“Our objective is to much better personalize treatment for prostate cancer clients, by offering the most accurate and precise quotes of the benefit of hormonal agent treatment.” ~ Senior Author, Daniel E. Spratt, MD. Credit: University Hospitals
First-of-its-kind meta-analysis released in The Lancet Oncology.
Prostate cancer is the leading reason for cancer in men worldwide, and radiotherapy is among the common kinds of treatment. In a first-of-its kind meta-analysis, released today in The Lancet Oncology, scientists from University Hospitals (UH) and Case Western Reserve University reveal that there is consistent enhancement in overall survival in males with intermediate- and high-risk prostate cancer with the addition of hormonal agent therapy to radiotherapy treatments.
Throughout the past 40 years, randomized trials have actually been conducted on the impact of including hormone therapy to prostate cancer treatments. While these trials individually show the benefit of hormonal agent therapy, there are inconsistencies in timing and duration of treatment suggestions.
” Our research group set out to conduct a first-of-its-kind, thorough analysis by collecting individual patient data from each and every randomized trial carried out worldwide, and performed a meta-analysis of the effect of numerous treatment surge strategies using hormonal agent therapy with radiation treatment for localized prostate cancer,” said senior author Daniel E. Spratt, MD, Vincent K. Smith Chair in Radiation Oncology at UH Seidman Cancer Center, Professor in the Department of Radiation Oncology at Case Western Reserve School of Medicine, and Member of the Developmental Therapeutics Program at Case Comprehensive Cancer Center. “Our objective is to better individualize therapy for prostate cancer patients, by offering the most accurate and exact estimates of the benefit of hormonal agent treatment.”
Jorge A. Garcia, MD. Credit: University Hospitals
Yilun Sun, PhD. Credit: University Hospitals
Nicholas G. Zaorsky, MD. Credit: University Hospitals
The Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium, is the first, thorough, global cooperation of randomized phase III scientific trial private patient data. The capability to examine data from every medical trial group in the world, investigating the impact of hormone treatment with radiotherapy, demonstrates tremendous progress in the prostate oncology field.
” This work from the MARCAP consortium will bring self-confidence in advising numerous treatment accumulation techniques, and permit service providers to have more precise, shared-decision making discussions with clients about the advantages of using hormone treatment with radiotherapy for prostate cancer treatment,” emphasized Dr. Spratt.
In this MARCAP analysis, 12 randomized trials were included. The research study group now has more than 20 trials, which number is continuing to grow, from groups from worldwide that have actually concurred to share information. In the next actions for this research, this repository will be utilized to examine additional scientifically relevant questions relating to optimum dosing of radiotherapy, fractionation, use of pelvic nodal radiotherapy, and extending studies into the sophisticated and reoccurring illness states.
Referral: “Androgen deprivation treatment use and duration with definitive radiotherapy for localized prostate cancer: an individual client information meta-analysis” by Amar U Kishan, MD; Yilun Sun, PhD; Holly Hartman, PhD; Prof Thomas M Pisansky, MD; Prof Michel Bolla, MD; Anouk Neven, MSc; Allison Steigler, BMath; Prof James W Denham, FRANZCR; Prof Felix Y Feng, MD; Almudena Zapatero, MD PhD; Prof John G Armstrong, MD; Abdenour Nabid, MD; Nathalie Carrier, MSc; Prof Luis Souhami, MD; Mary T Dunne, MSc; Prof Jason A Efstathiou, MD; Prof Howard M Sandler, MD; Araceli Guerrero, MD; Prof David Joseph, MD; Prof Philippe Maingon, MD; Theo M de Reijke, PhD; Xavier Maldonado, MD; Ting Martin Ma, PhD; Tahmineh Romero, MS; Xiaoyan Wang, PhD; Matthew B Rettig, MD; Prof Robert E Reiter, MD; Nicholas G Zaorsky, MD; Prof Michael L Steinberg, MD; Nicholas G Nickols, PhD; Angela Y Jia, MD and Prof Jorge A Garcia, MD, 17 January 2022, The Lancet Oncology.DOI: 10.1016/ S1470-2045( 21 )00705-1.
The Prostate Cancer Program at UH Seidman Cancer Center is one of the leading clinical and research study programs nationally, and works as among the 2 worldwide information repositories for the MARCAP consortium.
A special thanks to Dr. Jorge Garcia, Chief of Medical Oncology, UH Seidman Cancer Center; Dr. Nicholas Zaorsky, Vice Chair of Medical Education, UH Seidman Cancer Center Department of Radiation Oncology; Dr. Jonathan Shoag, UH Seidman Cancer Center, Department of Urology; Dr. Holly Hartman, Assistant Professor at Case Western Reserve University; and Dr. Yilun Sun, Director of Biostatistics at UH Seidman Cancer Center Department of Radiation Oncology, and Assistant Professor at Case Western Reserve University.
In this analysis, the group made three essential discoveries:
1) Men with intermediate- and high-risk prostate cancer have an increased survival rate from the addition of hormonal agent treatment to radiotherapy. This was seen in both more youthful and older men, and in males treated with lower and greater dosages of radiotherapy.
2) Survival rate in males with prostate cancer improves with the prolongation of adjuvant hormone therapy to radiotherapy. This advantage was seen in both more youthful and older guys, in guys treated with lower and greater dosages of radiotherapy, and in guys with both intermediate- and high-risk prostate cancer. Prior to this analysis, no trial was large enough to show a clear advantage in intermediate threat disease from extending the period of adjuvant hormone treatment.
3) The prolongation of neoadjuvant hormonal agent treatment before radiotherapy did not benefit guys in any result determined. This is a crucial finding, since some nations consistently provide prolonged periods of hormonal agent treatment before radiotherapy. The team showed that this approach isnt beneficial over shorter durations.
” We now have quotes that show the advantage of including and lengthening adjuvant hormonal agent therapy for scientifically relevant subsets of clients,” explained Dr. Spratt. “Our team showed that dealing with a group of approximately ten to 15 men with hormone treatment or extended adjuvant hormonal agent treatment, for at least 18 months, prevented one guy from developing metastatic disease 10 years after treatment. This is dependent on patient and growth particular factors, but provides us a more accurate price quote to work with when it comes to recommending treatment choices.”
2) Survival rate in men with prostate cancer improves with the prolongation of adjuvant hormone treatment to radiotherapy. Prior to this analysis, no trial was big enough to reveal a clear advantage in intermediate risk illness from extending the period of adjuvant hormone treatment.
3) The prolongation of neoadjuvant hormonal agent therapy before radiotherapy did not benefit men in any outcome determined.” We now have quotes that show the benefit of adding and prolonging adjuvant hormonal agent therapy for medically relevant subsets of clients,” explained Dr. Spratt. “Our group revealed that dealing with a group of approximately 10 to 15 guys with hormone therapy or extended adjuvant hormonal agent treatment, for at least 18 months, prevented one guy from developing metastatic illness 10 years after treatment.
