Do you ever consider intermittent ADT for metastatic prostate cancer?
The Intergroup 0162 trial did not demonstrate noninferiority, although OS difference only 5.1 vs. 5.8 yrs. Would pattern of spread affect your decision (i.e. oligometastatic recurrence after primary therapy with plan for local therapy to the met)?
Answer from: Medical Oncologist at Academic Institution
In general, I recommend continuous ADT for men with metastatic disease based on the OS difference from the Intergroup 0162 trial. I do agree, however, that this trial was a noninferiority design and the difference is not large, therefore in men with very limited disease who display intolerance to AD...
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Answer from: Medical Oncologist at Academic Institution
Most men with mHSPC deserve a trial of continuous ADT plus further intensification of therapy with a potent AR inhibitor (abi, enza, darolutamide, apalutamide) or docetaxel, and treatment of the primary, all of which provide level 1 survival benefits in certain contexts depending on volume of diseas...