Nonlinear association seen for effective castration period with metastasis-free survival for any ADT duration
By Elana Gotkine HealthDay Reporter
THURSDAY, Oct. 10, 2024 (HealthDay News) — For men receiving androgen deprivation therapy (ADT) for prostate cancer, time to testosterone recovery (TR) varies with ADT duration, according to a study published online Sept. 19 in European Urology.
Wee Loon Ong, M.B.B.S., from Monash University in Melbourne, Australia, and colleagues obtained individual patient data from randomized controlled trials of radiotherapy with ADT and prospectively collected serial testosterone data to examine the oncological impact of an effective castration period in patients receiving definitive radiotherapy and ADT for prostate cancer. For each prescribed ADT duration, the times to noncastrate TR (>1.7 nmol/l) and nonhypogonadal TR (>8.0 nmol/l) were estimated, and corresponding nomograms were developed. The analysis included 1,444 men from five trials, of whom 115 received four months, 880 received six months, 353 received 18 months, 36 received 28 months, and 60 received 36 months of ADT.
The researchers found considerable variation in times to noncastrate TR and nonhypogonadal TR by ADT duration. A higher likelihood of TR was seen for higher baseline testosterone and younger age. There was a nonlinear association for effective castration period with metastasis-free survival for any ADT duration. The optimal castration period for a metastasis-free survival benefit was 10.6 and 18 months for men who received six and 18 months of ADT, respectively.
“An understanding of TR kinetics is critical for counseling of men who are starting ADT so that they have realistic expectations regarding the likely time to resolution of ADT-related side effects,” the authors write.
Several authors disclosed ties to industry.
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