New research on length of ADT therapy for patients with RT

@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.

@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).

@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

@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.

@pesquallie

Respectfully offered, I can't agree with the "typically ignored" part of your comment.

Most of the studies I'm aware of list "cancer specific survival" as well as "overall survival" as end points. That "overall survival" most certainly takes into account any deaths caused/exacerbated by ADT side effects.

I have been in actual clinical trials and aware of progression free survivability, overall survivor ability, and Disease free. I think many are worried about the PFS, as they expect their cancer to return and worry how long until it does. I think pesquallie is right ADT side effects contribute in many ways to not only a reduced quality of life for many but sincere depression for many experiencing that do incur those side effects. How this effects their overall health is NOT addressed in the studies. People on this site have described being on ADT as hell, certainly not everyone and as Jeff will attest and others that sailed through.