Lancet
ASCO GCS 2026: Hormone therapy adds limited survival benefit to post-op radiotherapy in recurrent prostate cancer
An individual patient data meta-analysis of six randomized trials (N=6,057) found nearly identical 10‑year survival with postoperative radiotherapy alone (83.6%) vs. radiotherapy plus hormone therapy (84.3%). Overall survival didn’t significantly improve with added hormone therapy (hazard ratio [HR], 0.87; 95% confidence interval, 0.76–1.01; p=0.06), and short‑term treatment offered no survival benefit beyond a small reduction in metastasis. Pre‑radiotherapy PSA strongly influenced outcomes: men with PSA ≤0.5 ng/mL saw no benefit, whereas those with higher PSA experienced modest gains—mainly with long‑term therapy. However, extending short‑term to long‑term therapy didn’t further improve survival, despite slightly lowering metastatic risk. These results were presented during the plenary session of the American Society of Clinical Oncology Genitourinary Cancers Symposium in San Francisco.
Clinical takeaway: For most men receiving salvage radiotherapy—especially those with low PSA—routine addition of hormone therapy may offer limited survival benefit; consider PSA level when individualizing treatment decisions.
Source:
Kishan A, et al. (2026, February 26). Lancet. Hormone therapy use and duration with postoperative radiotherapy for recurrent prostate cancer: an individual patient data meta-analysis. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00137-6/fulltext