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Dr Louise Kostos discusses PSA kinetics in mHSPC
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"Personally, I think monitoring and analyzing PSA kinetics is a great one because it's cheap and it's readily available,” says Dr Louise Kostos.
A recent European Urology study examined data regarding combination therapies for the treatment of locally advanced and metastatic hormone-sensitive prostate cancer (mHSPC).1 In the paper, the investigators emphasized the importance of optimizing patient selection for combination therapies. In an interview with Urology Times®, study author was Dr Louise Kostos was asked, beyond traditional risk stratification, what novel biomarkers or clinical parameters did she believe hold the most promise for predicting treatment response and toxicity in mHSPC?
“I think that's a really good question, because I think as patients are living longer and are on treatment for longer, patient selection and optimizing that is becoming really important. I think the traditional parameters we look at, like the disease volume, timing of metastatic disease, Gleason score, PSA [prostate-specific antigen], I think they're still very relevant, but we are moving toward a more precision medicine and personalized approach in prostate cancer. We are seeing a lot more emerging biomarkers being evaluated. Personally, I think monitoring and analyzing PSA kinetics is a great one because it's cheap and it's readily available,” said Kostos, a medical oncologist and PhD candidate at Peter MacCallum Cancer Centre in Victoria, Australia.
Kostos also touched on circulating tumor DNA (ctDNA) as a potentially useful biomarker.
“I also think ctDNA as a whole, but particularly the ctDNA fraction, we've seen some really great work come through in the past 1 to 2 years in the castration-resistant setting, where the baseline ctDNA fraction can be used to risk stratify patients and then the ctDNA fraction kinetics on treatment can then potentially help guide treatment decisions about de-escalation or intensification, and hopefully we will start to see that move forward into the hormone-sensitive space as well,” Kostos said.
REFERENCE
1. Azad AA, Kostos L, Agarwal N, et al. Combination therapies in locally advanced and metastatic hormone-sensitive prostate cancer. Eur Urol. 2025 Feb 12:S0302-2838(25)00023-5. doi:10.1016/j.eururo.2025.01.010
