Prostate cancer remains one of the most prevalent cancers in men worldwide, often requiring a multimodal treatment approach for optimal management. Among the treatment modalities, combination androgen deprivation therapy (ADT) with radiotherapy has been a cornerstone in both localized and advanced disease settings. However, the effectiveness and tolerability of traditional ADT regimens have been a subject of ongoing investigation, leading to the exploration of novel therapeutic options such as relugolix. A recent study was published in JAMA Oncology. The study was conducted by Daniel E. and colleagues.

In this post hoc analysis, researchers evaluated the efficacy and safety of relugolix in combination with radiotherapy for the treatment of prostate cancer. The analysis incorporated data from two randomized clinical trials, including a subset from the phase 3 HERO trial comparing relugolix with leuprolide acetate and a phase 2 trial comparing relugolix with degarelix. A total of 260 patients with localized and advanced prostate cancer undergoing radiotherapy were included in the analysis, with 164 patients receiving relugolix.
The key findings of the study were as follows:
• The analysis revealed compelling findings regarding the efficacy of relugolix in achieving sustained castration in prostate cancer patients undergoing radiotherapy.
• Relugolix demonstrated high castration rates, with 95% among patients receiving short-term ADT and 97% among those receiving longer-term ADT.
• Asignificant proportion of patients achieved testosterone levels comparable to baseline or higher within 12 weeks post–short-term relugolix treatment, indicating rapid hormonal recovery following therapy cessation. In addition to its efficacy, relugolix exhibited a favorable safety profile in conjunction with radiotherapy.
• Adverse events of grade 3 or greater, such as headache, hypertension, and atrial fibrillation, were uncommon, affecting less than 5% of patients.
• These findings underscore the potential of relugolix as a well-tolerated treatment option for prostate cancer patients, offering a promising alternative to traditional ADT regimens.
The results of this analysis support the use of relugolix in combination with radiotherapy for the management of prostate cancer. The therapy's ability to rapidly achieve sustained castration, coupled with its favorable safety profile, positions it as a valuable addition to the treatment armamentarium for prostate cancer. Further research and long-term follow-up studies are warranted to validate these findings and explore the full potential of relugolix in improving outcomes for prostate cancer patients undergoing radiotherapy.
Reference:
Spratt, D. E., George, D. J., Shore, N. D., Cookson, M. S., Saltzstein, D. R., Tutrone, R., Bossi, A., Brown, B. A., Lu, S., Fallick, M., Hanson, S., & Tombal, B. F. (2024). Efficacy and safety of radiotherapy plus relugolix in men with localized or advanced prostate cancer. JAMA Oncology. https://doi.org/10.1001/jamaoncol.2023.7279