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Related Concept Videos

  • Biomedical And Clinical Sciences
  • Oncology And Carcinogenesis
  • Predictive And Prognostic Markers
  • Intermittent Versus Continuous Androgen Deprivation In Prostate Cancer.
  • Biomedical And Clinical Sciences
  • Oncology And Carcinogenesis
  • Predictive And Prognostic Markers
  • Intermittent Versus Continuous Androgen Deprivation In Prostate Cancer.

    • Related Experiment Videos

    Intermittent versus continuous androgen deprivation in prostate cancer.

    Maha Hussain1, Catherine M Tangen, Donna L Berry

    • 1University of Michigan, Division of Hematology/Oncology, 1500 E Medical Center Dr., 7314 CC, Ann Arbor, MI 48109-0946, USA. mahahuss@umich.edu

    The New England Journal of Medicine
    |April 5, 2013

    View abstract on PubMed

    Summary
    This summary is machine-generated.

    This study found intermittent androgen deprivation therapy for metastatic prostate cancer did not prove non-inferior to continuous therapy for survival. While quality of life improved short-term, long-term survival outcomes remain inconclusive.

    Related Experiment Videos

    Area of Science:

    • Oncology
    • Urology
    • Clinical Trials

    Background:

    • Metastatic hormone-sensitive prostate cancer (mHSPC) frequently develops castration resistance under androgen-deprivation therapy (ADT).
    • Hypotheses suggest that modulating androgen levels before disease progression may extend the duration of androgen dependence.

    Purpose of the Study:

    • To evaluate if intermittent androgen deprivation (IAD) is non-inferior to continuous androgen deprivation (CAD) in prolonging survival for mHSPC patients.
    • To assess differences in quality of life (QoL) between IAD and CAD groups.

    Main Methods:

    • A randomized trial involving 1535 mHSPC patients with PSA levels ≥5 ng/mL after initial 7-month ADT.
    • Patients were stratified and assigned to either IAD or CAD, with survival and QoL as coprimary endpoints.
    • Median follow-up was 9.8 years, with a non-inferiority margin of a hazard ratio of 1.20 for death with IAD.

    Main Results:

    • Median survival was 5.8 years for CAD versus 5.1 years for IAD (HR 1.10; 95% CI 0.99-1.23), indicating statistical inconclusiveness regarding non-inferiority.
    • IAD showed transient improvements in erectile function and mental health at 3 months post-randomization.
    • No significant differences in high-grade adverse events were observed between the groups.

    Conclusions:

    • The study could not definitively establish non-inferiority of IAD to CAD for survival in mHSPC due to statistical limitations.
    • While IAD offered minor short-term QoL benefits, the risk of increased mortality with IAD cannot be excluded.
    • Further research is needed to clarify the optimal ADT strategy for mHSPC.