Transdermal Estradiol Patches in Locally Advanced Prostate Cancer

New England Journal of Medicine 2026

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Authors: R. Langley, Duncan C. Gilbert, Stephen Mangar, S. Rosen, Ellie Bourmaki, Hannah L. Rush, Subramaniam Kananga Sundaram, Abdulla Alhasso, Roger Kockelbergh, Hoda Abdel-Aty, Claire Amos, Louise Brown
+40 more Simon Brown, C.S. Carvalho, Kitty S. Chan, Gerald N. Collins, William Cross, John Deighan, Sanjay Dixit, Trinh Duong, James Dyer, Joanna Gale, Silke Gillessen, Anna L. Griffiths, Marc Laniado, Anna Lydon, N. McPhail, Archie Macnair, Sanjeev Madaan, John Marshall, David Matheson, Robin Millman, Wael Mohamed, Laura Murphy, Krishna Narahari, Christopher Parker, Miguel Panades, A. Pope, Arpita Raval, Angus Robinson, Martin Russell, Christopher Scrase, Matthew R. Sydes, Rafał Turo, R. Venkitaraman, Simona Wade, Howard Kynaston, Gerhardt Attard, Nicholas D. James, Noel Clarke, Mahesh K. Parmar, Matthew Nankivell
DOI: 10.1056/nejmoa2511781
Cited by: 10
References: 28

Abstract

BACKGROUND: Transdermal estradiol (tE2) is an alternative to luteinizing hormone-releasing hormone (LHRH) agonists as androgen-deprivation therapy in patients with prostate cancer. With tE2, testosterone is suppressed, and the side effects of estrogen depletion due to LHRH agonists and the thromboembolic side effects of oral estrogen are mitigated. METHODS: In this phase 3, noninferiority, randomized trial, we assigned men with locally advanced (M0 and N0 or N+) prostate cancer to receive tE2 patches (100 μg of estradiol every 24 hours) or LHRH agonists. The primary outcome was 3-year metastasis-free survival. The noninferiority margin was 4 percentage points; this corresponded to a target hazard ratio of 1.31, as derived from the observed 3-year metastasis-free survival in the LHRH agonist group. Secondary outcomes included castrate levels of testosterone (

Fields of Study & Subjects

Prostate Cancer Treatment and Research Prostate Cancer Diagnosis and Treatment Estrogen and related hormone effects

Publication details

Journal / source
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Volume
394
Issue
16
Pages
1595–1607
Publication date
25 March 2026
Language
EN