Key clinical point: Prostate-specific antigen (PSA) levels >1.5 ng/mL before salvage radiotherapy (SRT) are significantly associated with an overall survival (OS) benefit from bicalutamide in biochemically recurrent prostate cancer.

Major finding: In men with pre-SRT PSA levels ≥1.5 ng/mL, bicalutamide vs. placebo was associated with an OS benefit with a 25% 12-year absolute benefit (hazard ratio [HR], 0.45; P = .01) and decreased the risk of distant metastasis (subdistribution HR, 0.67; P = .03).

Study details: In this secondary analysis of phase 3 RTOG 9601 study, 760 patients with recurrent prostate cancer who had PSA elevation after radical prostatectomy were randomly assigned to either SRT+bicalutamide or placebo.

Disclosures: Several of the investigators reported receiving grants and personal fees from multiple pharmaceutical companies.