title: Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy: SWOG S9921 study.
abstract: OBJECTIVE
  Men with high-risk features (extraprostatic extension or high Gleason grade) face a high risk of prostate cancer recurrence after radical prostatectomy. Clinical trials of adjuvant systemic therapy for such patients have been limited.
  
  
  METHODS
  The SWOG (Southwest Oncology Group) S9921 study randomly assigned 983 men with high-risk features at prostatectomy to receive adjuvant therapy with androgen deprivation (ADT) alone or in combination with mitoxantrone chemotherapy. ADT consisted of goserelin and bicalutamide for 2 years.
  
  
  RESULTS
  Although the final primary treatment comparison results are not ready for publication, this article reports results in the ADT-alone control arm with a median follow-up of 4.4 years. For these 481 men, the estimated 5-year biochemical failure-free survival is 92.5% (95% CI, 90 to 95), and 5-year overall survival is 95.9% (95% CI, 93.9 to 97.9).
  
  
  CONCLUSIONS
  The results of this trial, taken in context, make a compelling argument for counseling all high-risk patients with prostate cancer about adjuvant ADT. This article discusses the challenges in the design and implementation of clinical trials to take the next step forward in adjuvant therapy for prostate cancer because of the excellent survival achieved with currently available therapies and highlights the need for better molecular markers to personalize care.
authors.affiliation: Department of Medicine, Division of Medical Oncology, Genitourinary Cancers, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, USA. dorff@usc.edu
authors.forename: Tanya B
authors.initials: TB
authors.lastname: Dorff
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Flaig
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Tangen
authors.forename: Maha H A
authors.initials: MH
authors.lastname: Hussain
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Swanson
authors.forename: David P
authors.initials: DP
authors.lastname: Wood
authors.forename: Wael A
authors.initials: WA
authors.lastname: Sakr
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Dawson
authors.forename: Naomi B
authors.initials: NB
authors.lastname: Haas
authors.forename: E David
authors.initials: ED
authors.lastname: Crawford
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Vogelzang
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
authors.forename: L Michael
authors.initials: LM
authors.lastname: Glode
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000813:Anilides / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D017273:Goserelin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage*; D009570:Nitriles / Q000008:administration & dosage; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D014105:Tosyl Compounds / Q000008:administration & dosage
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D009570:Nitriles; D014105:Tosyl Compounds; D017273:Goserelin; C053541:bicalutamide; D008942:Mitoxantrone