Prostate cancer is the leading cause of cancer in men worldwide, and radiotherapy is one of the common forms of treatment. In a first-of-its kind meta-analysis, published today in The Lancet Oncology, researchers from University Hospitals (UH) and Case Western Reserve University show that there is consistent improvement in overall survival in men with intermediate- and high-risk prostate cancer with the addition of hormone therapy to radiotherapy treatments.
Throughout the past 40 years, randomized trials have been conducted on the impact of adding hormone therapy to prostate cancer treatments. While these trials individually show the benefit of hormone therapy, there are inconsistencies in timing and duration of treatment recommendations.
"Our research team set out to conduct a first-of-its-kind, comprehensive analysis by collecting individual patient data from each and every randomized trial conducted around the world, and performed a meta-analysis of the impact of various treatment intensification strategies using hormone therapy with radiation therapy for localized prostate cancer," said senior author Daniel E. Spratt, MD, Vincent K. Smith Chair in Radiation Oncology at UH Seidman Cancer Center, Professor in the Department of Radiation Oncology at Case Western Reserve School of Medicine, and Member of the Developmental Therapeutics Program at Case Comprehensive Cancer Center. "Our goal is to better personalize therapy for prostate cancer patients, by providing the most precise and accurate estimates of the benefit of hormone therapy."
In this analysis, the team made three key discoveries:
1) Men with intermediate- and high-risk prostate cancer have an increased survival rate from the addition of hormone therapy to radiotherapy. [...]
2) Survival rate in men with prostate cancer improves with the prolongation of adjuvant hormone therapy to radiotherapy. [...]
3) The prolongation of neoadjuvant hormone therapy before radiotherapy did not benefit men in any outcome measured. [...]
"We now have estimates that show the benefit of adding and prolonging adjuvant hormone therapy for clinically relevant subsets of patients," explained Dr. Spratt. "Our team showed that treating a group of approximately ten to 15 men with hormone therapy or extended adjuvant hormone therapy, for at least 18 months, prevented one man from developing metastatic disease ten years after treatment. This is dependent on patient and tumor specific factors, but gives us a more precise estimate to work with when it comes to recommending treatment options."
Amar U Kishan, MD, Yilun Sun, PhD, Holly Hartman, PhD, et al Hormone Therapy Treatments May Increase Survival Rate in Prostate Cancer Patients, , (DOI: 10.1016/S1470-2045(21)00705-1)