Dr. Taplin on Neoadjuvant ADT Plus Hormonal Therapy

Mary-Ellen Taplin, MD, associate professor of Medicine at Harvard Medical School and the Dana-Farber Cancer Institute, explains the rationale behind the recent study examining the neoadjuvant administration of abiraterone acetate (Zytiga) in combination with the LHRH analog leuprolide acetate, for patients with localized high-risk prostate cancer.

Taplin explains that several large studies were conducted in the 90's investigating the use of LHRH analogs with or without an antiandrogen therapy before prostatectomy. These trials did not show any additional benefits for the combination, causing the approach to be abandoned.

At the time, the most commonly used androgen deprivation therapy (ADT) was flutamide; however, the recent discovery of more potent ADTs, such as abiraterone acetate and enzalutamide (formally MDV3100), has called for the reinvestigation of the neoadjuvant combination of an LHRH analog and ADT, Taplin states.

The overarching theory behind the reinvestigation of the concept is that as therapies for cancer become more potent it may become necessary to reexamine treatment approaches that were previously thought to be ineffective.