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Effectiveness of ADT therapy affected by presence of metastases

This is hardly a surprising piece of information, but it does at least confirm the expectable … A study published a couple of weeks ago in Cancer has shown that “factors predicting the efficacy of androgen deprivation therapy (ADT) in men with hormone-sensitive prostate cancer (HSPC) depend on whether or not metastases are present at the start of treatment.” Apparently the presence of metastasis results in a major reduction in the time to disease progression (TTP).

The study reports on “553 prostate cancer patients treated with ADT for presumed nonlocalized cancer, examining the effects on PSA of time to progression.” However, about half of the patients were shown to have “metastases at the initiation of ADT. … For patients without metastases, the median TTP was 33.2 months, compared with 15.9 months in patients with metastases.”

A careful analysis showed that “the efficacy of ADT was associated with lower biopsy Gleason scores, the absence of metastases, and lower serum PSA at ADT initiation.” Furthermore, “the link between Gleason score and shortened TTP was seen only in patients with metastases.” By contrast, “the association between baseline PSA and reduced TTP was seen only in those without metastases,” and, “the use of ADT as part of local treatment was associated with reduced TTP” in all study participants.

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