Survival similar for on/off androgen deprivation vs continuous therapy

Intermittent androgen deprivation was just as effective as continuous therapy in terms of overall survival rates among men with prostate cancer and improved some quality-of-life factors as well, demonstrated a study reported in The New England Journal of Medicine (2012;367:895-903).

Noting that intermittent androgen deprivation for prostate-specific antigen (PSA) elevation after radiotherapy for prostate cancer may improve quality of life and delay hormone resistance, researchers compared overall survival in intermittent and continuous treatment. The study included men with a PSA level greater than 3 ng/mL more than 1 year after primary or salvage radiotherapy for localized prostate cancer.

A total of 690 men were randomized to intermittent therapy, provided in 8-month cycles, with nontreatment periods determined according to the PSA level. Another 696 men were assigned to continuous therapy. Median follow-up was 6.9 years.

Over the course of follow-up, 268 men undergoing intermittent therapy died, compared with 256 in the continuous-therapy group. Median overall survival was 8.8 years in the intermittent-therapy group, compared with 9.1 years for the men receiving continuous therapy. The estimated 7-year cumulative rates of disease-related death were 18% for intermittent therapy and 15% for continuous therapy.

No significant differences in adverse events were seen between the two groups. Intermittent therapy provided potential benefits in physical function, fatigue, urinary problems, hot flashes, libido, and erectile function.


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