Catherine M. Tangen, Dr.P.H., from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues compared overall survival in three sequential phase III trials of 3,096 men with hormone naive, metastatic prostate cancer. The men received similar androgen deprivation therapy in all trials. Two of the trials were conducted before the PSA era (S8494 and S8894), while the third study was conducted during the PSA era (S9346).

The researchers found that median overall survival was 30, 33, and 40 months in S8494, S8894, and S9346, respectively. There was a significantly lower risk of death (22 percent) in S9346 than in S8894 (hazard ratio, 0.78), after adjustment for risk factors. African-American men had a significantly greater improvement in overall survival. The median survival for black men was 27 months in S8494 and S8894, compared with 34 and 35 months, respectively, for nonblack men. In S9346, the racial difference disappeared, with overall survival of 48 and 49 months in black and nonblack men, respectively.

"Adjusting for risk factors, overall survival was significantly improved in the post-prostate-specific antigen era trial," the authors write. "However, it cannot be concluded that this was attributable only to prostate-specific antigen monitoring."

Several authors disclosed financial ties to pharmaceutical and biotechnology companies.

Abstract
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