Biochemical Recurrence: Difference between revisions

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=== Definition ===

* '''1996 ASTRO (American Society for Therapeutic Radiology and Oncology) definition: 3 consecutive PSA increases measured 6 months apart and backdating the time of cancer progression to halfway between the PSA nadir and the first rising PSA level'''

* '''<span style="color:#ff0000">1996 ASTRO (American Society for Therapeutic Radiology and Oncology) definition: 3 consecutive PSA increases measured 6 months apart and backdating the time of cancer progression to halfway between the PSA nadir and the first rising PSA level</span>'''

* '''2005 Phoenix definition: PSA nadir + 2 ng/mL; failure is not backdated'''. Thus the time to recurrence is further prolonged after the PSA level begins to rise, and often it takes a considerably longer time for the PSA level to increase by 2 ng/mL

* '''<span style="color:#ff0000">2005 Phoenix definition: PSA nadir + 2 ng/mL; failure is not backdated</span>'''. Thus the time to recurrence is further prolonged after the PSA level begins to rise, and often it takes a considerably longer time for the PSA level to increase by 2 ng/mL

** '''The Phoenix definition of definition of failure is associated with fewer false positives for failure than the ASTRO definition'''

* '''Given the differences in defining failure, it is not possible to make fair comparisons between radical prostatectomy and radiotherapy by use of these outcome measurements; other measurements such as metastasis-free survival or cancer-specific survival are more appropriate comparisons of treatment failure'''

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** 5-year metastasis-free survival: absolute risk reduction: 16% (87% combination group vs. 71% leuprolide-alone group, significant); NNT: 6

** 5-year overall survival: absolute risk reduction: 5% (92% combination group vs. 87% leuprolide-alone group, not significant)

**Enzalutamide monotherapy better than leuprolide monotherapy for progression-free survival

***First evidence that second-generation androgen deprivation therapy monotherapy better than first-generation monotherapy

* [https://pubmed.ncbi.nlm.nih.gov/37851874/ Freedland, Stephen J., et al.] "Improved outcomes with enzalutamide in biochemically recurrent prostate cancer." ''New England Journal of Medicine'' 389.16 (2023): 1453-1465.

@@ Line 195: / Line 195: @@
 === Definition ===
-* '''1996 ASTRO (American Society for Therapeutic Radiology and Oncology) definition: 3 consecutive PSA increases measured 6 months apart and backdating the time of cancer progression to halfway between the PSA nadir and the first rising PSA level'''
+* '''<span style="color:#ff0000">1996 ASTRO (American Society for Therapeutic Radiology and Oncology) definition: 3 consecutive PSA increases measured 6 months apart and backdating the time of cancer progression to halfway between the PSA nadir and the first rising PSA level</span>'''
-* '''2005 Phoenix definition: PSA nadir + 2 ng/mL; failure is not backdated'''. Thus the time to recurrence is further prolonged after the PSA level begins to rise, and often it takes a considerably longer time for the PSA level to increase by 2 ng/mL
+* '''<span style="color:#ff0000">2005 Phoenix definition: PSA nadir + 2 ng/mL; failure is not backdated</span>'''. Thus the time to recurrence is further prolonged after the PSA level begins to rise, and often it takes a considerably longer time for the PSA level to increase by 2 ng/mL
 ** '''The Phoenix definition of definition of failure is associated with fewer false positives for failure than the ASTRO definition'''
 * '''Given the differences in defining failure, it is not possible to make fair comparisons between radical prostatectomy and radiotherapy by use of these outcome measurements; other measurements such as metastasis-free survival or cancer-specific survival are more appropriate comparisons of treatment failure'''
@@ Line 425: / Line 425: @@
 ** 5-year metastasis-free survival: absolute risk reduction: 16% (87% combination group vs. 71% leuprolide-alone group, significant); NNT: 6
 ** 5-year overall survival: absolute risk reduction: 5% (92% combination group vs. 87% leuprolide-alone group, not significant)
+**Enzalutamide monotherapy better than leuprolide monotherapy for progression-free survival
+***First evidence that second-generation androgen deprivation therapy monotherapy better than first-generation monotherapy
 * [https://pubmed.ncbi.nlm.nih.gov/37851874/ Freedland, Stephen J., et al.] "Improved outcomes with enzalutamide in biochemically recurrent prostate cancer." ''New England Journal of Medicine'' 389.16 (2023): 1453-1465.