(UroToday.com) The 2025 American Society of Clinical Oncology (ASCO) Genitourinary (GU) Annual Symposium held in San Francisco, CA between February 13–15, 2025 was host to a rapid oral abstract prostate cancer session. Dr. Abdenour Nabid presented long-term data from a phase III trial evaluating the impact of testosterone recovery after androgen deprivation therapy (ADT) on overall survival outcomes with patients with high-risk prostate cancer.
The study objective was to determine the potential impact of persistent hypogonadism on overall survival after prolonged ADT in patients with high-risk prostate cancer. The study investigators included 630 patients from the PCS 4 trial who received radiotherapy plus either 36 (m=310) or 18 months of ADT (n=320).1 Serum testosterone levels were prospectively collected at baseline and regularly thereafter. Patients who did not receive 18 or 36 months of ADT were excluded (n=48), as well as those who did not have testosterone levels available at baseline or during follow-up (n=67). Of the 630 study patients, 515 were evaluable for analysis.
The baseline patient characteristics by testosterone recovery (yes versus no) are summarized below:
Of the 515 patients, 270 (52.4%) recovered eugonadal testosterone levels. The median follow-up was 17.4 years. Patients who recovered testosterone levels were younger (median: 70 versus 72 years, p<0.0001), had a lower comorbidity status (p=0.13), and had less clinically advanced disease (p=0.0025).
How did duration of ADT affect testosterone recovery levels? In patients who received 18 months of ADT, 188/330 (57%) recovered testosterone levels versus 82/185 (44.3%) of those who received 36 months of ADT (p=0.006).
Patients who had recovered testosterone levels (blue curve below) had superior overall survival outcomes (HR: 0.54, 95% CI: 0.44–0.67, p<0.001):
On multivariable analysis, testosterone recovery was significantly associated with improved overall survival outcomes in the overall cohort (HR: 0.69, 95% CI: 0.55–0.86, p=0.0012).
A consistent pattern was observed in both the 18- and 36-months cohorts:
Dr. Nabid concluded that in high-risk prostate cancer patients treated with long-term ADT plus radiotherapy, testosterone recovery to normal levels is associated with a significant improvement in overall survival.
Presented by: Abdenour Nabid, MD, Associate Professor at Centre Hospitalier de Universitaire de Sherbrooke, Sherbrooke, ON, Canada
Written by: Rashid K. Sayyid, MD, MSc – Robotic Urologic Oncology Fellow at The University of Southern California, @rksayyid on Twitter during the 2025 Genitourinary (GU) American Society of Clinical Oncology (ASCO) Annual Meeting, San Francisco, CA, Thurs, Feb 13 – Sat, Feb 15, 2025.
Reference: