Prostate Cancer Treatment Shows Promise with 5-Alpha Reductase Inhibitors

Strategic Insights -

Fresh data from a trial evaluating the use of 5-alpha reductase inhibitors as an alternative to LHRH-agonists in treating prostate cancer has shown promising results. According to the research from the University of Chicago, men treated with 5-ARIs had better preservation of hormonal quality of life with no obvious detriment in biochemical outcomes with 5 years of follow-up. The trial included 70 men with unfavorable intermediate or high-risk prostate cancer, who were treated with radiation therapy and either oral ADT (5-ARI with antiandrogen) or standard of care ADT (leuprolide with antiandrogen) for up to 28 months.

Key Takeaways:

  • Research at the University of Chicago investigated the use of 5-alpha reductase inhibitors as an alternative to LHRH-agonists in treating prostate cancer.
  • The trial showed that men treated with 5-ARIs had better preservation of hormonal quality of life with no obvious detriment in biochemical outcomes with 5 years of follow-up.
  • The primary endpoint of the trial was the preservation of hormonal quality of life, and secondary endpoints included biochemical control and survival as well as changes in cholesterol and hemoglobin levels.
  • The trial found that testosterone levels were higher, and hemoglobin levels were also higher in the oADT groups, with cholesterol levels being lower in the oADT group.
  • The research concluded that eugonadal testosterone with this approach may yield measurable benefits in cholesterol and hemoglobin levels.
  • The study included 40 men in the oADT group and 30 men in the standard of care group, with a median follow-up of 65 months.

Statistics:

  • 70 men were enrolled in the trial, with 40 in the oADT group and 30 in the standard of care group.
  • The median follow-up was 65 months, with an interquartile range of 36-94 months.
  • 5-year freedom from biochemical failure was 89% in the oADT group and 86% in the standard of care group.
  • 5-year disease-free survival was 62% in the oADT group and 69% in the standard of care group.
  • Cancer-specific survival was 100% in the oADT group and 96% in the standard of care group.
  • Overall survival was 70% in the oADT group and 81% in the standard of care group.

Sources:

  • Clinical Genitourinary Cancer, "Hormonal Therapy and Radiation Therapy In Prostate Cancer: 5-year Outcomes From a Trial Evaluating Combined Androgen Blockade With 5-alpha Reductase Inhibitors As an Alternative To Gonadotropin Releasing Hormone Agonists," August 2024.
  • University of Chicago, Dept. of Radiation and Cellular Oncology, 5758 S Ave, Chicago, IL 60637, United States.
  • Stanley L. Liauw, University of Chicago, Dept. of Radiation and Cellular Oncology, 5758 S Ave, Chicago, IL 60637, United States.