Initial 3-month dynamics of dehydroepiandrosterone sulfate can predict responsiveness to primary androgen deprivation therapy in patients with metastatic prostate cancer

Dear Editor,Intensive treatments such as primary androgen deprivation therapy(pADT)plus docetaxel or abiraterone acetate are reportedly beneficial in metastatic prostate cancer(mPCa)patients with high-volume disease or high-risk features,respectively.1,2 High-volume or high-risk features are determined exclusively via pretreatment parameters.Predicting patient responsiveness to pADT,which is one of the major determinants of survival in these patients,would be advantageous with regard to making primary treatment decisions.If an initial 3-month period is possible,short-term serum parameter dynamics can be used to predict pADT responsiveness.Prostate-specific antigen(PSA)and alkaline phosphatase(ALP)dynamics have been indicated as potential predictors.3,4 Although pADT can reportedly cause a 20%-30%decrease in adrenal androgen levels,5 it is not known whether the dynamics of adrenal androgens shortly after the initiation of pADT can predict pADT responsiveness.The aim of the current study was to identify predictors of pADT responsiveness among pretreatment parameters and 3-month dynamics(D3m)of serum parameters including the adrenal androgen,dehydroepiandrosterone sulfate(DHEAS).