{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:48:49Z","timestamp":1790218129588,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Time to prostate-specific antigen (PSA) nadir (TTN) has been proposed as an early indicator of treatment responsiveness in metastatic hormone-sensitive prostate cancer (mHSPC). However, its prognostic relevance in patients treated with next-generation androgen receptor pathway inhibitors (ARPIs), such as abiraterone or enzalutamide, remains incompletely defined. Methods: This retrospective cohort study included 147 patients with mHSPC treated with abiraterone or enzalutamide between 2019 and 2024. TTN, PSA kinetics, radiologic progression-free survival (rPFS), and PSA progression-free survival (PSA-PFS) were analyzed using Kaplan\u2013Meier methods and multivariable Cox regression. TTN was evaluated both as a continuous variable and dichotomized at the cohort median (\u22649 vs. &gt;9 months). Results: TTN distributions were comparable between treatment groups (median 9.0 vs. 6.0 months, p = 0.197). Patients with a shorter TTN (\u22649 months) experienced significantly longer median rPFS compared with those with longer TTN (&gt;9 months) (10.7 vs. 7.95 months; p = 0.036). No significant association was observed between TTN and PSA-PFS (9.3 vs. 10.75 months; p = 0.34). In multivariable analysis, enzalutamide was independently associated with a reduced risk of radiologic progression compared with abiraterone (HR 0.622; 95% CI 0.441\u20130.877), whereas TTN was not an independent predictor. Conclusions: A shorter TTN was associated with improved radiologic outcomes, suggesting that rapid PSA suppression may reflect more favorable disease biology in patients receiving ARPI therapy. Although TTN showed limited value in predicting biochemical progression, it may serve as a simple and accessible biomarker for early risk stratification and tailoring follow-up intensity in mHSPC. Validation in larger, multicenter cohorts is warranted.<\/jats:p>","DOI":"10.3390\/jcm15010386","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T12:38:56Z","timestamp":1767616736000},"page":"386","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association Between Time to PSA Nadir, Radiologic Progression, and PSA Progression in mHSPC Patients Treated with Abiraterone or Enzalutamide"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8527-1392","authenticated-orcid":false,"given":"Ugur","family":"Ozkerim","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5983-3291","authenticated-orcid":false,"given":"Oguzcan","family":"Kinikoglu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4398-5148","authenticated-orcid":false,"given":"Deniz","family":"Isik","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0634-7350","authenticated-orcid":false,"given":"Yunus Emre","family":"Altintas","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7555-2657","authenticated-orcid":false,"given":"Seval","family":"Ay Ersoy","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1604-8466","authenticated-orcid":false,"given":"Heves","family":"Surmeli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5757-4705","authenticated-orcid":false,"given":"Hatice","family":"Odabas","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2059-5502","authenticated-orcid":false,"given":"Tugba","family":"Basoglu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1140-8779","authenticated-orcid":false,"given":"Nedim","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Health Science University, Kartal Dr. L\u00fctfi Kirdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1007\/s00259-021-05471-4","article-title":"Intra-therapeutic dosimetry of [177Lu]Lu-PSMA-617 in low-volume hormone-sensitive metastatic prostate cancer patients and correlation with treatment outcome","volume":"49","author":"Peters","year":"2022","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.21873\/invivo.14016","article-title":"Prostate-specific antigen decline during primary androgen-deprivation therapy for predicting response and survival in metastatic castration-resistant prostate cancer patients receiving enzalutamide","volume":"39","author":"Nagata","year":"2025","journal-title":"In Vivo"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1002\/cncr.24064","article-title":"Time to prostate-specific antigen nadir independently predicts overall survival in patients with metastatic hormone-sensitive prostate cancer treated with androgen-deprivation therapy","volume":"115","author":"Choueiri","year":"2009","journal-title":"Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3595","DOI":"10.1158\/1078-0432.CCR-20-4298","article-title":"Lutetium-177-PSMA-617 in low-volume hormone-sensitive metastatic prostate cancer: A prospective pilot study","volume":"27","author":"Peters","year":"2021","journal-title":"Clin. Cancer Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1200\/JCO.2006.10.1949","article-title":"Initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer: ASCO guideline update","volume":"25","author":"Loblaw","year":"2007","journal-title":"J. Clin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Nevedomskaya, E., Baumgart, S.J., and Haendler, B. (2018). Recent advances in prostate cancer treatment and drug discovery. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19051359"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e073170","DOI":"10.1136\/bmjopen-2023-073170","article-title":"Cost-effectiveness analysis of rezvilutamide versus bicalutamide in metastatic hormone-sensitive prostate cancer","volume":"14","author":"Ding","year":"2024","journal-title":"BMJ Open"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"26712","DOI":"10.1038\/s41598-024-78592-z","article-title":"Prognostic role of prostate-specific antigen kinetics in primary high-volume metastatic hormone-sensitive prostate cancer treated with novel hormonal therapy agents","volume":"14","author":"Wang","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1007\/s00259-023-06165-9","article-title":"225Ac-PSMA-617 radioligand therapy in de novo metastatic hormone-sensitive prostate cancer","volume":"50","author":"Sathekge","year":"2023","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1093\/jjco\/hyab028","article-title":"Cabazitaxel versus abiraterone or enzalutamide in mCRPC: Post hoc analysis of the CARD study","volume":"51","author":"Suzuki","year":"2021","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Xiong, X., Xu, H., Wang, S., Liao, X., Yi, X., Jin, K., Lei, H., Bai, S., Qiu, S., and Yang, L. (2022). Association of novel androgen receptor axis-targeted therapies with diarrhea in prostate cancer. Front. Med., 8.","DOI":"10.3389\/fmed.2021.800823"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.euf.2021.04.003","article-title":"Overall survival after systemic treatment in high- versus low-volume metastatic hormone-sensitive prostate cancer","volume":"8","author":"Wenzel","year":"2022","journal-title":"Eur. Urol. Focus"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e077391","DOI":"10.1136\/bmj-2023-077391","article-title":"Added benefit and revenues of oncology drugs approved by the EMA between 1995 and 2020","volume":"384","author":"Brinkhuis","year":"2024","journal-title":"BMJ"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"7366","DOI":"10.3390\/curroncol30080534","article-title":"Understanding in-person and online exercise oncology programme delivery","volume":"30","author":"Duchek","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3251","DOI":"10.1002\/cam4.4685","article-title":"Prognostic significance of PSA nadir slope in hormone-sensitive prostate cancer","volume":"11","author":"Zeng","year":"2022","journal-title":"Cancer Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2623","DOI":"10.1002\/cncr.33543","article-title":"PSA nadir and testosterone level at PSA failure after radiation and ADT","volume":"127","author":"Bitterman","year":"2021","journal-title":"Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3109\/13685538.2011.580398","article-title":"Associations of PSA nadir and TTN with survival in prostate cancer treated with ADT","volume":"15","author":"Huang","year":"2012","journal-title":"Aging Male"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Conteduca, V., Mosca, A., Brighi, N., de Giorgi, U., and Rescigno, P. (2021). New prognostic biomarkers in metastatic castration-resistant prostate cancer. Cells, 10.","DOI":"10.3390\/cells10010193"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Kohaar, I., Petrovics, G., and Srivastava, S. (2019). Molecular biomarkers in prostate cancer. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20081813"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"17562872221103988","DOI":"10.1177\/17562872221103988","article-title":"Biomarkers for prostate cancer detection and risk stratification","volume":"14","author":"Farha","year":"2022","journal-title":"Ther. Adv. Urol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1056\/NEJMoa1503747","article-title":"Chemohormonal therapy in metastatic hormone-sensitive prostate cancer","volume":"373","author":"Sweeney","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1056\/NEJMoa1704174","article-title":"Abiraterone plus prednisone in metastatic castration-sensitive prostate cancer","volume":"377","author":"Fizazi","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e75","DOI":"10.1016\/j.clgc.2023.07.012","article-title":"Real-world efficacy of abiraterone versus docetaxel in Asian mHSPC patients","volume":"22","author":"Lam","year":"2024","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.eururo.2023.05.031","article-title":"Early endpoints in high-risk localized prostate cancer","volume":"84","author":"Feng","year":"2023","journal-title":"Eur. Urol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1111\/bju.12061","article-title":"Utility of PSA in advanced prostate cancer","volume":"112","author":"Crawford","year":"2013","journal-title":"BJU Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1056\/NEJMoa1315815","article-title":"AR-V7 and resistance to enzalutamide and abiraterone","volume":"371","author":"Antonarakis","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"383.e9","DOI":"10.1016\/j.urolonc.2015.04.015","article-title":"Active surveillance for low-risk prostate cancer","volume":"33","author":"Preston","year":"2015","journal-title":"Urol. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Vu, C.C., Haas, J.A., Katz, A.E., and Witten, M.R. (2014). Prostate-specific antigen bounce following stereotactic body radiation therapy for prostate cancer. Front. Oncol., 4.","DOI":"10.3389\/fonc.2014.00008"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1056\/NEJMoa041318","article-title":"Docetaxel and estramustine in advanced prostate cancer","volume":"351","author":"Petrylak","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_30","first-page":"7","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1038\/pcan.2016.17","article-title":"Androgen receptor variant-driven prostate cancer: Clinical implications and therapeutic targeting","volume":"19","author":"Antonarakis","year":"2016","journal-title":"Prostate Cancer Prostatic Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1111\/bju.14576","article-title":"DNA repair defects in prostate cancer: Impact for screening, prognostication and treatment","volume":"123","author":"Warner","year":"2019","journal-title":"BJU Int."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/386\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T12:59:48Z","timestamp":1767617988000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/386"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15010386"],"URL":"https:\/\/doi.org\/10.3390\/jcm15010386","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]}}}