Adam B. Weiner, Urologic Oncologist at Cedars Sinai Medical Center, shared on X:
“Exercise improved QoL for patients on ADT for prostate cancer and it costs less per QALY than most cancer drugs the NHS funds
The Lancet Oncology STAMINA trial:
- 700 men on ADT, median age 71.6, 34% metastatic, 19% on ARPI or chemo
- Randomized 5:4 vs an ACTIVE comparator: optimised usual care w/ clinician training and behavioural prompts
- 12 mo supervised aerobic + resistance exercise in community gyms, dietary advice, behavioural support, free membership
- FACT-P +4.5 (p=0.0004), FACT-G +3.7, above the >3 point clinically important threshold
- Fatigue (FACIT-F) +1.9 (p=0.0068)
- £13,920 to £19,077 per QALY. Median ICER for NICE-approved oncology drugs: £30,000
- Open label PROs, 97% of pts White, fatigue effect at the edge of MCID, physical outcomes unchanged
- 3 intervention-related SAEs, all recovered
- This beat an already-enhanced control, in a population including metastatic pts, delivered through community gyms at scale.
I think many of us have been telling patients for years to exercise while on ADT to reduce side effects, now we have trial-grade data!
‘The figure in this post is not from the paper, based on tabular data!’ ”
Title: An integrated lifestyle intervention for mitigation of adverse effects associated with androgen deprivation therapy for prostate cancer (STAMINA): a multicentre, randomised trial
Authors: Liam Bourke, Derek J Rosario, Sophie Reale, Said Ibeggazene, Aidan Innes, Alison Scope, Grace Price, Steph Taylor, Liz Steed, Eileen Sutton, Jamie Stokes, Jenny Hewison, Dylan Morrissey, Patrick Doherty, Janet Brown, David Meads, John L O’Dwyer, Davina Deniszczyc, Diana M Greenfield, Malcolm Mason, Michelle Collinson, Amanda Farrin
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