[PSA progression under hormone therapy - of prognostic relevance?]

In clinical routine, the anti-hormone therapy for prostate cancer with drugs is monitored by regular control measurements of the PSA value. An increase in the PSA value is considered to be a first sign of progression and thus of failure of the therapy. In the case of hormone-sensitive prostate carcinoma this means that the first stage of castration resistance has been reached. The question as to the relationship between PSA progression and overall survival as the most important clinical endpoint has been evaluated retrospectively in 2 studies. Both were able to confirm the relationship. However, in a therapy comparison, e.g., in phase III studies, the PSA progression does not have a surrogate status since the currently available analyses do not allow the recognition of an unambiguous relationship between the therapeutic effect on PSA progression and overall survival.