

More information on the proper use of the TRM can be found on the BJU International © 2014 BJU International.Technologies must be operated and maintained in accordance with Federal and Department security and

Phase III clinical trial advanced prostate cancer androgen-deprivation therapy palliation timing of treatment. The TOAD trial will contribute to answering at least in part, some of these questions.


Even with the advent of novel chemotherapy and the biological agents that are undergoing investigation for progressively earlier disease stages, the dilemma of when to commence palliative treatment in an asymptomatic patient will remain, unless or until these agents are shown to increase overall survival. The question of timing of ADT remains relevant in the current era of newer and more varied treatment methods. The study closed to follow-up at the end of 2013, with data analysis commencing mid-2014, and with the primary publication anticipated to be submitted by the end of 2014. Recruitment was slow, with fewer than half of the protocol requirement of 750 patients eventually accrued, but nonetheless it is considered that the trial will still contribute a major source of evidence in this area. An increase in overall survival at 5 years of 10% was judged to be clinically worthwhile. The principal hypothesis for the trial was that the early introduction of androgen-deprivation therapy (ADT experimental arm) at the time when curative therapies are no longer considered an option, would improve overall survival for these patients, whilst maintaining an acceptable quality of life compared with waiting for disease progression or the development of symptoms (control arm). To outline the development of the 'Timing of Androgen Deprivation' (TOAD) protocol, a collaborative randomised clinical trial under the auspices of the Cancer Council Victoria, the Trans-Tasman Radiation Oncology Group, and the Urological Society of Australia and New Zealand (USANZ), which opened to recruitment in 2004.
