Meta-analysis of ADT use and duration with definitive RT for localized prostate cancer

Randomized trials have investigated various androgen deprivation therapy (ADT) intensification strategies in men receiving definitive radiotherapy (RT) for prostate cancer. An individual patient data meta-analysis of twelve randomized studies (10,853 patients; median follow-up 11.4 years) found that among men receiving RT for localized prostate cancer, addition of ADT significantly improved metastasis-free survival (HR 0.83; p<0.0001), as did prolongation of adjuvant ADT from 4-6 months to 18-36 months (HR 0,84; p<0.0001). Extension of neoadjuvant ADT from 3-4 months to 6-9 months was not associated with longer MFS (HR 0.95; p=0.50). Treatment effects were similar irrespective of RT dose, patient age, or NCCN risk group.