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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
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Androgen Deprivation Therapy Practice Patterns in High-Risk Prostate Cancer Treated With Definitive Radiotherapy:
Michael P Dykstra1, Samuel N Regan1, Huiying Maggie Yin1
1Department of Radiation Oncology, University of Michigan, Ann Arbor, MI.
JCO Oncology Practice
|September 26, 2025
Summary
Guideline-concordant androgen deprivation therapy (ADT) was recommended for two-thirds of high-risk prostate cancer patients. Androgen receptor pathway inhibitor (ARPI) intensification was used in less than 25% of eligible patients, indicating a need for standardized care.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Current guidelines recommend 18-36 months of androgen deprivation therapy (ADT) with definitive radiotherapy for localized, high-risk prostate cancer.
- The STAMPEDE M0 trial suggests intensifying treatment with androgen receptor pathway inhibitors (ARPIs) for specific high-risk patient subgroups.
- Contemporary practice patterns require evaluation due to advances in imaging, risk stratification, and treatment delivery.
Purpose of the Study:
- To characterize contemporary practice patterns in androgen deprivation therapy (ADT) and androgen receptor pathway inhibitor (ARPI) use for high-risk prostate cancer.
- To assess adherence to guideline-concordant ADT (GC-ADT) recommendations.
- To evaluate the adoption of ARPIs following the STAMPEDE M0 trial publication.
Main Methods:
- Prospective data collection from the Michigan Radiation Oncology Quality Consortium (MROQC) for patients with high-risk M0/N0-1 prostate cancer.
- Analysis of intended ADT duration and ARPI use, with guideline-concordant ADT (≥18 months) as the primary outcome.
- Multivariable analyses to identify factors associated with GC-ADT recommendations and mixed-effects models to assess facility-level variability.
Main Results:
- Of 553 patients, 67.0% received guideline-concordant ADT (GC-ADT).
- GC-ADT was significantly associated with cN1, Grade Group (GG) 4-5, and PSA ≥40 ng/mL.
- Among patients meeting STAMPEDE criteria (27.9%), ARPI recommendations increased from 0% pre-STAMPEDE M0 publication to 23.2% post-publication.
Conclusions:
- Guideline-concordant ADT recommendations were observed in approximately two-thirds of patients within a statewide quality consortium.
- Androgen receptor pathway inhibitor (ARPI) intensification was adopted in less than 25% of STAMPEDE-eligible patients.
- Findings underscore the need for individualized ADT strategies and collaborative efforts to standardize high-quality prostate cancer care.
