The following article features coverage from the American Society of Clinical Oncology 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Men experiencing biochemical failure following radical prostatectomy for prostate cancer should receive salvage radiation therapy in combination with hormonal therapy, according to the authors of an updated analysis of the GETUG-AFU 16 study. The results from this study were presented at the 2019 American Society of Clinical Oncology Annual Meeting in Chicago, Illinois.1

Currently, most patients with biochemical relapse are treated with “salvage radiation therapy alone,” commented Dr Magné, the presenter of the study results.

Previously reported results from the open-label, multicenter, phase 3 GETUG-AFU 16 study (ClinicalTrials.gov Identifier: NCT00423475) at a median follow-up of 63 months revealed that men with biochemical failure following radical prostatectomy who received salvage therapy plus goserelin had improved progression-free survival (PFS): rates of 5-year PFS were 80% for the combination compared with 62% PFS for those who were administered radiation therapy alone; P <.0001.2

In this analysis, median follow-up of the GETUG-AFU 16 study was extended to 112 months. The results confirmed that 5-year PFS was significantly improved by the addition of a short-course of goserelin to salvage radiation therapy (64%) versus radiation therapy alone (PFS 49%; hazard ratio [HR], 0.54; 95% CI, 0.43-0.68; P <.0001).

Furthermore, the benefit of multimodality therapy was evident in subgroups of patients with low-risk disease and high-risk disease.

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Of note, at long-term follow-up, addition of goserelin to salvage radiation therapy (75%) versus radiation therapy alone (69%) was also associated with a significant improvement in the 10-year metastatic-free survival rate (HR, 0.73; 95% CI, 0.54-0.98; P =.034).

In their concluding statements, the study authors noted that the updated results from the GETUG-AFU 16 study, along with results from the RTOG-9601 study of salvage radiation therapy with or without 2 years of antiandrogen therapy plus daily bicalutamide in men with biochemical recurrence following surgery,3 confirm that salvage radiation therapy combined with hormone therapy “can be considered as the new standard for salvage treatment after radical prostatectomy.”

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References

  1. Carrie C, Magné N, Burban-Provost P, et al. Interest of short hormonotherapy (HT) associated with radiotherapy (RT) as salvage treatment for metastatic free survival (MFS) after radical prostatectomy (RP): Update at 9 years of the GETUG-AFU 16 phase III randomized trial (NCT00423475). Presented at: 2019 American Society of Clinical Oncology Annual Meeting. May 31-June 3, 2019; Chicago, IL: Abstract 5001.
  2. Carrie C, Hasbini A, de Laroche G, et al. Salvage radiotherapy with or without short-term hormone therapy for rising prostate-specific antigen concentration after radical prostatectomy (GETUG-AFU 16): a randomised, multicentre, open-label phase 3 trial. Lancet Oncol. 2016;17:747-756.
  3. Shipley WUSeiferheld WLukka HR, et al. Radiation with or without antiandrogen therapy in recurrent prostate cancer. N Engl J Med. 2017;376:417-428.