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Large study: Continuous ADT prolongs prostate Ca survival

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Many men with metastatic, hormone-sensitive prostate cancer live longer on continuous androgen deprivation therapy than on intermittent therapy, report SWOG researchers.

Many men with metastatic, hormone-sensitive prostate cancer live longer on continuous androgen deprivation therapy than on intermittent therapy, report SWOG researchers.

Their study, which was presented at the American Society of Clinical Oncology annual meeting in Chicago, included more than 500 sites, enrolling 3,040 men with hormone-sensitive, metastatic prostate cancer between 1995 and 2008. All men received an initial course of ADT for 7 months. The 1,535 eligible men whose PSA level dropped to 4.0 ng/mL or less by the end of those 7 months were then randomly assigned to stop therapy or continue therapy.

Men on continuous therapy had a median overall survival time of 5.8 years from the time of randomization, with 29% of these men surviving at least 10 years. Those on intermittent therapy had a median overall survival time of 5.1 years, with 23% surviving at least 10 years from the time they were randomly assigned to a treatment arm.

The authors found that, in additional analyses, men with minimal disease did significantly better on continuous therapy, while men with extensive disease seemed to do about as well using either treatment approach.

Additional analyses indicated that the median overall survival time for those with minimal disease was 7.1 years on continuous ADT compared with only 5.2 years on intermittent treatment. Patients with extensive disease had median overall survival times of 4.4 years on continuous therapy and 5.0 years on intermittent therapy.

"In the past, when it came to using hormone therapy in this disease, doctors viewed the disease as one entity and adopted a 'one size fits all' approach. Based on this study’s findings, it seems that one size does not necessarily fit all," said principal investigator Maha Hussain, MD, of the University of Michigan, Ann Arbor.

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