New tool helps physicians tailor hormone therapy in prostate cancer patients

Researchers at Fox Chase Cancer Center in Philadelphia have developed a prediction tool that uses a prostate cancer patient’s clinical information to estimate the benefit of adding androgen deprivation therapy of various durations to radiation therapy.

“Studies have generally lumped patients into three levels of risk, and physicians have recommended hormone therapy based on these studies,” said study co-author Niraj H. Pahlajani, MD, who presented the prediction tool at the 2008 American Society for Therapeutic Radiology and Oncology annual meeting in Boston. “Our experience tells us that prostate cancer patients can’t be lumped together into broad categories and be expected to respond the same way to treatment even when they fall into similar risk categories.

“Fortunately, we’ve been able to generate a nuanced prediction tool that incorporates disease burden and individualizes treatment recommendations. We can enter each patient’s clinical information and estimate the probability of the cancer coming back using different durations of hormone therapy to determine the best course.”

Dr. Pahlajani said other, similar tools exist to predict cancer treatment outcomes, but none is as personalized and none has yet been used to estimate the gains from different lengths of hormone therapy. The researchers used two key factors derived via biopsy to identify subtle differences among those at intermediate to high risk of recurrence: the percent of cancer-positive tissue identified and the percent of that positive tissue with a Gleason grade of 4 or 5.

“With this information, we’re able to personalize each man’s treatment by quantifying the optimal duration of hormones based on his individual factors,” Dr. Pahlajani said.