Appropriate Duration of ADT in Prostate Cancer Depends on Risk

THURSDAY, Dec. 4, 2025 (HealthDay News) -- Increasing duration of androgen deprivation therapy (ADT) is beneficial for some men with prostate cancer, while those with lower risk cancer may not need long-term ADT, according to research published online Nov. 25 in JAMA Oncology.Nicholas G. Zaorsky, M.D., from the Case Western Reserve School of Medicine in Cleveland, and colleagues conducted an individual patient data meta-analysis of 13 randomized phase 3 clinical trials to examine use of radiotherapy alone or with ADT. Data were included for 10,266 male patients with prostate cancer (median age, 70 years), 72 percent of whom had National Comprehensive Cancer Network (NCCN) high-risk or very high-risk disease.The researchers observed associations for longer durations of ADT with nonlinear improvement in relative benefits of distant metastasis (DM), prostate cancer-specific mortality, and overall survival; based on the end point, the estimated benefits were reduced beyond nine to 12 months of ADT. A near-linear increase was seen in other-cause mortality in association with long-term ADT use (hazard ratio, 1.28 for 28 versus zero months of ADT). Based on 10-year DM, the optimal ADT duration was zero, six, 12 months, and undefined for patients with one intermediate risk factor, two or more intermediate risk factors, and NCCN high-risk and very high-risk disease, respectively."Prostate cancer treatment should not be one-size-fits-all," co-senior author Amar U. Kishan, M.D., from the University of California Los Angeles, said in a statement. "These findings help doctors personalize therapy, balancing cancer control with potential side effects and other health risks."Several authors disclosed ties to the pharmaceutical industry.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter