Cleveland, OH—The addition of hormone therapy to radiotherapy treatment consistently improves overall survival in men with intermediate- and high-risk prostate cancer, according to a new study.
The first-of-its-kind meta-analysis, which was published in The Lancet Oncology, provides "the strongest level of evidence so far to the magnitude of the benefit of ADT treatment intensification with radiotherapy for men with localized prostate cancer," according to researchers from University Hospitals and Case Western Reserve University. "Adding ADT and prolonging the portion of ADT that follows radiotherapy is associated with improved metastasis-free survival in men, regardless of risk group, age, and radiotherapy dose delivered; however, the magnitude of the benefit could vary and shared decision making with patients is recommended."
The authors note that randomized trials have been conducted for decades assessing the effect of adding hormone therapy to prostate cancer treatments, but inconsistencies in timing and duration of treatment recommendations have made it difficult to draw solid conclusions.
"Our research team set out to conduct a first-of-its-kind, comprehensive analysis by collecting individual patient data from each and every randomized trial conducted around the world, and performed a meta-analysis of the impact of various treatment intensification strategies using hormone therapy with radiation therapy for localized prostate cancer," stated senior author Daniel E. Spratt, MD. "Our goal is to better personalize therapy for prostate cancer patients, by providing the most precise and accurate estimates of the benefit of hormone therapy."
Among key findings were that:
• Patients with intermediate- and high-risk prostate cancer have an increased survival rate from the addition of hormone therapy to radiotherapy, despite age or dosages of radiotherapy.
• Extended duration of adjuvant ADT with radiotherapy improved survival rates in younger and older men, in men treated with lower and higher doses of radiotherapy, and in men with both intermediate- and high-risk prostate cancer.
• Longer use of neoadjuvant hormone therapy before radiotherapy did not benefit men in any outcome measured.
"We now have estimates that show the benefit of adding and prolonging adjuvant hormone therapy for clinically relevant subsets of patients," Dr. Spratt pointed out. "Our team showed that treating a group of approximately 10 to 15 men with hormone therapy or extended adjuvant hormone therapy, for at least 18 months, prevented one man from developing metastatic disease 10 years after treatment. This is dependent on patient and tumor-specific factors but gives us a more precise estimate to work with when it comes to recommending treatment options."
The study team searched studies with metastasis-free survival as the primary outcome. Ultimately, 12 trials were included that provided individual data on 10,853 patients with a median follow-up of 11·4 years (IQR 9·0-15·0).
The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.
