A standard treatment for men with high-risk prostate cancer is radiation therapy (RT) plus ADT. ADT may be prescribed before the start of RT (neo-adjuvant ADT), during RT (concurrent ADT), or following RT (adjuvant ADT, or A-ADT).
In a recent retrospective study out of Korea, researchers explored the survival benefits of combined RT plus A-ADT in men with locally advanced prostate cancer. The data were from 197 men with high-risk (n = 86) or very high-risk (n = 111) prostate cancer who received A-ADT for at least one year following RT. Study participants had an average initial PSA of 20 ng/mL and were on A-ADT for 12.4 – 94.3 months after RT.
Results: Consistent with the findings from previous randomized trials, the addition of A-ADT to RT was associated with better survival outcomes for men with advanced disease. In this study, A-ADT for at least one year after RT significantly predicted favourable biochemical failure-free survival and overall survival. Furthermore, survival outcomes were better for those who were on A-ADT for 2 years or longer versus those on A-ADT for less than two years. Men whose PSA levels dropped quickly to below the detectable limit of ≤0.001 ng/mL after RT had the best prognosis.
The authors concluded that “combination therapy with RT and A-ADT could be an effective treatment in patients with locally advanced prostate cancer. For high- or very high-risk patients without comorbidities, long-term A-ADT for at least 1 year and achieving nadir PSA of ≤0.001 ng/mL could prevent biochemical failure and improve survival….”
To read the full paper, see: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248461
Jeong, J. U., Nam, T. K., Song, J. Y., Yoon, M. S., Ahn, S. J., Chung, W. K., Cho, I. J., Kim, Y. H., Cho, S. H., Jung, S. I., Kang, T. W., & Kwon, D. D. (2021). Favorable prognosis of patients who received adjuvant androgen deprivation therapy after radiotherapy achieving undetectable levels of prostate-specific antigen in high- or very high-risk prostate cancer. PloS one, 16(3), e0248461. https://doi.org/10.1371/journal.pone.0248461