Maximal androgen blockade the prime prostate cancer treatment option in older patients

Among prostate cancer patients aged ≥75 years, maximal androgen blockage (MAB) appears to be the most common treatment option, reports a new South Korea study. Meanwhile, the combination of leuprolide and bicalutamide is the most common MAB regimen.

The retrospective study included 873 patients with biopsy-proven disease. All participants enrolled were ≥75 years of age at diagnosis, had prostate biopsy with ≥12 cores, and were followed for ≥1 year.

The most common primary treatment for this patient population was androgen deprivation therapy (ADT), performed in 614 patients. This was followed by radical prostatectomy (n=114) and radiation therapy (n=62). Nine patients who underwent resection received ADT before surgery.

In the ADT subgroup, MAB was the most common therapeutic regimen (n=571), which was most frequently carried out by the combination of leuprolide and bicalutamide (n=330).

Multivariate analysis showed that patients with low baseline prostate-specific antigen levels (odds ratio [OR], 0.943; p<0.001), better Eastern Cooperative Oncology Group Performance Status (OR, 0.066; p<0.001), and those who were younger (OR, 0.653; p<0.001) were more likely to be recommended for radical prostatectomy.

The same factors were also independently predictive of secondary treatment. Twenty-two patients needed tertiary treatment, of which enzalutamide was the most frequent therapy of choice.

“Further studies, including survival outcome studies with more patients, are warranted,” the researchers said.