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Transient Benefit in Outcomes Seen With Androgen Suppression + RT for Prostate Cancer

Transient clinically meaningful decline noted in EPIC hormonal and sexual domains with total androgen suppression added to radiation

By Elana Gotkine HealthDay Reporter

WEDNESDAY, May 24, 2023 (HealthDay News) — For patients with intermediate-risk prostate cancer, adding total androgen suppression (TAS) to dose-escalated radiation therapy (RT) yields transient clinically meaningful declines in Expanded Prostate Cancer Index Composite (EPIC-50) hormonal and sexual domains, according to a study published online April 27 in the Journal of Clinical Oncology.

Benjamin Movsas, M.D., from the Henry Ford Cancer Institute in Detroit, and colleagues evaluated patient-reported outcomes (PROs) of a phase 3 trial assessing TAS combined with dose-escalated RT for patients with intermediate-risk prostate cancer compared with RT alone, at six, 12, and 60 months. The validated EPIC-50 was the primary PRO, and the Patient-Reported Outcome Measurement Information System (PROMIS)-fatigue and EuroQOL five-dimensions scale questionnaire (EQ-5D) were included as secondary PROs.

The researchers observed clinically meaningful deficits in the RT + TAS arm for the EPIC hormonal and sexual domains. However, by one year, there were no clinically meaningful differences between the two arms. For PROMIS-fatigue, EQ-5D, and EPIC bowel/urinary scores, there were no clinically meaningful differences seen at any time points between the arms.

“While there is an initial decline in the hormone and sexual quality of life for men that received short term hormones in addition to radiation, it is reassuring that this impact was temporary and that quality-of-life outcomes were not clinically meaningfully different between arms by one year,” Movsas said in a statement. “Patient-reported outcomes such as these are incredibly valuable to help individuals make informed decisions when determining their treatment options.”

Several authors disclosed ties to the pharmaceutical and medical device industries.

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