RADICALS-HD sheds light on the role of ADT addition to post-operative radiotherapy

The addition of short-course androgen-deprivation therapy (ADT) to upfront radiotherapy is the standard-of-care approach for patients with intermediate-risk or high-risk localized prostate cancer; however, the role of ADT in those receiving radiotherapy after radical prostatectomy is unclear. Now, results from the phase III RADICALS-HD trial provide insights that could help to guide treatment decision making.

In this trial, patients eligible for radiotherapy at any time after radical prostatectomy were randomly allocated (1:1:1) to radiotherapy alone or with ADT (LHRH agonist or bicalutamide) for either 6 months or 24 months (short or long course, respectively). Participant sites were encouraged to perform three-way allocation of patients, although two-way allocation was also permitted to facilitate recruitment. In 2010, the trial was repowered for two separate comparisons, both with metastasis-free survival (MFS) as the primary end point. The median follow-up duration was 9 years.