Study: Antiandrogen Therapy Increases Overall Survival in Men with Recurring Prostate Cancer

According to a new study, hormone therapy combined with salvage radiation therapy reduces the mortality risk of men with recurring prostate cancer.

Researchers performed a double-blind, placebo-controlled trial that included 760 patients who had undergone a prostatectomy with a lymphadenectomy, and had tumor stage T2 or T3 from 1998 through 2003. Patients were randomly assigned to receive a daily placebo tablet, or a daily 150 mg dose of bicalutamide for 24 months during or after radiation therapy. The median follow-up with surviving patients was 13 years.
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At 12 years, the actuarial rate of overall survival was 76.3% in the bicalutamide group and 71.3% in the placebo group. The incidence of death from prostate cancer at year 12 was 5.8% in the bicalutamide group and 13.4% in the placebo group. The cumulative incidence of metastatic prostate cancer was 14.5% in the bicalutamide group and 23% in the placebo group at year 12.

In the bicalutamide group, 69.7% of patients had gynecomastia, compared with only 10.9% of patients in the placebo group.

The 2 groups had similar incidences of late adverse events associated with radiation therapy.

Overall, the trial suggests that the addition of antiandrogen therapy to salvage radiation therapy increases the rates of long-term survival, and reduces the incidences of metastatic prostate cancer.

—Melissa Weiss

Reference:

Shipley WU, Seiferheld W, Lukka HR, et al. Radiation with or without antiandrogen therapy in recurrent prostate cancer [published online February 2, 2017]. New England Journal of Medicine. doi:10.1056/NEJMoa1607529.