A real-world study of nearly 5,000 men with metastatic hormone-sensitive prostate cancer suggests a specific prostate-specific antigen (PSA) milestone may better correlate with survival than relative PSA decline rates. The research indicates that patients whose PSA fell below 0.2 ng/mL within nine months of starting therapy had substantially different outcomes than those who did not meet that threshold. The report frames the result as a practical guidance question for clinicians, since PSA metrics often drive treatment decisions and trial stratification. A stable, interpretable cutoff could improve comparability across settings where % decline targets vary. If adopted in future protocols, PSA thresholding may refine risk stratification and help standardize endpoints tied to survival in ongoing prostate cancer studies.