What data support the use of continuing GnRH therapy "backbone" in metastatic castration resistant prostate cancer (mCRPC) receiving additional therapies?

Long-term ADT is deleterious to multiple organ systems (bone/sexual/psychiatric) and increases the risk of MACE. What level 1 evidence do we have to continue GnRH therapy in metastatic prostate cancer after progression to castration resistant disease? In selected cases, can ADT be safely withdrawn with close monitoring for PD in the mCRPC setting?

Answer from: Medical Oncologist at Academic Institution

The short answer is that ALL phase 3 trials of life-prolonging therapies now approved in mCRPC required ongoing ADT (medical or surgical) and there is not a single positive life-prolonging phase 3 trial that did not do this. Until then our strongest evidence is to follow how these trials were conduc...

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Medical Oncologist at University of Minnesota–Masonic Cancer Center
I fully agree with Dr. @Armstrong.

Answer from: Medical Oncologist at Community Practice

The best paper that has tackled this question recently is this one (it's a good read):Sena et al., PMID 37244750

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What data support the use of continuing GnRH therapy "backbone" in metastatic castration resistant prostate cancer (mCRPC) receiving additional therapies?

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