Continuous androgen deprivation therapy (cADT) is the standard management for metastatic prostate cancer (mPCa). Intermittent androgen deprivation therapy (iADT) is sought to have better quality of life (QoL) and adverse events profile during off-treatment period. This multicentre European randomised study was the ‘first’ to prospectively assess the difference between both modalities in patients with mPCa who initially responded to the six-month-induction course of ADT. Over 170 patients with mPCa were included in the study between 1996 and 2005 after responding to induction ADT. They were randomised to either cADT or iADT. Mean follow-up was close to four years. No significant difference in either overall survival or progression-free survival was observed between the two groups. Moreover, no clinically significant difference in QoL was shown. It was noticed, however, that iADT has less adverse events such as hot flushes, headache and joint pains compared to cADT. In this study, the authors concluded that iADT has better tolerability and hence should be considered in patients suffering from side-effects of the treatment. Limitations to this study were recognised including under-power and a declared conflict of interest. Despite that, the study provided level one evidence in the management of mPCa.

Intermittent hormonal therapy in the treatment of metastatic prostate cancer: a randomized trial.
Mottet N, Damme JV, Loulidi S, et al.
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Ayman Younis


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