Researchers involved in a randomized multi-center trial have reported that intermittent androgen suppression (IAS) in advanced prostate cancer is safe and results in 40% of time being spent off therapy with an improvement in quality of life. The details of this study were presented at the 2007 meeting of the American Society of Clinical Oncology.  

Intermittent androgen suppression has been explored in Phase II trials in patients with various stages of prostate cancer treated with androgen suppression.  The rationale for this approach is to decrease toxicities associated with this form of palliative therapy, which include loss of libido, weight gain, osteoporosis, fractures, and anemia. Another assumption is that there may be advantages to immediate institution of androgen suppression rather than delayed institution and that this can be accomplished with IAS without committing to indefinite treatment at the onset of therapy. Another potential benefit is that IAS might restore apoptosis and delay hormone refractoriness.  

The current study compared intermittent with continuous therapy with goserelin and bicalutamide in 335 patients with advanced prostate cancer. These authors reported that approximately 2/3 of patients had disease progression during the study period. The median time to disease progression in the IAS group was 16.5 months compared to 11.5 months in the continuous arm, which was not statistically significant. The median time to death from any cause was 52.4 months in the IAS group and 53.8 months in the continuous arm. Eighty-Eight percent of patients in the IAS group experienced treatment-free days 50% of the time. Patients’ self-assessment, sexual activity and overall health were better in the IAS group.  

Comments: This randomized trial confirms observations made in Phase II studies. IAS should be the preferred method of delivery of androgen suppression.

Reference:  Miller K, Steiner U, Lingnau A, et al. Randomized prospective study of intermittent versus continuous androgen suppression in advanced prostate cancer. Proceedings from the American Society of Clinical Oncology. Chicago/IL.  2007. Abstract # 5015.  

Related News:

Intermittent Androgen Suppression Therapy Confirmed Effective for Prostate Cancer (04/27/2007)

Intermittent Androgen Suppression an Acceptable Alternative for Treatment of Recurrent Prostate Cancer (07/11/2006)

Intermittent Androgen Ablation Decreases Side Effects in Men with Prostate Cancer (12/14/2005)

Intermittent Androgen Suppression Feasible in Men with Prostate Cancer who Fail Radiation Therapy (10/27/2003)