When should you start ADT if your PSA starts to climb after primary treatment for prostate cancer?

Two groups compared, both with about 145 men. At five year mark, there was a slight statistical survival advantage for the patients started on ADT immediately upon biochemical failure. In the delayed arm 86.4% were alive at 5 years. That rose to 91.2% for those who started ADT earlier.


Duchesne GM, Woo HH, Bassett JK, Bowe SJ, D'Este C, Frydenberg M, King M, Ledwich L, Loblaw A, Malone S, Millar J, Milne R, Smith RG, Spry N, Stockler M, Syme RA, Tai KH, Turner S. 2016. Timing of androgen-deprivation therapy in patients with prostate cancer with a rising PSA (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial. Lancet Oncol [Epub ahead of print] 4 May 2016. www.ncbi.nlm.nih.gov/pubmed/27155740