Transdermal estradiol for androgen suppression in locally advanced prostate cancer

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Transdermal estradiol for androgen suppression in locally advanced prostate cancer​



Duncan Gilbert, MA, MRCP, FRCR, PhD, University College London, London, UK, discusses the Phase III PATCH trial (ISRCTN70406718), which investigated transdermal estradiol as an alternative to traditional androgen suppression (LH-RH analogues) in men with locally advanced, treatment-naive prostate cancer. Patients from the STAMPEDE trial (ISRCTN78818544) were additionally recruited and results from the locally advanced cohort were presented. Patients were randomized between standard LH-RH therapy and the experimental use of transdermal estradiol patches. This interview took place at the European Society for Medical Oncology (ESMO) 2024 Congress in Barcelona, Spain.
 
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PATCH: transdermal estradiol versus LH-RH analogues in prostate cancer​



Duncan Gilbert, MA, MRCP, FRCR, PhD, University College London, London, UK, comments on findings from the PATCH trial (ISRCTN70406718) of transdermal estradiol for androgen suppression in prostate cancer. Prior results showed that transdermal estradiol achieved sufficient testosterone suppression, improved bone density, and enhanced quality of life by reducing hot flushes, although gynecomastia was reported in some patients. Transdermal estradiol was additionally found to be non-inferior to LH-RH analogues in terms of metastasis-free survival. This interview took place at the European Society for Medical Oncology (ESMO) 2024 Congress in Barcelona, Spain.
 

The future of transdermal estradiol in managing prostate cancer​



Duncan Gilbert, MA, MRCP, FRCR, PhD, University College London, London, UK, explores the potential of transdermal estradiol as a viable alternative to LH-RG analogs for androgen deprivation therapy in men with prostate cancer. The key benefits of transdermal estradiol include reduced hot flushes and improved long-term bone health, while noting that transdermal estradiol patches are not yet licensed for this indication. With positive oncological outcomes, there is hope for future integration within the NHS, providing men with prostate cancer an additional treatment option. This interview took place at the European Society for Medical Oncology (ESMO) 2024 Congress in Barcelona, Spain.
 

Estrogen patches as a safer androgen suppression alternative in prostate cancer​



Duncan Gilbert, MA, MRCP, FRCR, PhD, University College London, London, UK, discusses the role of androgen suppression in prostate cancer treatment, traditionally achieved with LH-RH analogues, which lower testosterone but also reduce estrogen, leading to side effects like hot flushes, fatigue, and bone health deterioration. A safer alternative is using estrogen patches, which suppress testosterone without reducing estrogen, mitigating these side effects. Unlike oral estrogen, which increases cardiovascular risks, patches bypass liver metabolism and have shown no increased cardiovascular risk. This interview took place at the European Society for Medical Oncology (ESMO) 2024 Congress in Barcelona, Spain.
 
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