I think this is a really important question for our field and I think a really outstanding question despite the results we presented today are the duration and type of hormonal therapy to use in combination with metastasis-directed radiation. A number of the earlier phase two trials in this space have omitted androgen deprivation therapy and used metastasis-directed radiation as an approach to delay hormone therapy initiation...
I think this is a really important question for our field and I think a really outstanding question despite the results we presented today are the duration and type of hormonal therapy to use in combination with metastasis-directed radiation. A number of the earlier phase two trials in this space have omitted androgen deprivation therapy and used metastasis-directed radiation as an approach to delay hormone therapy initiation. And other trials have used androgen deprivation therapy alone in combination with metastasis-directed radiation. A few more recent studies have looked at hormone intensification, which the Metacure trial also did. But I think there are really outstanding questions about the duration of hormonal therapy that’s appropriate for patients in this trial. The Metacure trial, the results we presented, looked at 6 to 10 months of hormone therapy in combination with metastasis-directed radiation. And I think our disease control rates were very promising. But I think the jury is still out on the optimal duration of hormone therapy and extrapolating from data in high-risk localized prostate cancer. Many providers do use longer durations, 18 to 24 months or potentially even lifelong hormonal therapy in combination with metastasis-directed radiation. I think future trials will need to further address that question.
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