Immediate androgen deprivation: for all or for some?
Mené sur 293 patients atteints d'un cancer de la prostate et présentant une augmentation du taux de PSA après un traitement à visée curative (radiothérapie ou chirurgie), cet essai randomisé international de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité de deux modalités d'administration d'un traitement anti-androgénique, immédiatement ou après un délai de 2 ans (durée médiane de suivi : 5 ans)
There has been much debate about the optimal management of men with prostate cancer who relapse after surgery or radiotherapy as assessed by serum prostate-specific antigen (PSA) levels. In The Lancet Oncology, Gillian Duchesne and colleagues inform this debate through reporting the results of a multicentre, randomised trial comparing immediate androgen-deprivation therapy with delaying therapy by about 2 years. Participants who received immediate androgen deprivation seemed to fare slightly better than did those who had delayed treatment (log-rank p=0·047; hazard ratio for overall survival in the immediate therapy arm vs delayed therapy arm 0·55 [95% CI 0·30–1·00]; p from Cox regression=0·050).
The Lancet Oncology , commentaire, 2015