Androgen deprivation therapy (ADT) combined with external beam radiation therapy (EBRT) is associated with better long-term oncologic outcomes than ADT alone among men with locally advanced prostate cancer, updated findings from a phase 3 trial confirm.
Paul Sargos, MD, of Institut Bergonié, Bordeaux, France, and colleagues studied 263 patients randomly assigned to received ADT plus EBRT or ADT alone. Patients had a median follow-up of 7.3 years. The 8-year rate of progression-free survival (PFS)—the primary end point—was significantly higher in the combination arm than the ADT-only recipients (48% vs 7%). EBRT plus ADT was associated with a significant 73% decreased risk of progression compared with ADT alone, the investigators reported in BJU International.
The investigators compared the 2 treatment approaches according to baseline PSA levels. Compared with ADT alone, EBRT plus ADT was associated with a significant 90% decreased risk of progression among men with baseline PSA levels of 50 ng/mL or higher and 72% decreased risk among those with levels below 50 ng/mL.
In addition, ADT plus EBRT was associated with a significant 52% decreased risk of death from prostate cancer and 39% decreased risk of locoregional recurrence compared with ADT alone.
The 8-year overall survival rates did not differ significantly between the ADT plus EBRT group and ADT monotherapy arm (65% vs 57%). The treatment arms also did not differ significantly with respect to metastasis-free survival.
Sargos P, Mottet N. Bellera C, Richaud P. Long-term androgen deprivation, with or without radiotherapy, in locally advanced prostate cancer: updated results from a phase III randomized trial. BJU Int. 2019.