Dr. Higano on the GETUG-AFU 16 Trial Results in Prostate Cancer

Celestia S. Higano, MD
Published: Wednesday, Jul 17, 2019



Celestia S. Higano, MD, medical oncologist with expertise in genitourinary oncology, member, Clinical Research Division, Fred Hutchinson Cancer Research Center, professor, Department of Medicine and Urology, University of Washington, Seattle Cancer Care Alliance, discusses the outcomes of the GETUG-AFU 16 and its impact on current practices for prostate cancer.

According to Higano, the GETUG-AFU 16 trial answers the clinical question, "If a patient receives salvage radiation after a radical prostatectomy, should you add hormone therapy?" For many years, radiation specialists said patients do not need to receive hormone therapy with salvage radiation after a radical prostatectomy, Higano explained. However, this trial examined whether adding 6 months of short-term hormone therapy improved outcomes with radiation in terms of metastasis-free survival (MFS).

In the first report of this trial, there was a difference in MFS, but now after 5 years, there continues to be a significant MFS difference. The 10-year MFS rate was significantly improved in the combination arm of radiation with hormone therapy at 75% compared with 69% for radiation alone (HR, 0.73; 95% CI, 0.54-0.98; P = .034). It’s not clear if the increased MFS translates into an overall survival advantage, but Higano believes many patients would say delaying metastasis in their disease trajectory is very important.
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Celestia S. Higano, MD, medical oncologist with expertise in genitourinary oncology, member, Clinical Research Division, Fred Hutchinson Cancer Research Center, professor, Department of Medicine and Urology, University of Washington, Seattle Cancer Care Alliance, discusses the outcomes of the GETUG-AFU 16 and its impact on current practices for prostate cancer.

According to Higano, the GETUG-AFU 16 trial answers the clinical question, "If a patient receives salvage radiation after a radical prostatectomy, should you add hormone therapy?" For many years, radiation specialists said patients do not need to receive hormone therapy with salvage radiation after a radical prostatectomy, Higano explained. However, this trial examined whether adding 6 months of short-term hormone therapy improved outcomes with radiation in terms of metastasis-free survival (MFS).

In the first report of this trial, there was a difference in MFS, but now after 5 years, there continues to be a significant MFS difference. The 10-year MFS rate was significantly improved in the combination arm of radiation with hormone therapy at 75% compared with 69% for radiation alone (HR, 0.73; 95% CI, 0.54-0.98; P = .034). It’s not clear if the increased MFS translates into an overall survival advantage, but Higano believes many patients would say delaying metastasis in their disease trajectory is very important.



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