The NEJM this week has an article directly relevant to patients receiving long term androgen deprivation with radiation therapy for high risk prostate cancer. In this phase III trial, patients undergoing androgen deprivation were randomized to receive denosumab, a monoclonal antibody targeting the NFKB ligand. The intervention resulted in improved bone density, and perhaps more importantly, resulted in decreased vertebral fractures, all at no significant observed toxicities.
This joins a number of randomized trials conducted by Dr. Smith and others on similar agents (see table below). What remains to be seen is what the best intervention is, both in terms of efficacy and cost.
Denosumab in Men Receiving Androgen-Deprivation Therapy for Prostate Cancer