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New research on length of ADT therapy for patients with RT

Posted by ededed @ededed, Dec 11, 2025

Interesting article !!! What I got out of it is that if you take ADT longer than 12 months you may be less likely to die from prostate cancer and more likely to die from other causes. Oh joy !

Here's the article
Original Investigation:
Optimal Duration of Androgen Deprivation Therapy With Definitive Radiotherapy for Localized Prostate Cancer
A Meta-Analysis
https://jamanetwork.com/journals/jamaoncology/article-abstract/2841671

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ededed | @ededed | 1 day ago
In reply to @northoftheborder "@ededed (Late reply) Yes, monitoring closely. Right now, whatever the article speculates, we don't have phase..." + (show)
Profile picture for northoftheborder @northoftheborder

@ededed (Late reply) Yes, monitoring closely. Right now, whatever the article speculates, we don't have phase 3 trials showing that it's safe to go off ADT with stage 4, but they're underway. In my case, the LIBERTAS trial covers *exactly* my situation: stage-4 castrate-sensitive prostate cancer being treated with ADT and Erleada (Apalutamide). We should have preliminary results this fall. Small-scale retrospective studies and "may be optimal" are intriguing, but I need a little more than that before making a potentially life-threatening decision. I very much hope that the article you shared ends up being validated in full trials.

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@northoftheborder For me it was a quality of life decision. Walking up a flight of stairs was difficult and painful from my ADT. Yes, our decisions on this pc road can have devastating results or lead us to a better tomorrow. I recognize that each decision whether it is ours or our trusted physicians has potential costs and hopefully benefits.

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datasource | @datasource | 17 hours ago
In reply to @jim18 "@copyman I always look at the inverse for these. If your treatment has an 80% chance..." + (show)
Profile picture for jim18 @jim18

@copyman I always look at the inverse for these. If your treatment has an 80% chance of 10 years no recurrence going to 88% is an additional 10%. However, looked at from chance of a recurrence the 20% went down to 12% for a 40% decrease. This can be applied to recurrence, metastases, death or any other success statistic available. Sometimes even these numbers get very small especially with extended (> 1 year) ADT for localized prostate cancer when the total effect on the body is considered (all causes mortality).

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@jim18

"Absolute" risk: 80% recurrence free becomes 88%, an 8% absolute benefit.

"Relative" risk: 20% relapse becomes 12% relapse. 20 - 12 = 8. 8/20 = 40% less relapse.

A guy's gotta know which risk is being discussed.

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pesquallie | @pesquallie | 7 hours ago
In reply to @heavyphil "@copyman Yes - 8% is a whole lot…many poo-poo a single digit advantage but if you..." + (show)
Profile picture for heavyphil @heavyphil

@copyman Yes - 8% is a whole lot…many poo-poo a single digit advantage but if you were investing your $$, would you go for the 10% return or the 18% return?
True, the higher return comes with some risk (SE’s), but they are usually not permanent and there are tried and true ways to overcome them.
I think your RT and ADT regimen will totally do the job…Best,
Phil

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@heavyphil

Mortality risk also goes up with ADT use. One also needs to be careful about how statistical studies are done. ADT studies typically ignore the non-cancer risks which biases the overall results.

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johnwf | @johnwf | 6 hours ago

Thanks, that means the hot flashes and burning when peeing is worth it after all.
Seriously, that is good news.

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