Just 6 months of androgen-deprivation therapy (ADT) combined with radiotherapy reduced mortality by nearly half compared with radiotherapy alone in men with locally advanced prostate cancer.
These results emerged from the Trans-Tasman Radiation Oncology Group (TROG) 96.01 trial, in which 818 men with locally advanced prostate cancer were randomized to 6.5 to 7 weeks of radiotherapy alone or in combination with 3 months or 6 months of monthly subcutaneous goserelin and oral flutamide three times a day. In 2005, 5-year TROG findings suggested that 6 months of the neoadjuvant ADT (NADT) improved prostate-cancer-specific survival by reducing metastases. In the current study—presented online by The Lancet Oncology—James W. Denham, MD, of the School of Medicine and Public Health at the University of Newcastle in Newcastle, New South Wales, Australia, and colleagues analyzed TROG data from 802 participants who had now been followed for a median of 10.6 years.
The new data showed that compared with radiotherapy alone, 6-month NADT resulted in significantly lower 10-year rates of prostate-cancer-specific mortality (11% vs 22%) and all-cause mortality (29% vs. 43%). However, 3-month NADT was no more effective at reducing distant progression, prostate-cancer-specific mortality, or all-cause mortality than radiotherapy alone.
Both 3-month and 6-month NADT decreased the cumulative incidence of prostate-specific antigen concentration progression and local progression, and improved event-free survival, better than radiotherapy alone.
The authors concluded that a 6-month course of ADT plus radiotherapy is an effective treatment option for locally advanced prostate cancer, “particularly in men without nodal metastases or pre-existing metabolic comorbidities that could be exacerbated by prolonged androgen deprivation.”