Prostate cancer: short-term androgen deprivation+salvage radiotherapy delays metastasis, progression

  • Carrie C & et al.
  • Lancet Oncol
  • 16 Oct 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Combining 6-month goserelin (androgen deprivation treatment; ADT) with salvage radiotherapy significantly improves 120-month PFS and metastasis-free survival (MFS) in patients with prostate cancer with biochemical relapse after radical prostatectomy vs salvage radiotherapy alone.

Why this matters

  • Study supports the use of ADT with standard radiotherapy in these patients.

Study design

  • 112-month follow-up analysis of phase 3 GETUG-AFU 16 study of 743 patients with prostate cancer with initial undetectable PSA increasing to 0.2-2 ng/mL after radical prostatectomy.
  • Patients were randomly assigned to radiotherapy±goserelin.
  • Funding: The French Health ministry; AstraZeneca; others.

Key results

  • At data cutoff, median follow-up was 112 months.
  • Radiotherapy+goserelin vs radiotherapy alone significantly improved:
    • 120-month PFS (64% vs 49%; HR, 0.54; P<.0001>
    • 120-month MFS (75% vs 69%; HR, 0.73; P=.0339).
  • No difference was observed in 120-month OS (HR, 0.93; P=.73).
  • 2 reported cases of secondary cancer since the primary analysis were not treatment related.
  • 1 grade 3 treatment-related serious adverse event was reported.
  • Late grade 3-4 adverse events of urinary incontinence: 4% with radiotherapy+goserelin and 5% for radiotherapy alone.
  • No treatment-related death was reported.

Limitations

  • Open-label design.