Androgen deprivation therapy for prostate cancer: New developments

Experimental approaches to improve outcomes of prostate cancer include luteinizing hormone-releasing hormone antagonists for metastatic prostate cancer to prevent disease flare and neoadjuvant androgen deprivation therapy prior to definitive therapy for localized disease. Despite improved pathologic results with neoadjuvant hormonal therapy before radical prostatectomy, this approach remains controversial, since a benefit in outcomes has vet to be demonstrated in the underpowered studies performed to date; a large prospective, randomized study with adequate follow-up is necessary to resolve the issue. Interpretation of the radiotherapy trials is difficult because of imprecise and variable definitions of local control and inappropriately high thresholds for prostate-specific antigen relapse, as well as use of adjuvant therapy in some trials.