Study: Shorter course of ADT may be sufficient for many patients with prostate cancer

A recent study published in JAMA Oncology suggests that the ideal duration of hormone therapy for patients with localized prostate cancer may depend on a patients’ individual cancer risk, allowing physicians to tailor treatment plans and reduce unnecessary therapy.¹

Specifically, data showed that many patients with lower risk prostate cancer may not need long-term androgen deprivation therapy (ADT).

“Prostate cancer treatment should not be one-size-fits-all,” said co-senior author Amar U. Kishan, MD, professor and executive vice chair of radiation oncology and co-director of the cancer molecular imaging, nanotechnology and theranostics program at the UCLA Health Jonsson Comprehensive Cancer Center, in a news release on the results.² “These findings help doctors personalize therapy, balancing cancer control with potential side effects and other health risks.”

For the study, the investigators conducted a meta-analysis of data from 10,266 men across 13 randomized phase 3 clinical trials. The studies all evaluated the use of radiotherapy alone of with ADT. Patients included in the analysis had received ADT for 0 to 36 months. The median age was 70 years (IQR, 65 to 74), and 72% of patients had high-risk or very high-risk disease per National Comprehensive Cancer Center Network (NCCN) guidelines.

Overall, the authors reported that “longer durations or ADT were associated with nonlinear improvement in relative benefits of [distant metastasis], prostate cancer–specific mortality, and overall survival.” The trends showed large benefits in ADT within the first 9 to 12 months of treatment, with reduced benefits thereafter.

Further, data showed that longer durations of ADT were associated with a non-linear increase in other-cause mortality (HR, 1.28; 95% CI, 1.09 to 1.50; P = .002 for 28 vs 0 months of ADT).

According to the authors, the optimal duration of treatment could be tied to individual patient factors such as cancer risk. For example, the optimal duration of ADT based on 10-year distant metastasis was 0 months for patients with 1 intermediate-risk factor, 6 months for patients with 2 or more intermediate-risk factors, 12 months for patients with NCCN high-risk disease, and undefined for patients with NCCN very high-risk disease.

Based on these findings, the authors concluded, “The results of this meta-analysis suggest that, for men with localized prostate cancer treated with definitive radiotherapy and ADT, there are relative and absolute benefits from increasing durations of ADT that help provide individualized risk estimates.”

REFERENCES

1. Zaorsky NG, Sun Y, Nabid A, et al. Optimal duration of androgen deprivation therapy with definitive radiotherapy for localized prostate cancer: A meta-analysis. JAMA Oncol. 2025:e254800. doi:10.1001/jamaoncol.2025.4800

2. Study suggests many men may not need long-term hormone therapy for prostate cancer. News release. University of California, Los Angeles (UCLA), Health Sciences. November 25, 2025. Accessed November 26, 2025. https://www.newswise.com/articles/study-suggests-many-men-may-not-need-long-term-hormone-therapy-for-prostate-cancer