Androgen-deprivation therapy in men with metastatic prostate cancer: less may not necessarily be more

Abstract

In a pivotal phase 3 randomized controlled trial, Hussain et al. tested the hypothesis that, with respect to survival, intermittent androgen deprivation therapy (ADT) is non-inferior to continuous in men with newly diagnosed metastatic prostate cancer. While the trial findings were statistically inconclusive, the study suggests, but does not prove, that intermittent may do more harm than good, although findings are not definitive. While outcomes of ongoing trials are awaited, the trial by Hussain et al., in conjunction with an earlier trial in men with non-metastatic prostate cancer by Crook et al., does provide important new guidance regarding the choice of ADT in men with androgen-sensitive prostate cancer.