ANDROGEN deprivation therapy (ADT) is commonly used for the treatment of metastatic hormone sensitive prostate cancer (mHSPC) and, while benefits to the patient have been proven, it is an expensive regimen associated with virulent side-effects. Additionally, the decision of the doctor to prescribe this treatment is often not well-informed because there is a lack of reliable biomarkers.
A team of researchers, led by Dr Neeraj Agarwal, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA, believes that the duration it takes from definitive therapy (DT) to the commencement of ADT can independently predict the risk of metastatic castration-resistant prostate cancer (mCRPC). Their analysis included 253 men recently diagnosed with mHSPC, 155 (45%) of whom had undergone prior DT for their non-metastatic tumours.
The team’s findings indicated that, somewhat unsurprisingly, prior DT treatment delayed the time it took for mCRPC to manifest (24 months compared to 13.8 in the control) and improved survival (117.5 months compared to 45.6). Interestingly, each further year between DT and the start of ADT conferred a 9% decrease in the risk of mCPRC and a 13% increase in survival rate. The study was adjusted for numerous variables such as race and volume-adjusted prostate specific antigen (PSA).
Dr Agarwal’s team commented: “If this hypothesis-generating data can be validated independently, time to DT to the start of ADT for new mHSPC may assist with risk stratification and systemic therapy selection in these men.” This is an important step in the right direction towards developing better pipelines for treating this difficult to manage cancer.