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Encore: Intermittent or Continuous ADT in Metastatic Prostate Cancer


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Jim Marshall (not a doctor) said ...

The findings in a large trial of intermittent (IAD) or continuous hormone therapy made such an impact at the recent American Society of Clinical Oncology annual meeting that a special session was called to discuss it.

At a press conference called to present the results to the public, Dr. Bruce J. Roth made some very clear points.

Some extracts of those reported in OncologySTAT by Elsevier are below.

Basically, continuous ADT remains the standard of care for metastatic men who respond to ADT (PSA going under 4 in this study). It is particularly important for men with light disease, whom the study showed losing almost 2 years on intermittent ADT.

The original topic can be found here:


... end Jim

"This study for the first time demonstrates that there is a price to pay, and in the patients most likely to receive intermittent therapy in this country and around the world, the minimal disease patients, it is almost 2 years' median survival. So I think that is an important fact," said Dr. Bruce J. Roth, moderator of a press briefing at the American Society of Clinical Oncology annual meeting, where the outcomes are being presented in a plenary session on Sunday, June 3.

The greatest impact was seen in men with minimal disease, who lived a median of 5.2 years if randomized to intermittent therapy vs. 7.1 years with continuous treatment, according to Dr. Maha Hussain, the lead author. Half of the men in the continuous arm, but only 42% on intermittent therapy, were alive at 7 years in the phase III intergroup study led by the Southwest Oncology Group (SWOG).


While the number of men trying IAD is not known, it is used in the United States, Dr. Roth said. He does not offer it to his patients - and will not offer it going forward - but often sees it in the charts of patients referred to him.

"A 2-year difference in median survival is huge," he said, predicting patients would not press for IAD once they discussed the research with their physicians.

"Are you going to trade off hot flashes for a 2-year decrease in median overall survival with IAD?" he proposed asking a patient. "I think the average patient will say, 'Those hot flashes are not so bad.'"

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