Prostate cancer study casts doubts over intermittent dosing approach
Intermittent androgen deprivation in prostate cancer may not be as effective as continuous therapy, according to the authors of an international trial published in the New England Journal of Medicine (2013;368:1314). This contrasts with a trial published last year suggesting similar efficacy for the two treatment approaches (PJ 2012,289:284).
In the latest study, intermittent and continuous androgen deprivation therapies were compared in men with metastatic, hormone-sensitive prostate cancer (n=1,535) to determine whether intermittent therapy is non-inferior in terms of survival. Treatment in the intermittent therapy group was based on prostate specific antigen levels.
Median survival was 5.8 years with continuous therapy and 5.1 years with intermittent therapy (hazard ratio for death with intermittent therapy 1.10; 90% confidence interval 0.99 to 1.23). The results are statistically inconclusive, but suggest that intermittent therapy may compromise survival, the authors say. Intermittent therapy was associated with better erectile function and mental health at three months than continuous therapy, but this difference between the groups was not sustained.
Discussing why the results differ from those reported last year, the authors note that the previous trial was in patients with non-metastatic disease. They also suggest the follow-up period might have been too short in the previous study.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11119707
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