Clinical Edge

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Adjuvant ADT appears to be superior to a neoadjuvant approach

Key clinical point: In patients with localized prostate cancer undergoing radiotherapy, adjuvant androgen deprivation therapy (ADT) improves oncologic outcomes without increasing late toxicities compared with neoadjuvant ADT.

Major finding: At 15 years, adjuvant vs neoadjuvant ADT significantly improved biochemical failure: (33% vs 43%; P = .002), distant metastasis (12% vs 18%; P = .04) and progression-free survival (36% vs 29%; P = .01). There was no significant increase in either late grade 3 gastrointestinal (P = .21) or genitourinary (P = .98) toxicity.

Study details: The data come from a combined individual patient analysis of 2 phase 3 randomized trials (RTOG9413 and an open-label trial).

Disclosures: No data on funding and conflict of interest was available.


Spratt DE et al. ASTRO 2020. Abstract 32.