PROSTATE CANCER

Maha Hussain, M.D., F.A.C.P., was lead investigator of the 500-site SWOG study.

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Many men with meta-static, hormone-sensitive prostate cancer live longer on continuous androgen-deprivation therapy than on intermittent therapy, according to a 17-year study led by SWOG.

Earlier data had suggested that intermittent treatment in men with newly diagnosed metastatic prostate cancer may delay a cancer relapse, and that the rise in testosterone may result in an improvement in the patient's quality of life.

However, results of the Phase III clinical trial, the largest such study to date, found that intermittent androgen-deprivation (IAD) therapy is not as good as continuous hormone therapy with regard to patient longevity.

The study's principal investigator was Maha Hussain, M.D., F.A.C.P., associate director of clinical research at the University of Michigan Comprehensive Cancer Center. The study was conducted at more than 500 sites, enrolling 3,040 men with hormone-sensitive, metastatic prostate cancer between 1995 and 2008.

All men got an initial course of androgen-deprivation treatment for seven months. The 1,535 eligible men whose prostate-specific antigen (PSA) level dropped to 4 ng/mL or less by the end of those seven months were then assigned at random to the intermittent therapy group or the continuous therapy group.

Men on continuous therapy had a median overall survival time of 5.8 years from the time of randomization, with 29 percent of these men surviving at least 10 years. Those on intermittent therapy had a median overall survival time of 5.1 years, with 23 percent surviving at least 10 years.

"Though we see potential quality-of-life benefits with IAD," Hussain says, "from a medical perspective, the primary findings of the study demonstrating that IAD is inferior with regard to overall survival should be the primary consideration in counseling all patients who are interested in intermittent therapy and particularly those with minimal disease."

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