Unfavorable-risk prostate cancer (PCa) patients with co-existing conditions, predominantly a prior heart attack, do not have a survival benefit from combined radiation treatment (RT) and androgen deprivation therapy (ADT), researchers find.
“These findings give us reason to rethink how we manage prostate cancer in men with known heart disease,” stated lead researcher Anthony V. D’Amico, MD, of Brigham and Women’s Hospital in Boston, according to a news release. “Specifically, we should be cautious in prescribing ADT in all men who have had a prior heart attack. Men with significant heart disease that is not amenable to medical or surgical correction may be best served with RT alone.”
The investigators examined survival and mortality by comorbidity status in 206 men randomly assigned to RT with or without ADT for 6 months using updated data from their original trial conducted in 1995–2001.
After a median follow-up of 17 years, RT alone was associated with a 64% and 83% reduction in overall and cardiac mortality, respectively, in patients with co-existing illnesses, according to results in the Journal of the American Medical Association (2015;314:1291-1293). (These results differed from data presented after 8 years of follow-up, noted the investigators.)
As the findings are from a small group of patients, they need to be validated by future trials, the researchers stated. They also suggested further research on newer forms of hormone therapy that do not lower testosterone and the impact on survival.