600: Intermittent Androgen Deprivation in Patients with PSA-Relapse after Radical Prostatectomy - Final Results of a European Randomized Prospective Phase-III Clinical Trial Auo Study AP 06/95, EC 507

Tunn, U.; Canepa, G; Hillger, H.; Fuchs, Winfried

doi:10.1016/s0022-5347(18)30840-1

Cited by 22 publications

(9 citation statements)

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“…The fact that prostate cancer deaths trended higher in the intermittent than in the continuous arm (balanced precisely by an increased number of non-prostate cancer deaths in the continuous arm) reinforces the suggestion that the difference in time to castration resistance was probably an artefact. Time to castration resistance was nonsignificantly different between the groups in several other phase iii trials 14,17 .…”

Section: Phase III Trialsmentioning

confidence: 81%

Androgen Deprivation Therapy in Advanced Prostate Cancer: Is Intermittent Therapy the New Standard of Care?

Klotz

Toren

2012

Current Oncology

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Purpose: Intermittent androgen deprivation is increasingly used as an alternative to continuous life-long androgen deprivation therapy for men with advanced or recurrent prostate cancer. Recent Findings: Two recent phase III trials have clarified the benefits of intermittent therapy. The Canadian-led pr.7 trial in men with nonmetastatic disease and prostate-specific antigen recurrence after definitive local therapy showed that intermittent therapy resulted in survival equivalent to that with continuous therapy, with significant improvements in quality of life. Patients on intermittent therapy experienced improved bone health, fewer metabolic and hematologic disturbances, fewer hot flashes, and improved sexual function. In men with metastatic disease, the data are less clear. The long-awaited results of the Southwest Oncology Group 9346 trial, comparing intermittent with continuous therapy in metastatic disease, showed no difference in overall survival. Post hoc stratification analysis showed a worse outcome in patients with “minimal” metastatic disease, and no difference in those with widespread bone metastases. The significance of that observation is in dispute. The present review also addresses practical issues in the use of intermittent therapy, including patient selection, follow-up, and therapy cycling. Summary: The recent results of randomized clinical trials now establish that intermittent androgen deprivation therapy is an approach that should be considered the standard of care in most patients with nonmetastatic prostate cancer requiring hormonal therapy and in selected patients with metastatic disease. Key Points: (1) Level I evidence supports the oncologic equivalence of intermittent compared with continuous androgen blockade in men with biochemical failure. (2) Compared with continuous androgen deprivation, intermittent therapy demonstrates improved quality of life and fewer side effects. (3) Patient selection for intermittent therapy is important to maintain good oncologic results. (4) Monitoring of prostate-specific androgen response and duration of off-treatment intervals allow for stratification of patients by risk of progression.

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Section: Phase III Trialsmentioning

confidence: 81%

Androgen Deprivation Therapy in Advanced Prostate Cancer: Is Intermittent Therapy the New Standard of Care?

Klotz

Toren

2012

Current Oncology

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“…We excluded trials that did not assess mortality outcomes 18,19 or provide count data on outcomes of interest after attempted contacts. 20,21 We included 4664 men with advanced PCa from 8 trials in this meta-analysis. Table 1 summarizes the study characteristics of these trials.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Intermittent Androgen Deprivation Therapy vs Conventional Continuous Androgen Deprivation Therapy for Advanced Prostate Cancer: A Meta-analysis

Tsai

Penson

Makambi

et al. 2013

Urology

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OBJECTIVE To compare the efficacy of intermittent androgen deprivation therapy (IADT) vs continuous androgen deprivation therapy (CADT) for the treatment of advanced prostate cancer; we performed a meta-analysis of randomized controlled trials (RCTs), assessing the risks of disease progression, all-cause, and disease-specific mortality. MATERIALS AND METHODS We conducted a systematic search of several bibliographic systems to identify all RCTs of IADT in men with newly diagnosed metastatic or biochemical only prostate cancer. We abstracted outcome data, study characteristics, and participant demographics. We performed heterogeneity tests and calculated the summarized risk differences (RD) and risk ratios at 95% confidence intervals (CI), using inverse variance methods in random-effects approaches. RESULTS We identified 8 RCTs (N = 4664) comparing mortality between IADT and CADT. For all men combined, we observed small but nonsignificant differences in all-cause mortality (RD = 0.02, 95% CI = −0.02, 0.06), disease-specific mortality (RD = 0.04, 95% CI = −0.01, 0.08), and disease progression (RD = −0.03, 95% CI = −0.09, 0.04). Among the prespecified subgroup with histologically confirmed, newly diagnosed metastatic disease, we found no difference in overall survival (RD = 0.00, 95% CI = −0.09, 0.09). CONCLUSION We found no difference in overall survival, but a small increased risk in disease-specific survival for men treated with IADT relative to CADT was observed. IADT could be considered as an alternative to CADT because of better quality of life outcome. Patients should be informed of the possible risks and benefits of both therapies. More research confirming the benefits of IADT vs CADT is needed to inform treatment decisions.

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“…Several randomized comparative clinical trials have been conducted to compare the efficacy between intermittent and continuous androgen suppression (Table 3). [27][28][29][30][31][32][33][34] At the present time, while only a few trials have obtained the final results, 27 no report has demonstrated a significantly worse time to progression and survival with intermittent androgen suppression than with continuous androgen suppression. On the other hand , most trials have indicated that the benefits of intermittent therapy were fewer adverse effects and increased quality of life.…”

Section: Randomized Clinical Trials Comparing Intermittent Vs Continumentioning

confidence: 99%

Hormonal therapy for prostate cancer: Current topics and future perspectives

et al. 2010

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600: Intermittent Androgen Deprivation in Patients with PSA-Relapse after Radical Prostatectomy - Final Results of a European Randomized Prospective Phase-III Clinical Trial Auo Study AP 06/95, EC 507

Cited by 22 publications

References 0 publications

Androgen Deprivation Therapy in Advanced Prostate Cancer: Is Intermittent Therapy the New Standard of Care?

Androgen Deprivation Therapy in Advanced Prostate Cancer: Is Intermittent Therapy the New Standard of Care?

Efficacy of Intermittent Androgen Deprivation Therapy vs Conventional Continuous Androgen Deprivation Therapy for Advanced Prostate Cancer: A Meta-analysis

Hormonal therapy for prostate cancer: Current topics and future perspectives

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