Oncology

Prostate Cancer

Expert Roundtables Podcast: Optimizing Androgen Deprivation Therapy by Integrating Risk-Benefit Profiles

expert roundtables by Neeraj Agarwal, MD, FASCO; Judd W. Moul, MD; Matthew R. Smith, MD, PhD

Overview

<p>In this Expert Roundtables conversation, our experts delve into ADT optimization by balancing risk-benefit profiles, exploring ADT’s association with cardiovascular disease and the potential role of intermittent ADT in reducing toxicities.</p>

References

Bhatia N, Santos M, Jones LW, et al. Cardiovascular eﬀects of androgen deprivation therapy for the treatment of prostate cancer: ABCDE steps to reduce cardiovascular disease in patients with prostate cancer. Circulation. 2016;133(5):537-541. doi:10.1161/CIRCULATIONAHA.115.012519

Campbell P, Gebrael G, Narang A, et al. Testosterone suppression and recovery in patients with advanced prostate cancer treated with intermittent androgen deprivation therapy with relugolix. Ther Adv Urol. 2024;16:17562872241293779. doi:10.1177/17562872241293779

Freedland SJ, Tutrone R, Saad F, et al. Testosterone recovery following treatment suspension of enzalutamide plus leuprolide or leuprolide alone in patients with high-risk biochemically recurrent prostate cancer: EMBARK post hoc analysis. J Urol. 2025;213(suppl 5):e506. doi:10.1097/01.JU.0001109880.25183.6b.03

Hu JR, Duncan MS, Morgans AK, et al. Cardiovascular effects of androgen deprivation therapy in prostate cancer: contemporary meta-analyses. Arterioscler Thromb Vasc Biol. 2020;40(3):e55-e64. doi:10.1161/ATVBAHA.119.313046

Keating NL, O’Malley AJ, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol. 2006;24(27):4448-4456. doi:10.1200/JCO.2006.06.2497

Nabid A, Carrier N, Vigneault E, et al. Testosterone recovery after androgen deprivation therapy in localised prostate cancer: long-term data from two randomised trials. Radiother Oncol. 2024;195:110256. doi:10.1016/j.radonc.2024.110256

Ong M, Roy S, Chi KN, et al. Prognostic significance of PSA>0.2 after 6-12 months treatment for metastatic hormone-sensitive prostate cancer (mHSPC) intensified by androgen-receptor pathway inhibitors (ARPI): a multinational real-world analysis of the IRONMAN registry. J Clin Oncol. 2025;43(suppl 16):5002. doi:10.1200/JCO.2025.43.16_suppl.5002

Ong M, Sokolova A, Hotte SJ, et al. TRIPLE-SWITCH (SWOG/CCTG-PR26): a randomized phase III clinical trial for the addition of docetaxel to androgen receptor pathway inhibitors in patients with metastatic castration sensitive prostate cancer (mCSPC) and suboptimal PSA response (NCT06592924). J Clin Oncol. 2025;43(suppl 16):TPS5129. doi:10.1200/JCO.2025.43.16_suppl.TPS5129

Perera M, Roberts MJ, Klotz L, et al. Intermittent versus continuous androgen deprivation therapy for advanced prostate cancer. Nat Rev Urol. 2020;17(8):469-481. doi:10.1038/s41585-020-0335-7

Tutrone R, Saad F, George DJ, et al. Testosterone recovery for relugolix versus leuprolide in men with advanced prostate cancer: results from the phase 3 HERO study. Eur Urol Oncol. 2024;7(4):906-913. doi:10.1016/j.euo.2023.11.024

Profile

Neeraj Agarwal, MD, FASCO

Professor of Medicine
Presidential Endowed Chair of Cancer Research
Senior Director for Clinical Research
Director, Genitourinary Oncology Program and Center of Investigational Therapeutics
Huntsman Cancer Institute
University of Utah
Salt Lake City, UT

Profile

Judd W. Moul, MD

James H. Semans, M.D. Distinguished Professor of Urologic Surgery
Professor in Anesthesiology
Department of Urology
Member, Duke Cancer Institute
Duke University School of Medicine
Durham, NC