Fig. 5: Administering IADT without induction period increases TTP when compared with IADT with induction and continuous ADT.

a–d Treatment times for a Bruchovsky trial data and simulations of b extrapolated IADT with induction, c IADT without induction, and d continuous ADT. Red and black denote when treatment is on and off, respectively. e Kaplan–Meier estimates of progression comparing IADT with induction (black curve) against IADT without induction (blue) and continuous ADT (gray) (double S indicates predictive model simulation). With and without induction period, IADT TTP increases when compared with continuous therapy TTP. Red symbols denote patients who experienced an adverse event/death prior to the conclusion of the trial. Statistical significance was determined using logrank test (IADT w/o induction vs. continuous: p = 0.073, IADT w/induction vs. continuous: p = 0.129, IADT w/induction vs. w/o induction: p = 0.795). f TTP comparison between IADT with induction (black), continuous therapy (gray), and IADT without induction (blue). Open circles denote end of simulation (EOS). Red dots denote patients who experienced an adverse event/death prior to the conclusion of the trial. Solid lines denote mean TTP (67.11, 57.25, and 71.87 months for IADT with induction, continuous therapy, and IADT without induction, respectively). The average TTP is longer with IADT without induction, compared with IADT with induction and continuous ADT. g Simulation results for Patient 054 (IADT with induction (black curve), without induction (blue curve), and continuous ADT (gray)). With IADT with induction, the patient became resistant after 49 months. Simulating continuous ADT would result in progression after 24 months. Simulating IADT without the induction would increase TTP by 5 months. PCaSC dynamics show that treatment selects for PCaSC population, accelerating resistance development. Dashed curve represent time when ADT is off.