The importance of PSADT in high-risk, biochemically recurrent prostate cancer

Findings of a recent study point to the importance of calculating prostate-specific antigen doubling time (PSADT) in patients with high-risk, biochemically recurrent prostate cancer.¹

The data were presented at the 2025 American Society of Clinical Oncology Genitourinary Cancers Symposium in San Francisco, California, by Alicia Morgans, MD, MPH, a genitourinary medical oncologist and the director of the Survivorship Program at Dana-Farber Cancer Institute in Boston, Massachusetts.

For the study, Morgans and her coauthors evaluated data for 284 patients. Of the cohort, 37% had known PSADT and 63% had unknown PSADT. More patients with known PSADT had characteristics of more aggressive disease such as time from prostate cancer diagnosis to biochemical recurrence of less than 2 years, a Gleason score of at least 8, an ECOG Performance Status of 1 or higher, and higher PSA levels at nonmetastatic hormone-sensitive prostate cancer and high-risk biochemical recurrence diagnoses, the investigators reported.

“From my perspective, the take-home message from this study is that we need to be aware that patients have options for treatment of high-risk biochemical recurrence, and in order to identify that they have high-risk biochemical recurrence and may be good candidates for the treatments that are available, which is really enzalutamide [Xtandi], with or without a GnRH analog, we need to calculate PSA doubling time,” Morgans said in a video interview with Urology Times.®

In the interview, she also mentioned the importance of using “standardized, validated calculators” to obtain PSADT.

“It's important that we calculate those numbers to be as accurate as possible, because we wouldn't want to overestimate the PSA doubling time and underestimate the aggressiveness of disease,” Morgans said.

She emphasized the importance of shared decision-making with patients.

“Ultimately, it's important then to have a shared decision[-making conversation] with patients to understand whether they want to go through treatment in any of its forms, or whether they want to continue to monitor, because at the end of the day, it is up to the patient, but it's also up to the physician to make that suggestion/recommendation and give the guidance that we can around treatment options,” Morgans said.

REFERENCE

1. Morgans AK, Touya M, El-Chaar N, et al. Impact of physicians’ awareness of prostate-specific antigen doubling time (PSADT) on treatment (Tx) decisions in high-risk (HR) biochemically recurrent (BCR) prostate cancer (PC). J Clin Oncol 43, 2025 (suppl 5; abstr 354). doi:10.1200/JCO.2025.43.5_suppl.354