A recent study co-led by investigators at the UCLA Health Jonsson Comprehensive Cancer Center suggests that many men with prostate cancer may not require long-term hormone therapy. The research indicates that the majority of the benefits from androgen deprivation therapy (ADT) occur within the first 9 to 12 months, while extending treatment beyond that period offers minimal additional protection and raises the risk of health complications.
The study, published in the journal JAMA Oncology, highlights the varying effectiveness of ADT according to cancer risk. ADT is often administered alongside radiation therapy to inhibit prostate cancer growth by reducing testosterone levels. Although it effectively manages the disease, long-term ADT can lead to side effects such as bone loss, muscle loss, and cardiovascular issues. Current guidelines recommend 4 to 6 months of ADT for patients at intermediate risk and 18 to 36 months for those at high risk, yet the optimal duration remained uncertain.
To address this, researchers conducted a comprehensive analysis through the Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium. This effort involved data from 10,266 men participating in 13 international clinical trials. The analysis focused on outcomes such as overall survival, cancer-specific survival, and mortality from other causes, comparing the effects of different ADT durations.
Implications for Personalized Treatment
The findings underscore the necessity for personalized treatment strategies in managing prostate cancer. Shorter courses of ADT might be adequate for many patients, thereby minimizing side effects while maintaining treatment effectiveness. Physicians can now consider factors such as cancer risk, overall health, age, and individual preferences to make more informed decisions regarding ADT duration. This tailored approach aims to enhance both safety and quality of life for patients.
Dr. Amar Kishan, professor and executive vice chair of radiation oncology at the UCLA Health Jonsson Comprehensive Cancer Center, emphasized the importance of individualized treatment protocols. “Prostate cancer treatment should not be one-size-fits-all,” he stated. “These findings help doctors personalize therapy, balancing cancer control with potential side effects and other health risks.”
The implications of this research extend beyond immediate treatment decisions. By refining the approach to ADT, healthcare providers can foster a better understanding of the relationship between treatment duration and patient outcomes. This shift toward personalized care may transform how prostate cancer is treated, ultimately leading to improved health and well-being for those affected.
For further details, refer to the work of Nicholas G. Zaorsky et al., titled “Optimal Duration of Androgen Deprivation Therapy With Definitive Radiotherapy for Localized Prostate Cancer,” published in JAMA Oncology on March 15, 2025. The study’s DOI is 10.1001/jamaoncol.2025.4800.
