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ASCO 2025 | The significance of PSA levels in prostate cancer prognosis

Michael Ong, MD, BSc, FRCPC, The Ottawa Hospital Cancer Centre, Ottawa, Canada, comments on the significance of PSA levels in prostate cancer prognosis. Dr Ong notes that PSA levels over 0.2 are associated with poor prognosis, but emphasizes that this information should not be used to dictate treatment decisions, rather it should inform the need for further clinical trials to determine the optimal approach. He also highlights the importance of studying low-PSA patients to determine if they require less therapy, This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

Right now what we can say is in multiple post hoc analyses of randomized clinical trials, as well as now large real-world data from the Ironman registry, that if you have a PSA over 0.2, that has a poor prognosis. That’s information that can be given to patients. It does not imply right now that anything should be done about that situation, simply because I think that’s the role of clinical trials to really understand if we should be adding on more therapy or not...

Right now what we can say is in multiple post hoc analyses of randomized clinical trials, as well as now large real-world data from the Ironman registry, that if you have a PSA over 0.2, that has a poor prognosis. That’s information that can be given to patients. It does not imply right now that anything should be done about that situation, simply because I think that’s the role of clinical trials to really understand if we should be adding on more therapy or not. I think at the same time, if you look at patients that have PSA that’s very low, PSA that is, say, under 0.1 or under 0.02, you know, these patients are faring very well. Do we need as much therapy as we’re giving? Again, that does not imply that we should be stopping patients’ therapy, but we should be studying how it’s safe to do those kind of approaches.

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