Dr. Koontz Discusses LHRH in High-Risk Prostate Cancer

Bridget F. Koontz, MD, radiation oncologist, Duke Cancer Institute, discusses a phase II trial of 6 months of androgen deprivation therapy/abiraterone acetate (Zytiga) plus prednisone and definitive radiotherapy for men with intermediate- to high-risk localized prostate cancer.

According to Koontz, this trial was a single-arm phase II study where patients received 6 months of concurrent LHRH therapy with abiraterone and prednisone. Concurrent with that was 6 months of hormone manipulation. Patients received radiation months 3 and 4. Those patients have been monitored for prostate-specific antigen (PSA) and testosterone maintenance.

The trial was well tolerated with a low grade III toxicity rate mostly related to abiraterone hypertension, explains Koontz. All 33 patients were able to finish the therapy. Overall, patients had a high testosterone recovery rate. At 1 year, half the patients had full testosterone recovery.

There were low scores of PSA, suggesting that low PSA with radiation is prognostic for late outcome. In the men who had testosterone recovery, 95% of the men had a PSA under 0.5.