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. 2026 Feb 12;16:1778687. doi: 10.3389/fonc.2026.1778687

Table 2.

Research on predictive markers related to the treatment of Mcspc.

Author Year Markers Result Conclusion
Li X (89) 2023 PSAPDR PSA decline rate: 11.6 ± 1.5% vs 2.9 ± 2.2% per day (RARP+ADT vs ADT) A higher PSA decline rate is associated with better treatment response.
Saad F (90) 2024 undetectable PSA (<0.2 ng/ml) Undetectable PSA (<0.2 ng/mL) rate in low-volume disease: 84% vs 38% (Darolutamide+ADT+DTX vs Placebo+ADT+DTX) Achieving undetectable PSA with intensified therapy correlates with superior clinical outcomes.
Harshman LC (91) 2018 PSA ≤ 0.2 ng/mL at 7 months mOS from 7-month PSA: 60.4 months for <0.2 ng/mL vs 22.2 months for <0.4 ng/mL. PSA <0.2 ng/mL rate: 45.3% vs 28.8% (Darolutamide+ADT vs ADT). PSA <0.2 ng/mL at 7 months is a surrogate for long-term survival; intensified therapy increases its attainment.
Ali A (92) 2021 Bone Metastatic Burden OS/PFS by metastatic burden: HR 0.62/0.57 (low) vs HR 1.08/0.87 (high) Prostate radiotherapy improves survival in patients with low metastatic burden (M1a/oligometastatic bone).
Jiménez N (93) 2024 TSGs: RB1, PTEN, and TP53 CRPC-FS & OS: TSGlow associated with shorter survival (HR 1.8/2.0). TSGWT patients on ADT+darolutamide showed significant benefit (HR 0.4). TSGlow is a prognostic biomarker for poor outcomes in mCSPC.
Hearn JWD (94) 2020 HSD3B1 Genotype 2-yr CRPC-free rate: 51.0% vs 70.5%; 5-yr OS: 57.5% vs 70.8% (HSD3B1 adrenal-permissive vs restrictive genotype) The HSD3B1 adrenal-permissive genotype is prognostic for faster progression and shorter survival.
Hamid AA (95) 2021 gene expression profile Benefit from ADT+darolutamide: HR 0.45 (Luminal B subtype) vs HR 0.85 (Basal subtype). Greater benefit with high Decipher risk (HR 0.41). Molecular subtyping can predict differential benefit from treatment intensification.
Ross AE (96) 2024 Decipher genomic classifier、 AR-Ascore、PAM50 cell subtype signature Higher Decipher/AR-A scores & luminal subtype associated with: >25% PSA rise on enzalutamide; lower rate of negative biopsy at 2 years. These molecular features may serve as predictive biomarkers for enzalutamide efficacy.
Kohli M (97) 2020 ctDNA Higher baseline ctDNA level associated with faster ADT failure (HR 2.29). ctDNA level is a prognostic marker for time to ADT failure.
Du X (98) 2023 ctDNA sequencing\HRR gene Median time to event: ctDNA decline (17.70 months) vs rise (8.43 months); with HRR alteration (8.02 months) vs without (13.20 months). ctDNA dynamics and HRR alterations are indicative of treatment benefit or disease progression.
Andrews JR (99) 2025 PSMA+EVs bPFS/rPFS: 26.1/36.0 months (low PSMA+EVs) vs 15.0/25.0 months (high PSMA+EVs) A low PSMA+EVs score is a predictive biomarker for benefit from SABR.
Tang C (40) 2023 TCR regulation Controlled TCR repertoire rate: 55% vs 15% (MDT+ADT vs ADT). Associated with PFS benefit (HR 0.21). TCR repertoire modulation predicts benefit from MDT.
Lin HM (100) 2025 PCPro PCPro-negative status associated with worse OS (HR 1.81) and clinical PFS (HR 1.65). PCPro status is a prognostic biomarker, supporting investigation of lipid metabolism-targeting therapies.
Zaffaroni M (101) 2023 Nutritional and Inflammatory Status No significant differences in nutritional/inflammatory scores between groups over time. Common nutritional/inflammatory parameters lack prognostic utility in this setting.
Wang JH (102) 2025 ArteraAI MMAI OS: MMAI-high vs MMAI-low (HR = 6.46); TTCRPC: MMAI-high vs MMAI-low (HR = 2.07) High MMAI score is a strong prognostic marker for poor survival and rapid progression to CRPC.

PSAPDR, prostate-specific antigen percentage decline rate; RARP, robot-assisted radical prostatectomy; ADT, androgen deprivation therapy; DTX, Docetaxel; mOS, median overall survival; PSMA, prostate-specific membrane antigen; EVs, extracellular vesicles; bPFS, Biochemical progression-free survival; rPFS, radiographic progression-free survival; SABR, Stereotactic ablative body radiotherapy; HR, hazard ratio; TSG, tumor suppressor genes; CRPC-FS, castration-resistant prostate cancer (CRPC)-free survival; mCSPC, metastatic castration-sensitive prostate cancer; AR-A, androgen receptor activity; ctDNA, circulating tumor DNA; HRR, homologous recombination repair; MMAI, multimodal artificial intelligence; TTCRPC, time to castration-resistant prostate cancer; clinPFS, clinical progression-free survival; TCR, T-cell receptor; MDT, Metastases-directed therapy.