Endocrine therapy in prostate cancer: time for reappraisal of risks, benefits and cost-effectiveness?
Bourke L, Kirkbride P, Hooper R, Rosario AJ, Chico TJ, Rosario DJ. Br J Cancer. 2013 Jan 15;108(1):9-13. doi: 10.1038/bjc.2012.523. Epub 2012 Nov 29.


Department of Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, LondonE1 2AT, UK.


In the 70 years following the first description of the benefits of surgical castration, despite advances in medical therapy e.g. cabazitaxel, enzalutamide, abiraterone, androgen deprivation therapy (ADT) remains the cornerstone of treatment for advanced prostate cancer. However, with increasing numbers of men undergoing PSA testing, the disease is being diagnosed earlier and the costs of ADT, with uncertain survival benefits and associated risks, have risen dramatically. Clinical studies of potent novel agents have shown survival benefits in advanced disease, but timing, risks and cost-effectiveness of treatment remain controversial. As new agents enter clinical practice, a comprehensive research strategy is essential to optimise benefits whilst minimising harm.