Sophia C. Kamran, MD
Sophia C. Kamran, MD, a radiation oncologist at Massachusetts General Hospital and Assistant Professor of Radiation Oncology at Harvard Medical School, who was not involved in the RTOG 0815 study, commented: “The results of RTOG 0815 demonstrate that in the setting of contemporary dose-escalated radiation for intermediate-risk prostate cancer, the addition of total androgen suppression does not improve overall survival, likely due to the short follow-up at this time [median of 6.2 years]. Yet there are significant benefits in other endpoints, including the rates of distant metastases, prostate-specific antigen failure, and prostate cancer–specific deaths in the arm that received total androgen suppression.”
Dr. Kamran noted that more than two-thirds of patients had only one intermediate risk factor. “It will be important to tease out how many patients had more favorable vs unfavorable features to fully understand the role of total androgen suppression in this risk group,” she added.
“The [patient-reported outcome] data from the trial demonstrate that the total androgen suppression group did have significant declines in hormonal and sexual scores that improved over time, with no clinically meaningful differences between the two arms by year 1 after the start of treatment. Of note, there were no differences in gastrointestinal/genitourinary scores between the two arms,” she continued.
“These data, along with the benefits in clinical outcomes, can help inform patients about their treatment options and support shared decision-making for those with intermediate-risk prostate cancer,” Dr. Kamran stated.
DISCLOSURE: Dr. Kamran’s spouse is employed by Sanofi Genzyme.
Both dose-escalated radiation therapy and short-course androgen-deprivation therapy have been shown to improve outcomes in intermediate-risk prostate cancer, but it is not clear whether giving both modalities upfront to newly diagnosed patients is of benefit. The phase III RTOG 0815 study presented ...