Another timely video from the Prostate Cancer Research Institute talking about the recent EMBARK study that examines combination ADT [androgen deprivation therapy, also called hormone therapy] + enzalutamide therapy versus Lupron alone or enzalutamide alone. (The study was funded by Pfizer and Astellas Pharma, the manufacturers of enzalutamide.)

There were 1,068 patients divided into three groups that were followed for five years. The groups were combination therapy (leuprolide + enzalutamide); leuprolide alone; and enzalutamide alone. The metastasis-free survival rate for each group:

  • Combination therapy: 87.3%
  • Leuprolide alone: 71.4%
  • Enzalutamide alone: 80.0%

One thing the study summary doesn’t address is whether combination therapy accelerates or delays the cancer developing a resistance to ADT. That would be interesting to know. While it doesn’t explicitly say in the summary, it appears that the patients were on the treatments continuously for the five years.

This is something that’s been added to my list of discussion points for my visit with the medical oncologist on 19 March.

Here’s another informative video about hormone therapy from the Prostate Cancer Research Institute. It answered some of the questions that I had from the previous video. Specifically:

  • Participants in the study were not on continuous hormone therapy as I wrongly inferred from the summary.

  • It is possible to do PSMA PET scans while on a break from hormone therapy if the PSA rises to detectable levels (>1.0 ng/mL).

  • Time to the cancer becoming resistant to the intermittent combination hormone therapy if started in a timely manner can be up to 17 to 18 years.

A moderator on the HealthUnlocked website shared a link to the new 2024 American Urological Association guidelines for salvage therapy for recurrent prostate cancer:

https://www.auanet.org/guidelines-and-quality/guidelines/salvage-therapy-for-prostate-cancer

These are the generally agreed-upon guidelines that practitioners should follow when a patient has recurrent prostate cancer after initial treatment.

These blog posts were originally posted February 24 , February 29 and March 1, 2024, on DansJourney.com.