What is the minimum duration to be on bicalutamide prior to starting GnRH agonist in de novo metastatic prostate cancer with significant bone disease?  

The onset of action for bicalutamide is rapid--typically slightly more than a day to reach maximum/peak concentration. In contrast, the pharmacological effect of leuprolide is related to the time to testosterone suppression which occurs approximately 2-4 weeks after starting. So the time to testoste...