FRIDAY, April 10, 2026 (HealthDay News) -- For men with locally advanced prostate cancer, transdermal estradiol (tE2) patches are noninferior to luteinizing hormone-releasing hormone (LHRH) agonists as androgen deprivation therapy, according to a study published online March 25 in the New England Journal of Medicine.
Ruth E. Langley, M.B., B.S., Ph.D., from University College London, and colleagues conducted a phase 3, noninferiority, randomized trial involving men with locally advanced prostate cancer who received tE2 patches (100 µg estradiol every 24 hours) or LHRH agonists.
A total of 1,360 patients at 75 U.K. centers were recruited between 2007 and 2022. The researchers found that the observed three-year metastasis-free survival was 87.1 and 85.9 percent with tE2 and LHRH agonists, respectively (hazard ratio [HR] for confirmed metastasis or death, 0.96; upper limit of the one-sided 95 percent confidence interval [CI], 1.11, which met the criterion for noninferiority). Castrate levels of testosterone (<1.7 nmol/L) were sustained during the first year after randomization in 85 percent in each group among patients continuing their assigned treatment. Observed five-year overall survival was 81.1 and 79.2 percent with tE2 and LHRH agonists, respectively (HR for death, 0.90; 95 percent CI, 0.75 to 1.07). Hot flashes occurred in 44 and 89 percent of patients who received tE2 and LHRH agonists, respectively, and gynecomastia occurred in 85 and 42 percent, respectively.
"We believe our findings should lead to men with locally advanced prostate cancer being able to choose which hormone therapy suits them best. For some men, for instance, hot flushes can be very debilitating, and so the patches could greatly increase their quality of life," Langley said in a statement.
Several authors disclosed ties to the biopharmaceutical industry.