In a patient with very high risk prostate cancer opting for prostatectomy, when, if ever, do you recommend neoadjuvant ADT?
Answer from: Medical Oncologist at Academic Institution
I generally do not offer ADT with or without a potent ARSI prior to RP even in high risk disease. While small single arm studies have shown that a few such men can achieve a pathologic CR and that path CR/MRD is associated with better outcomes after RP, for most patients, this approach has no clear ...
Answer from: Medical Oncologist at Academic Institution
The only patients I consider doing neoadjuvant hormone therapy are for those who strongly select prostatectomy instead of definitive prostate radiation but who also have many high risk features making surgical resection more challenging to achieve optimal resection (e.g., T3/T4). Most of these patie...
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Radiation Oncologist at West Virginia University Since the high or very high risk features are not ...
Medical Oncologist at Massachusetts General Hospital If using neoadjuvant ADT prior to surgery, then wh...
Answer from: Medical Oncologist at Academic Institution
The data is controversial regarding neoadjuvant therapy in high risk prostate cancer. Multiple trials with neoadjuvant ADT have shown a lack of survival benefit but remarkable improvement in biochemical relapse free interval. The dilemma is heightened by the early detection of metastases on PSMA PET...
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Radiation Oncologist at Beth Israel Deaconess Medical Center/Harvard Medical School Caution is needed when looking at the results of s...