A recent study co-led by investigators at the UCLA Health Jonsson Comprehensive Cancer Center indicates that many men with prostate cancer might not require long-term hormone therapy. The research suggests that most benefits from androgen deprivation therapy (ADT) occur within the first 9 to 12 months, and extending treatment beyond this period provides only marginal additional benefits. Furthermore, the extended therapy can increase the risk of other significant health issues, including cardiovascular and metabolic complications.
Published in the journal JAMA Oncology, the study highlights how the ideal duration of ADT should be tailored to individual cancer risk. ADT is a hormone therapy often administered alongside radiation to inhibit the growth of prostate cancer by lowering testosterone levels. While effective in managing the disease, long-term ADT is associated with a range of side effects, such as bone loss, muscle deterioration, and cardiovascular problems.
Current treatment guidelines recommend 4 to 6 months of ADT for patients classified as intermediate risk, and 18 to 36 months for those at high risk. However, the optimal duration of therapy has remained unclear until now. Researchers conducted a meta-analysis through the Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium, utilizing data from 10,266 men across 13 international clinical trials. They assessed various outcomes, including overall survival, cancer-specific survival, and mortality from other causes.
The implications of these findings could be significant for personalized prostate cancer care. Shortening the duration of hormone therapy may prove sufficient for many patients, allowing them to avoid adverse side effects while still maintaining treatment effectiveness. Physicians can now consider patient-specific factors such as cancer risk, overall health, age, and individual preferences when determining the appropriate duration of ADT.
Dr. Amar Kishan, a professor and executive vice chair of radiation oncology at the UCLA Health Jonsson Comprehensive Cancer Center, emphasized the importance of personalized treatment. He stated, “Prostate cancer treatment should not be one-size-fits-all. These findings help doctors personalize therapy, balancing cancer control with potential side effects and other health risks.”
This study paves the way for more tailored approaches to managing prostate cancer, potentially improving both the safety and quality of life for patients. As healthcare evolves, the focus on individualized treatment plans is becoming increasingly vital in achieving optimal patient outcomes.
For further details, see Nicholas G. Zaorsky et al, “Optimal Duration of Androgen Deprivation Therapy With Definitive Radiotherapy for Localized Prostate Cancer,” JAMA Oncology, March 2025, DOI: 10.1001/jamaoncol.2025.4800.
