The time between diagnosis of organ-confined prostate cancer and definitive therapy with radical prostatectomy provides an interval for intervention, with the benefit of pre- (biopsy specimen) and post-intervention (surgical specimen) tissue for comparison. The authors of “Loss of SNAI2 in Prostate Cancer Correlates with Clinical Response to Androgen Deprivation Therapy” present molecular studies from their phase II neoadjuvant trial of 6 months of combinatorial androgen blockade with degarelix, abiraterone, and bicalutamide. Of 17 patients enrolled, 16 had radical prostatectomy.  All subjects treated with the study regimen had a PSA response of at least 95% but the key observation of disparate tissue response that provided entrée to their correlative investigations.  Four subjects had a complete response (n=1) or minimal residual disease and four had no response at all, with the remaining eight subjects with partial response.  The varying outcomes were not explained by pre-treatment variables or depth of PSA nadir.

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