Mednet Logo
CommunityMedical Oncology

What duration of ADT do you recommend for a patient with locally treated prostate cancer who undergoes metastasis-directed radiation therapy to a single oligometastatic bone lesion?

Would you add abiraterone or enzalutamide?
5 Answers
Mednet Member
Mednet MemberInvited Expert
Medical Oncology · Duke University School of Medicine
Answered on

While I agree with @Dr. First Last that very small studies like STOMP and ORIOLE suggest that a small subset of men can delay the need for ADT by 1-3 years, this is not level 1 evidence. Most men with oligometastatic HSPC will still progress with metastasis directed therapy alone over a short time h...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Medical Oncology · Cedars-Sinai Medical Center
Answered on

Treating oligometastatic prostate cancer has become a point of great controversy in the field as this definition has relied on relatively soft definitions. Even in the case of a single bone metastasis detected by conventional CT or bone scan, PET imaging may identify more disease. Moreover, the imag...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · UC San Diego
Answered on

I believe this is referring to a single metastasis identified at time of initial staging. For these patients, my default is to recommend long-term ADT. That is particularly true for patients whose metastasis was detected only with next-gen imaging, since these would have qualified for the RT+ADT tri...

Join for free or sign in to see the full answer

Mednet Member
Mednet Member
Radiation Oncology · Dattoli Cancer Center
Answered on

18 months.

Join for free or sign in to see the full answer

Mednet Member
Mednet Member
Radiation Oncology · UW Carbone Cancer Center
Answered on

I tend to use 4- 6 months, though have used a year occasionally for larger lesions, strictly as a radiosensitizer, since we still don't achieve local control with SBRT in 100%, and is likely ADT's primary benefit here.

Current data suggests quicker and fuller recovery of testosterone levels with sh...

Join for free or sign in to see the full answer