A study published in Lancet Oncology indicates that adding androgen deprivation therapy (ADT) to radiotherapy improves survival outcomes among patients with localized prostate cancer. It also said that among men with intermediate-risk and high-risk prostate cancer, prolonging ADT use also provided significant benefit despite the dose of the radiotherapy.
This study was a meta-analysis that included 10,853 men from 12 multicenter randomized clinical trials published between January 1, 1962, and December 30, 2020. It had a median follow-up of 11.4 years. The author used metastasis-free survival (how long a man will live before developing metastatic disease, which might serve as a surrogate for overall survival) as the study endpoint.
The analysis was performed by Amar U. Kishan, MD, associate professor and vice-chair of clinical and translational research, and chief of the genitourinary oncology service for the department of radiation oncology at David Geffen School of Medicine at UCLA and UCLA Jonsson Comprehensive Cancer Center.
According to Kishan, benefits are derived by "… the addition of ADT to radiotherapy, prolonging the duration of ADT that follows radiotherapy (adjuvant ADT prolongation), and extending the duration of ADT that may precede radiotherapy (neoadjuvant ADT extension)."
Kishan also said, "Regardless of radiotherapy dose, patient age or prostate cancer risk group — as defined by the National Comprehensive Cancer Network classification — the addition of ADT to radiotherapy and prolonging adjuvant ADT improved all clinical endpoints, including OS."
Kishan also said, "These findings provide the strongest evidence so far to the magnitude of the benefit of ADT treatment intensification with radiotherapy for men with localized prostate cancer."
Kishan AU, et al. Lancet Oncol. 2022;doi;10.1016/S1470-2045(21)00705-1.
