A mid-stage trial presented at the 2025 ASCO Genitourinary Cancers Symposium in San Francisco is sparking interest among oncologists. In the study led by Dr. Nick James at The Royal Marsden NHS Foundation Trust, 79 prostate cancer patients receiving androgen receptor pathway inhibitors were randomized to standard LHRH therapy or a transdermal patch delivering estradiol.
Key findings include:
- Comparable Efficacy: Both arms showed a 61% response rate (as measured by PSA levels) within six months.
- Improved Tolerability: Patients using the estradiol patch reported lower incidences of hot flashes (5% vs. 24%) and high blood pressure (5% vs. 17%). However, an increased occurrence of breast tissue enlargement was noted.
- Mechanistic Advantages: Unlike LHRH drugs, the estradiol patch suppresses testosterone while preserving estrogen, which may enhance bone density and overall metabolic parameters.
"This sort of repurposing of an older, cheap drug is an important way to improve outcomes, separate from developing new drugs." - said Dr. James, NHS
Earlier studies have also suggested that estradiol patches are non-inferior to LHRH agents in androgen suppression and metastasis-free survival among men with locally advanced disease. While long-term outcomes remain under review, these encouraging results point to a cost-effective alternative that could mitigate some of the common side effects associated with traditional Androgen Deprivation Therapy.
