Early Prostate Cancer Salvage ADT Therapy Better
Among men who had PSA failure following radiation therapy for localized PCa, those with a long PSA doubling time had an increased risk of PCa mortality if they started androgen-deprivation therapy lat
|The following article is part of conference coverage from the 2018 Genitourinary Cancers Symposium in San Francisco. Renal and Urology News' staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from GU 2018.|
SAN FRANCISCO—Among men who experience biochemical recurrence of prostate cancer (PCa) following radiation therapy, early initiation of salvage androgen-deprivation therapy (ADT) for those with a long PSA doubling time may decrease the risk of cancer-specific mortality, according to study findings presented at the 2018 Genitourinary Cancers Symposium.
According to investigators, the findings challenge an unproven assumption that patients with a short PSA doubling time (PSADT) are those most likely to benefit from early initiation of salvage ADT.
Out of a cohort of 206 men with localized unfavorable-risk PCa randomized to radiation therapy (RT) or RT plus 6 months of ADT from 1995 to 2001, Brandon Arvin Virgil Mahal, MD, of the University of Connecticut in Storrs, and colleagues selected 54 men who received salvage ADT for PSA failure after a median follow-up almost 18.72 years.
After a median follow-up of 5.68 years following salvage ADT, 49 men (91%) died, 27 from PCa. Increasing PSADT as a continuous covariate was associated with a decreasing risk of prostate cancer-specific mortality (PCSM).
Among patients with a long PSADT (6 months or more) initiating salvage ADT later (at a PSA level greater than 12 ng/mL) vs earlier was associated with a significant 8.8-fold increased risk of PCSM in adjusted analysis. Later initiation of salvage ADT in men with a short PSADT (less than 6 months) did not increase PCSM risk.
Mahal BAV, Chen MH, Renshaw AA, et al. Early versus delayed initiation of salvage androgen deprivation therapy and the risk of prostate cancer-specific mortality. Data presented at the 2018 Genitourinary Cancers Symposium, held in San Franciso Feb. 8-10. Abstract 189.