Non-metastatic (M0) hormone sensitive

Androgen Deprivation Therapy (ADT), or other endocrine therapies, alone may be appropriate for some patients in the M0 hormone sensitive prostate cancer (HSPC) setting. It remains the responsibility of the treating clinician to determine which patients are suitable for ADT monotherapy.

For use of ADT alongside radiotherapy, please refer to the radiotherapy pathway.

Information about different ADT options can be found in "Androgen deprivation therapy" section of the SACT CMP.

Abiraterone 1000mg orally once daily, with prednisolone 5mg orally once daily, may be used for a total of 2 years in eligible patients, with radical radiotherapy to the prostate and 3 years of androgen deprivation therapy (ADT). NCMAG102 [PDF only]

Note: For some patients 5mg prednisolone daily may be insufficient to combat the mineralocorticoid-mediated side effects of abiraterone. Consider escalating to 10mg once daily if the patient experiences treatment-induced hypertension or hypokalaemia.

Eligibility:

• Disease which is not metastatic (M0),
• Node positive (N1),
• or if node negative (N0) at least of two of;
  o tumour stage T3 or T4,
  o Gleason score 8-10 or
  o PSA ≥ 40micrograms/ml.

For use of abiraterone alongside radiotherapy, please refer to the radiotherapy pathway.