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Invited Commentary
April 2016

Harms of Intermittent vs Continuous Androgen-Deprivation Therapy for Prostate Cancer

Author Affiliations
  • 1CancerCare Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
  • 2Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
JAMA Oncol. 2016;2(4):461-462. doi:10.1001/jamaoncol.2015.4682

Discussion about the relative merits of intermittent vs continuous androgen-deprivation therapy (ADT) for treatment of prostate cancer has for many years occupied prostate cancer researchers and patients. The concept of intermittent ADT is based on evidence from animal models that development of the castration-resistant state may be delayed as compared with continuous ADT1 and that reduced exposure to ADT is likely to be associated with less likelihood of harms from treatment. Several randomized clinical trials (RCTs) and 4 meta-analyses have since compared intermittent with continuous ADT in men with various stages of prostate cancer and have failed to demonstrate better survival with one strategy vs the other. Data on adverse events (AEs) and quality of life (QOL) are even less consistent and inadequately reported by most trials.

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