Is ‘time to biochemical failure’ predictive of survival?

When planning and evaluating treatment protocols, various factors can be used as indicators of treatment effectiveness. In terms of prostate cancer treatment, an important question is whether certain indicators or ‘end points’ may be predictive of overall and prostate cancer-specific survival. Recently researchers analyzed the predictive power of one such factor or “surrogate end point,” namely  the amount of time from treatment to biochemical failure (i.e., the point at which PSA begins to rise or metastases appear).

In this study, researchers assessed the biochemical failure status of men with high-risk, localized prostate cancer as early as 2 years from completion of treatment, which was ADT plus radiation therapy.  They sought to understand if a longer amount of time between treatment and biochemical failure was predictive of overall and prostate cancer-specific survival. 

Results clearly demonstrated that men who were free of biochemical failure (i.e., maintained a low PSA and didn’t have evidence of metastasis) at 3 years post-treatment had significantly reduced risk of overall and prostate cancer-specific mortality. 

Although more clinical trials are needed, these findings strongly suggest that time to biochemical failure, as a surrogate end point, can be useful for planning and evaluating prostate cancer treatment protocols.

To read the full article, please see:

Dignam, J. J., Hamstra, D. A., Lepor, H., Grignon, D., Brereton, H., Currey, A., Rosenthal, S., Zeitzer, K. L., Venkatesan, V. M., Horwitz, E. M., Pisansky, T. M., & Sandler, H. M. (2019). Time interval to biochemical failure as a surrogate end point in locally advanced prostate cancer: Analysis of randomized trial NRG/RTOG 9202. Journal of Clinical Oncology, 37(3), 213-221. doi: 10.1200/JCO.18.00154