Prostate cryoablation combined with androgen deprivation therapy (ADT) for newly diagnosed metastatic prostate cancer improves oncologic outcomes compared with ADT alone, according to investigators.
In a retrospective study that included 108 men (54 who underwent whole-gland cryoablation plus ADT propensity score matched to 54 who received ADT alone), the combination arm had a significantly lower median PSA nadir (0.025 vs 0.230 ng/mL) and a significantly longer median failure-free survival (39 vs 21 months) and time to development of castration-resistant disease (39 vs 21 months). The investigators found no significant difference in cancer-specific and overall survival.
Compared with ADT alone, cryoablation plus ADT decreased the risk of treatment failure by 45.8%, corresponding authors Fangjian Zhou, MD, and Yonghong Li, MD, of Sun Yat-Sen University Cancer in Guangzhou, Guangdong, China, and colleagues reported in Prostate Cancer and Prostatic Diseases.
A higher proportion of patients in the combination arm than ADT-only arm experienced clinical relief of urinary symptoms (79.1% vs 59.1%), the investigators reported. A lower proportion of patients in the combination arm required treatment of primary lesions for symptomatic relief (13.0% vs 31.5%). Cryoablation was well tolerated, according to the authors.
After propensity score matching, both study arms had similar ECOG performance status, PSA levels, Gleason score, clinical stage, and metastatic burden. The median follow-up duration was 40 and 39 months in the cryoablation plus ADT group and ADT-only group, respectively.
Wang N, Ye Y, Deng M, et al. Prostate cryoablation combined with androgen deprivation therapy for newly diagnosed metastatic prostate cancer: a propensity score-based study. Published online March 4, 2021. Prostate Cancer Prostatic Dis. doi:10.1038/s41391-021-00335-2