Survival worse with intermittent vs continuous androgen deprivation in prostate cancer
Androgen Deprivation Tx Compared in Prostate Cancer
(HealthDay News) -- In patients with metastatic hormone-sensitive prostate cancer, intermittent androgen deprivation is associated with slightly, but not significantly, worse survival than continuous androgen deprivation, according to a study published in the April 4 issue of the New England Journal of Medicine.
Maha Hussain, M.D., from the University of Michigan in Ann Arbor, and colleagues analyzed data from 1,535 men with metastatic hormone-sensitive prostate cancer who had been receiving a luteinizing hormone-releasing hormone analog and an antiandrogen agent for seven months. If prostate-specific antigen levels fell to 4 ng per milliliter or lower after treatment, the men were randomly assigned to continuous or intermittent androgen deprivation.
After a median follow up of 9.8 years, the researchers found that median survival was lower for the intermittent therapy group (5.1 versus 5.8 years, hazard ratio 1.10, 90% confidence interval, 0.99 to 1.23). Erectile function and mental health were significantly better after intermittent therapy, but only at 3 months. The two groups had similar numbers of treatment-related high-grade adverse events.
"In patients with metastatic hormone-sensitive prostate cancer, the confidence interval for survival exceeded the upper boundary for noninferiority, suggesting that we cannot rule out a 20% greater risk of death with intermittent therapy than with continuous therapy, but too few events occurred to rule out significant inferiority of intermittent therapy," Hussain and colleagues conclude.
The study was partly funded by AstraZeneca.