ASTRO 2022: Sequencing of Short-Term Androgen-Deprivation Therapy With Radiotherapy for Prostate Cancer

By: Sarah Campen, PharmD
Posted: Friday, November 18, 2022

The sequencing of short-term androgen-deprivation therapy relative to radiotherapy seems to be significantly associated with clinical outcomes in men with localized prostate cancer, based on the results of the SANDSTORM study, presented at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 221). According to Ting Martin Ma, MD, PhD, of the University of California, Los Angeles, and colleagues, concurrent or adjuvant androgen-deprivation therapy in combination with prostate-alone radiation therapy appears to be the optimal sequencing option in this patient population.

The pooled analysis of 12 randomized trials examined 7,409 records from the Meta-Analysis of Randomized Trials in Cancer of the Prostate consortium. The study included patients who received radiation therapy and androgen-deprivation therapy for localized prostate cancer, including 6,325 patients who received neoadjuvant or concurrent androgen-deprivation therapy and 1,084 patients who received concurrent or adjuvant androgen-deprivation therapy. The median follow-up was 10.2 years.

Concurrent or adjuvant androgen-deprivation therapy with prostate-alone radiotherapy was associated with improved metastasis-free survival, biochemical recurrence, distant metastasis, and prostate cancer–specific mortality compared with neoadjuvant or concurrent androgen-deprivation therapy and prostate-alone radiotherapy. In patients receiving whole-pelvis radiation therapy, a benefit for neoadjuvant or concurrent androgen-deprivation therapy was noted for distant metastases, according to the investigators.

A comparison of the four groups based on androgen-deprivation sequencing and type of radiotherapy revealed that concurrent or adjuvant androgen-deprivation therapy with prostate-alone radiotherapy yielded superior rates of metastasis-free survival compared with neoadjuvant or concurrent androgen-deprivation therapy plus prostate-alone radiotherapy (P < .0001), neoadjuvant or concurrent androgen-deprivation therapy plus whole-pelvis radiotherapy (P < .0001), or concurrent or adjuvant androgen-deprivation therapy plus whole-pelvis radiotherapy (P < .0001).

Disclosure: Dr. Ma has received honoraria from ViewRay.

2022 ASTRO Annual Meeting

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