Is Intermittent Androgen Deprivation Therapy Beneficial For Advanced Prostate Cancer Patients?
Wolff JM, Abrahamsson PA, Irani J, Calais da Silva F. BJU Int. 2014 Jan 17. doi: 10.1111/bju.12626. [Epub ahead of print]

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Department of Urology, AKH Viersen, Germany.


Use of intermittent androgen deprivation therapy (IADT) in patients with prostate cancer (PCa) has been evaluated in several studies, in an attempt to delay the development of castration resistance and reduce side effects associated with ADT. However it is still not clear whether survival is adversely affected in patients treated with IADT. In this review, we explore the available data in an attempt to identify the most suitable candidate patients for IADT, and discuss factors that may inform appropriate patient stratification. ADT is first-line treatment for advanced/metastatic PCa and is also recommended for use with definitive radiotherapy for high-risk localised PCa. The changes in hormone levels induced by ADT can lead to short- and long-term side effects which, although treatable in most cases, can significantly reduce the tolerability of ADT treatment. IADT has been investigated in several phase 2 and phase 3 studies in patients with locally advanced or metastatic PCa, in an attempt to delay time to tumour progression and reduce the side effect burden of ADT. In selected patient groups IADT is no less effective than continuous ADT, ameliorating the impact of ADT-related side effects, and, to a degree, their impact on patient quality of life (QoL). Further comparative study is required, particularly in relation to QoL and long-term complications associated with ADT.