{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:56:52Z","timestamp":1773017812484,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Treatment selection for metastatic castration\u2010sensitive prostate cancer (mCSPC) remains challenging, as reliable and practical biomarkers predicting response to androgen receptor pathway inhibitor (ARPI)\u2010based therapy are limited. We evaluated whether prostate\u2010specific antigen (PSA) and Ki\u201067 expression in diagnostic biopsy specimens can predict oncologic outcomes in patients with mCSPC treated with ARPI\u2013androgen deprivation therapy (ADT) doublet therapy, and whether these biomarkers can guide optimal treatment selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter study included 58 patients with mCSPC who received ARPI\u2013ADT doublet therapy between 2018 and 2024. Immunohistochemical staining for PSA and Ki\u201067 was performed on diagnostic biopsy specimens. Receiver operating characteristic curve analyses were used to determine optimal cutoff values for predicting progression to castration\u2010resistant prostate cancer (CRPC). Survival outcomes were analyzed using the Kaplan\u2013Meier method and Cox proportional hazards models. Exploratory analyses included patients treated with triplet therapy (ADT\u2009+\u2009docetaxel + darolutamide) or upfront docetaxel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Low PSA expression, high Ki\u201067 expression, and a bone metastasis extent of disease (EOD) score \u2265\u20093 were independently associated with shorter CRPC\u2010free survival (CRPC\u2010FS). Stratification by risk factors (0, 1, or 2) showed a stepwise decline in CRPC\u2010FS. In exploratory analyses, triplet therapy achieved the longest CRPC\u2010FS and progression\u2010free survival 2 among high\u2010risk patients, whereas no significant differences among treatment modalities were observed in the low\u2010risk group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Immunohistochemical PSA and Ki\u201067 expression provide practical prognostic information for patients with metastatic castration\u2010sensitive prostate cancer. Combined assessment with EOD \u2265\u20093 identifies a high\u2010risk subgroup with unfavorable clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70368","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T10:44:09Z","timestamp":1770029049000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Immunohistochemical\n                    <scp>PSA<\/scp>\n                    and Ki\u201067 Expression on Prognosis in Metastatic Castration\u2010Sensitive Prostate Cancer"],"prefix":"10.1111","volume":"33","author":[{"given":"Miyaka","family":"Umemori","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Technology, Faculty of Medical Science Juntendo University  Chiba 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