Achieving PSA <0.2 ng/mL Improves Survival in Metastatic Castration-Sensitive Prostate Cancer

MONDAY, Aug. 10, 2026 (HealthDay News) — For patients with metastatic castration-sensitive prostate cancer (mCSPC), achieving a prostate-specific antigen (PSA) level of <0.2 ng/mL within nine months of initiating treatment is associated with improved overall survival (OS), according to a study published online Aug. 10 in Cancer.

Stephen J. Freedland, M.D., from Cedars‐Sinai Medical Center in Los Angeles, and colleagues conducted a retrospective analysis to examine the association between PSA response and OS in patients with mCSPC who initiated androgen deprivation therapy (ADT) with or without other treatments. Metrics of PSA response included ≥90 percent PSA decline and a PSA <0.2 ng/mL within nine months of therapy initiation.

The researchers found that 44 percent of 4,890 patients reached a PSA <0.2 ng/mL and 74 percent had ≥90 percent PSA decline. Compared with patients without, those with a PSA <0.2 ng/mL within nine months of ADT initiation had a reduced risk for death thereafter (adjusted hazard ratio, 0.46). Similar OS improvements were seen with a PSA <0.2 ng/mL, regardless of ≥90 percent or <90 percent PSA decline (adjusted hazard ratios, 0.43 and 0.36, respectively). No relation was seen with improved OS for achieving ≥90 percent PSA decline without a PSA <0.2 ng/mL. The likelihood of achieving a PSA <0.2 ng/mL during PSA follow-up was higher for patients who initiated ADT plus androgen receptor pathway inhibitors versus ADT alone (adjusted hazard ratio, 1.71).

“These data show that we need to target a PSA below 0.2 ng/mL as our metric of success to optimize outcomes for our patients with metastatic prostate cancer,” Freedland said in a statement.

Several authors disclosed ties to biopharmaceutical companies, including Astellas Pharma and Pfizer, which funded the study.

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