In high or very high risk prostate cancer, do you utilize combined androgen blockade in patients receiving definitive RT?

Since I had initially posted this, the STAMPEDE investigators have released a new publication reporting the utility of intensified androgen axis blockade (abiraterone ± enzalutamide) in high-risk non-metastatic patients which included high-risk N0 (≈ 60%) and N1 patients (≈ 40%). For this combined p...

While improvements in FFS are superior in this M0 N0 (by conventional imaging) very high risk PC population treated with ADT/Abi and RT to the primary as compared to ADT alone, the impact on OS is still not known and we await randomized trials dedicated to this high risk RT-treated population, such ...

Prior studies utilizing combined androgen blockade in the adjuvant or neoadjuvant surgical setting have similarly failed to demonstrate an overall survival advantage (McKay et al., PMID 30811282). At this time, there is no definitive evidence of survival benefit with this approach. However, there is...

Yes, I do use combined ADT, typically 12 mo in an attempt to take advantage of other endpoints of prostate treatment failure and success e.g., BFS, PFS, DFS, especially LC, etc. I would caution putting too much weight into OS with prostate cancer as long-term ADT following relapse, continuous or int...

Absolutely. Dual androgen blockade requires some clarification. What agent are we talking about? Historically, we would have been referring to bicalutamide which I use in all my patients I think to warrant it, even in some unfavorable intermediate-risk cases.

However, the reason is not that eloquent...

I don't use casodex 50mg with LHRH agonist or antagonist. I have been using LHRH ag/antag with Abi per STAMPEDE platform in HRN0 any/N1. I have also occ used Abi alone without LHRH in patients intolerant of dual. Test still castrate and tolerance improved.