2 or 3 yrs ADT

[snugrose]

I was diagnosed im Jan 2022 with Gleason 9. PSA was 5.68. Prostatectomy in April 2022. The post surgical pathology showed 1 of 9 lymph nodes was positive, positive margins and one seminal vesical positive. Started Eligard in June 22 and abiraterone with predisone in July 2022. Radiation (34 days, 68 GY) to prostate girdle from August to Sept 2022.

My treatment plan from the start (citing Stampede) was always for 3 yrs ADT with two years of abiraterone. I have spent many hours researching why under Stampede three yrs ADT is is talked about but not suggested as the correct duration for ADT. Most studies now conclude 18 months to 24 months is sufficient. (of course I would like to stop ADT at 24 months) Please help me find an answer. All my doctors (MO, urologist and RO) at the Univ of Miami cannot answer the question."Is 3 yrs ADT with the first 2 years including abiraterone better than 2 yrs ADT with abiraterone in terms of survival or metastasis free survival. I am 18 months into ADT with abiraterone.

[Tall_Allen]

"Most studies now conclude 18 months to 24 months is sufficient." No, they don't, not for positive LNs.

2 yrs of abi+3 yrs of ADT was arbitrary in Stampede.

There is a current clinical trial that will see if 2 yrs of apalutamide+ADT will improve results in patients with high Decipher scores.

clinicaltrials.gov/study/NC...

[snugrose in reply to Tall_Allen]

Thanks TA for your response. Please suggest studies I should review in making my decision to stop at 2 yrs or continue to 3 yrs.

[Tall_Allen in reply to snugrose]

See link above.

[CancerConcierge]

I would be interested int his discussion as well.

My husband is following the Stampede trial protocol for high risk, localized PCa .( Gleason 9, PSA 46.6) Your situation is of course different with a positive lymph node.

He is on Orgovyx, Abiraterone/ prednisone...Recommended 2 years Abi and "at least" two years ADT....

[tango65]

IMHO you should follow the best data available showing it can prolong your life and/or in your case may cure you.

ADT is problematic to say the least, but if stopped early and the cancer comes back, then you will be on ADT for life.