Meta-analysis of optimal duration of androgen deprivation therapy with definitive radiotherapy for localized prostate cancer

The optimal duration of androgen deprivation therapy (ADT) for treating localized prostate cancer is unknown. An individual patient data meta-analysis of 13 randomized phase 3 clinical trials evaluated outcomes with various durations of ADT (0 to 36 months) among 10,266 men with prostate cancer. The analysis demonstrated a nonlinear relative benefit of ADT duration, whereas the absolute benefit varied by risk group. Prolongation of ADT had a differential association with cancer-specific mortality versus other-cause mortality. The authors conclude that these results suggest that individualized ADT decisions are needed for patients based on prognostic risk, comorbidities, life expectancy, and patient preferences.