Individual Patient Data Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium: Impact of Androgen Deprivation Therapy Use and Duration With Definitive Radiotherapy for Localized Prostate Cancer
Abstract
PURPOSE/OBJECTIVE(S)
To conduct the first global individual patient data (IPD) meta-analysis of randomized trials to assess the impact of androgen deprivation therapy (ADT) use and duration with definitive radiotherapy (RT) in localized prostate cancer.
MATERIALS/METHODS
The MARCAP Consortium was formed from international trial groups (NRG/RTOG, EORTC, TROG, DART/GICOR, and ICORG). IPD for 10,131 patients enrolled across 11 RT trials were available for three pre-specified meta-analyses: addition of ADT to RT (5 trials; n = 4736), addition of long-term adjuvant ADT (12-30 months) to short-term ADT (4 trials; n = 3674), and addition of longer neoadjuvant ADT (3-7 months) to short-term ADT (3 trials; n = 2213). The primary endpoint of all meta-analyses was overall survival (OS), with metastasis-free survival (MFS) as a secondary endpoint. Interaction tests between treatment and receipt of dose-escalated RT (≥74 Gy in 2 Gy fractions) were performed.
RESULTS
After a median follow-up of 12.0 years, the addition of ADT to RT improved 12-year OS (absolute 7.2%, HR 0.87, 95% CI 0.8-0.95) and 12-year MFS (absolute 8.3%, HR 0.85, 95% CI 0.79-0.92). After a median follow-up of 10.9 years, prolongation of adjuvant ADT improved 12-year OS (absolute 6.3%, HR 0.86, 95% CI 0.78-0.94) and 12-year MFS (absolute 6.3%, HR 0.83, 95% CI 0.77-0.90). After a median follow-up of 10.3 years, prolongation of neoadjuvant ADT was not associated with a significant benefit in any endpoint (MFS HR 0.95, 95%…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 10,131 participants or records.
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