A clinical trial shows that the addition of androgen deprivation therapy (ADT) for 24 months is more effective than 6 months of hormone therapy in people with prostate cancer who have a radical prostatectomy and receive postoperative radiation therapy. Results from the RADICALS-HD study were reported at a Presidential Symposium during the 2022 European Society for Medical Oncology Congress.

David J. Byun, MD, a radiation oncologist at NYU Langone Health’s Perlmutter Cancer Center, tells Medscape that the role and optimal duration of ADT continue to remain controversial.

“The majority of the patients in the RADICALS-HD study were randomized to no ADT versus 6 months ADT or 6 months ADT versus 24 months ADT, limiting the ability to compare no ADT to 24 months of hormone therapy adequately,” says Dr. Byun, also a clinical instructor in the Department of Radiation Oncology at NYU Grossman School of Medicine. “RADICALS-HD appears to reinforce the notion that early salvage radiation therapy may not necessitate the addition of short-term ADT other than to delay time to detection of biochemical progression in most patients. That is to say, six months of ADT may not confer clinically meaningful survival benefits for patients with low levels of prostate-specific antigen where the extent of disease likely remains local.”

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