPS232"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2025.43.16_suppl.TPS5129"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00155"},{"key":"e_1_2_9_28_1","unstructured":"CornfordP TilkiD vanden BerghRCN et\u00a0al.EAU \u2010 EANM \u2010 ESTRO \u2010 ESUR \u2010 ISUP \u2010 SIOG guidelines on prostate cancer. EAU Guidelines. Paper presented at: EAU Annual Congress Paris; April 2024."},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.9433"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1200\/OP\u201024\u201000690"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2024.07.002"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2025.43.5_suppl.104"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2025.43.5_suppl.74"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16577"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol32030119"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2025.09.010"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2019.01.029"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(21)02437\u20105"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70494","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.70494","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70494","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:12:36Z","timestamp":1787137956000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.70494"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":37,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2026,8,15]]}},"alternative-id":["10.1002\/cncr.70494"],"URL":"https:\/\/doi.org\/10.1002\/cncr.70494","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]},"assertion":[{"value":"2025-12-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70494"}}