• Davide Bosso, Martina Pagliuca, Guru Sonpavde, Gregory Pond, Giuseppe Lucarelli, Sabrina Rossetti, Gaetano Facchini, Sarah Scagliarini, Giacomo Cartenì, Bruno Daniele, Franco Morelli, Matteo Ferro, Livio Puglia, Michela Izzo, Vittorino Montanaro, Teresa Bellelli, Francesca Vitrone, Sabino De Placido, Carlo Buonerba, and Giuseppe Di Lorenzo.
• Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy Department of Medicine, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL McMaster University, Hamilton, Ontario, Canada Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari Division of Medical Oncology, Department of Uro-Gynecological Oncology, Istituto Nazionale Tumori Fondazione G. Pascale Unità Operativa Sperimentazioni Cliniche Oncologia, Azienda Ospedaliera di Rilievo Nazionale 'Antonio Cardarelli' Naples Medical Oncology Department, G. Rummo Hospital, Benevento Department of Medical Oncology, Casa Sollievo della Sofferenza Hospital, Medical Oncology, San Giovanni Rotondo Ospedale di Vallo della Lucania, Vallo Della Lucania, Salerno, Italy.
• Medicine (Baltimore). 2017 Jun 1; 96 (24): e6817.

RationalePSA responses have been associated with a survival benefit in patients treated with enzalutamide in retrospective analyses.Patient ConcernsHowever the prognostic value of PSA declines in highly pretreated patients receiving enzalutamide remains to be defined.Diagnoses And InterventationsMedical records of patients with documented mCRPC treated with enzalutamide between September 2011 and August 2016 were reviewed at multiple participating centers and assessed for overall survival (OS), PSA variations, and other variables of interest. Univariable and multivariable analyses were conducted.OutcomesA total of 129 patients received enzalutamide. PSA response rates (>50% PSA declines) were 58/119 (48.7%), 58/115 (50.4%), 54/110 (49.1%), and 47/91 (51.7%) at weeks 4, 8, 12, and 16, respectively. Having a PSA response was a statistically significant prognostic factor of improved OS at 8 and 12 weeks in univariable analysis, whereas it was significant at 12 weeks in the multivariable analysis. Patients treated with enzalutamide had a median OS of 7.8 months.LessonsOur study supports the prognostic value of PSA declines in heavily treated patients receiving enzalutamide.

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