Publications by authors named "H Kynaston"

Background And Objective: The use and duration of androgen deprivation therapy (ADT) with postoperative radiotherapy (RT) have been uncertain. RADICALS-HD compared adding no ("None"), 6-months ("Short"), or 24-mo ("Long") ADT to study efficacy in the long term.

Methods: Participants with prostate cancer were indicated for postoperative RT and agreed randomisation between all durations.

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Article Synopsis
  • A clinical trial called RADICALS-HD studied the effects of adding short-course androgen deprivation therapy (ADT) to postoperative radiotherapy in patients with localized prostate cancer after surgery.
  • It involved 1480 patients, examining how ADT impacts metastasis-free survival compared to radiotherapy alone, and measured outcomes like distant metastasis and overall survival.
  • The trial aimed to see if combining ADT with radiotherapy could improve the 10-year metastasis-free survival rate, potentially increasing it from 80% to 86%.
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Article Synopsis
  • The study investigates the effectiveness and optimal duration of androgen deprivation therapy (ADT) combined with postoperative radiotherapy for patients with localized prostate cancer following radical prostatectomy.
  • A randomised controlled trial, RADICALS-HD, compared short-course ADT (6 months) to long-course ADT (24 months) among participants who met specific criteria, including PSA levels and absence of metastatic disease.
  • The primary outcome measured was metastasis-free survival, with the trial aiming to determine if longer ADT duration leads to better survival rates, involving over 1,500 patients from 2008 to 2015.
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As the treatment landscape for prostate cancer gradually evolves, the frequency of treatment-induced neuroendocrine prostate cancer (NEPC) and double-negative prostate cancer (DNPC) that is deficient for androgen receptor (AR) and neuroendocrine (NE) markers has increased. These prostate cancer subtypes are typically refractory to AR-directed therapies and exhibit poor clinical outcomes. Only a small range of NEPC/DNPC models exist, limiting our molecular understanding of this disease and hindering our ability to perform preclinical trials exploring novel therapies to treat NEPC/DNPC that are urgently needed in the clinic.

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Background: The optimal timing of radiotherapy (RT) after radical prostatectomy for prostate cancer has been uncertain. RADICALS-RT compared efficacy and safety of adjuvant RT versus an observation policy with salvage RT for prostate-specific antigen (PSA) failure.

Patients And Methods: RADICALS-RT was a randomised controlled trial enrolling patients with ≥1 risk factor (pT3/4, Gleason 7-10, positive margins, preoperative PSA≥10 ng/ml) for recurrence after radical prostatectomy.

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