Does the Timing of Androgen-Deprivation Therapy Affect Outcomes in Prostate Cancer?
Posted: Friday, December 7, 2018
For patients with prostate cancer as well as their clinicians, does the timing of androgen-deprivation therapy after radiation affect outcomes? According to D. Andrew Loblaw, MD, MSc, FRCPC, of the Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada, and colleagues, their combined analysis indicated it may make little difference. Their study data, presented at the 2018 Annual Meeting of the American Society for Radiation Oncology (ASTRO) in San Antonio (Abstract 303), indicated similar overall survival between those who received immediate and those who received delayed androgen-deprivation therapy.
In total, their combined analysis centered on 261 patients from the TOAD (TROG 03.06) phase III trial and 78 patients from the ELAAT trial. The patients were followed for a median of 5 years. In the deferred arms of each trial, 63% of patients in TOAD received androgen-deprivation therapy at a median of 1.57 years after randomization. Among patients in the ELAAT group, 38% received androgen-deprivation therapy at a median of 1.65 years after randomization. The mean prostate-specific antigen (PSA) leveles at the start of androgen-deprivation therapy in the immediate and deferred arms were 3.52 and 30.2 ng/L for the TOAD group and 3.98 and 18.1 ng/mL for the ELAAT group, respectively.
“Not all relapsed men need [immediate androgen-deprivation therapy],” the authors concluded. “Further work is needed to identify patients who will benefit from [immediate androgen-deprivation therapy] and those suitable for [delayed androgen-deprivation therapy].”
