When it comes to overall survival benefits of ADT, does age matter?

ADT is the standard of care for prostate cancer patients with metastatic prostate cancer. But are there age-dependent disparities in the survival outcomes for patients on ADT?

In a recent retrospective study, investigators looked at five-year overall survival outcomes for 21,977 men who had been diagnosed with metastatic prostate cancer. Patients were subdivided according to age (<65 and > 65 years) and treatment type. The different treatment groups included ADT + chemotherapy, ADT alone, or no treatment (observation only).

In controlling for various variables (e.g., disease status), the authors found no benefit to younger patients in going on ADT compared to older patients. As the study investigators note, there may be certain subgroups of younger patients with metastatic prostate cancer who do not benefit from ADT in terms of overall survival.

The authors thus argued for caution in starting younger patients on ADT given the side effects associated with this treatment. This makes sense given the fact that several of the major side effects of ADT (e.g., hot flashes, sexual dysfunction) are more bothersome for younger versus older patients.

 To read the study abstract, please see:


 Keating, M. J., Giscombe, L., Tannous, T., Reddy, N., Mukkamalla, S. K. R., DeSouza, A., & Rathore, R. (2019). Age-dependent overall survival benefit of androgen deprivation therapy for metastatic prostate cancer. Journal of Oncology Pharmacy Practice [Epub ahead of print]. doi: 10.1177/1078155219835597.