Daniel E. Spratt, MD, on Prostate Cancer: Short-Term Adjuvant vs Neoadjuvant Hormone Therapy
2020 ASTRO Annual Meeting
Daniel E. Spratt, MD, of the University of Michigan Rogel Cancer Center, discusses a pooled analysis of two phase III trials showing adjuvant androgen-deprivation therapy (ADT) improves biochemical control and reduces distant metastasis when compared with a neoadjuvant approach, with no difference in late gastrointestinal or genitourinary toxicities. The analysis also showed that delaying radiotherapy to deliver neoadjuvant ADT did not benefit most patients (Abstract 32).
Linda G.W. Kerkmeijer, MD, PhD, of the University Medical Center Utrecht and Radboud University Medical Center, discusses results from the phase III FLAME trial, which explored the question of whether biochemical disease–free survival can be improved by adding a focal boost to the intraprostatic lesion in whole-gland external-beam radiotherapy for patients with intermediate- and high-risk prostate cancers (Abstract 126).
Neha Vapiwala, MD, of the University of Pennsylvania, who served as a discussant for LBA1, summarizes her review of this study of patients with prostate cancer who had biochemical recurrence in the post-prostatectomy setting, who were candidates for salvage radiotherapy, and who received either conventional imaging or PET scans to help determine the course of treatment.
Cynthia Menard, MD, of the University of Montreal, discusses a study on the use of prostate-specific membrane antigen PET and CT to guide treatment. The scans led to high rates of new lesion detection and therefore intensification of radiotherapy for patients with prostate cancer, without an increase in side effects (Abstract 34).
Daniel E. Spratt, MD, of the University of Michigan Rogel Cancer Center, discusses phase III results of the HERO trial, which suggested benefits of the oral medication relugolix: a substantially faster time to castration with longer duration, fewer cardiac events, and a faster return to normal testosterone levels compared with leuroplide (Abstract 35).
Paul Sargos, MD, of the Institut Bergonié, discusses phase III findings from the GETUG-AFU 17 study, which compared adjuvant vs early salvage radiotherapy, both combined with short-term androgen-deprivation therapy after radical prostatectomy for localized prostate cancer. Although lacking statistical power, the study showed no benefit in event-free survival for adjuvant compared to salvage radiotherapy (Abstract 33).