Posting ADT Piece: New Info on Intermittent therapy

We have known since the mid-1990’s that androgen suppressive therapy could be used in an interrupted fashion, but we didn’t know until now that men were not sacrificing length of life in the hopes of having a better quality of life,” says Juanita M. Crook, MD, principal investigator and radiation oncologist with the British Columbia Cancer Agency. “The results of this trial will change the standard of care.”
The Canadian study, supported by a team of cross-border North American scientists, administered intermittent androgen deprivation in patients for eight months then stopped and restarted only when their PSA levels reached >3 ng/ml when off the treatment, compared to men treated with continuous androgen deprivation (CAD). The data showed that intermittent antiandrogen treatment was equivalent to continuous antiandrogen treatment with similar overall survival and quality-of-life measures. Biostatiscally, intermittent therapy was called “a non-inferior” (in laymen’s terms, “comparable”) arm of the trial—disease specific death was 18% in the intermittent arm compared with 15% in the continuous arm.
Dr. Crook believes the IAD method will be widely accepted. “There is no detriment to survival, some men see quality-of-life benefit, and it also happens to be cheaper,” says Crook.
Summary
Intermittent androgen deprivation provides similar outcomes to continuous therapy with the potential for fewer side effects and less disruption to quality of life—good news for many men and their families. IAD patients complained of fewer hot flashes and 35% of them had full recovery of serum testosterone after completing IAD. Cardiac events and osteoporotic fracture events were equal in both arms. Further, intermittent androgen deprivation offers cost-savings to health systems as both patients and the systems pay only 27% of the cost of continuous treatment.