THURSDAY, Sept. 22, 2022 (HealthDay News) — Neoadjuvant therapy with a novel hormonal agent prior to radical prostatectomy is associated with better outcomes for men with high-risk prostate cancer versus upfront radical prostatectomy, according to a study published in the Oct. 1 issue of The Journal of Urology.

Praful Ravi, M.D., from the Lank Center for Genitourinary Oncology at the Dana-Farber Cancer Institute in Boston, and colleagues compared outcomes between neoadjuvant therapy with a novel hormonal agent prior to RP (neo-RP) and upfront radical prostatectomy (RP) in patients with high-risk prostate cancer. The analysis included 112 patients in the neo-RP group and 259 in the RP group followed for four years.

The researchers found that after inverse probability of treatment weighting, time to biochemical recurrence (hazard ratio, 0.25) and metastasis-free survival (hazard ratio, 0.26) were significantly longer in the neo-RP versus the RP group. Additionally, in the neo-RP group, rates of adjuvant (7 versus 24 percent) and salvage therapy (34 versus 46 percent) were lower.

“Neoadjuvant therapy with novel hormonal agents before radical prostatectomy is an innovative approach to treatment of prostate cancer with high-risk characteristics,” a coauthor said in a statement. “While we await the results of definitive clinical trials, our findings suggest that this approach can improve key outcomes, compared to starting treatment with radical prostatectomy.”

Several authors disclosed financial ties to pharmaceutical companies, including Janssen, which funded the study.

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