This is the best review article of 2016 on research that is currently underway to improve when and how ADT is administered to optimize therapy. It starts with the assumption that LHRH drugs are the mainstay for ADT, but then looks at all the research underway to improve upon that. One of the conclusion that come out of this review is that patients on ADT should check their testosterone level and strive to get it below 20 ng/dl. Another conclusion is that combined androgen blockade, using both an LHRH drug and an anti-androgen, may be more beneficial for men who have a good prognosis than those with a poor prognosis. Similarly, chemotherapy with docetaxel combined with LHRH is likely to be more beneficial when given before the cancer spreads outside the prostate gland or becomes resistant to ADT.
The article has two large tables that summarize the MANY clinical studies now underway to look at combinations of old (e.g., Lupron, Zoladex, anti-androgen) and new (e.g., Enzalutamide, Abiraterone, radium 223) drugs. The article makes a good case that within the next decade ADT protocols will be both more complex and personalized, taking into consideration patients’ disease burden and genetics.
Merseburger AS, Hammerer P, Rozet F, Roumeguere T, Caffo O, da Silva FC, Alcaraz A. 2014. Androgen deprivation therapy in castrate-resistant prostate cancer: how important is GnRH agonist backbone therapy? World J Urol 33(8):1079-1085. www.ncbi.nlm.nih.gov/pubmed/25261259