SAN DIEGO, CA USA (UroToday.com) - More data are now available to support intermittent androgen deprivation therapy (ADT) for men with advanced prostate cancer.
Since few randomized studies have compared intermittent hormonal therapy to continuous therapy for the treatment of advanced prostate cancer, the authors of this study pooled results from two similar randomized trials (MAB and CAB) to compare overall and cause-specific survival between patients receiving intermittent therapy. The relevance of this abstract was underscored by a plenary session in San Diego being dedicated to this debate.
The pooled analysis included 1 543 patients (769 continuous vs. 774 intermittent) with 1 002 deaths recorded. In patients with low burden of advanced disease, no statistical difference was seen in treatment survival. However, a difference that approached significance in favor of continuous therapy was observed. Sexual activity was found to be better in the intermittent group compared to patients on continuous ADT.
The authors concluded that intermittent therapy should be considered for use in routine practice in men with low burden, non-metastatic, advanced prostate cancer given no observed reduction in survival and improved sexual activity. Prior reports and recent debates support the use of intermittent ADT in men with early PSA recurrence and overall low burden of disease. Continuous therapy may be best suited for men with a greater overall tumor burden or higher PSA values. This may allow men to begin on intermittent therapy, and thus enjoy a better side-effect profile. Once disease progresses, continuous therapy likely should be introduced.
Abstract Title: Pooled analysis of two protocols of intermittent hormonal therapy in advanced prostatic cancer
Presented by Fernando Calais da Silva Junior; Fernando Calais Da Silva, Maurizio Brausi, Frederico Gonsalves, Jan Kliment, Antonio Queimadelos, and Chris Robertson at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Reported for UroToday.com by Anthony T. Corcoran, MD
