Fitting Oral ADT Options Into the Prostate Cancer Treatment Plans

EP: 1.The Current Landscape of ADT in Prostate Cancer

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EP: 2.Fitting Oral ADT Options Into the Prostate Cancer Treatment Plans

EP: 3.Initiating ADT: Factors to Consider

EP: 4.Adherence of Various ADT Options

EP: 5.Guideline Recommendation for ADT Treatment in Prostate Cancer

EP: 6.Navigating Newer ADT Combination Therapies in the Absence of Prospective Data

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Oral androgen deprivation therapy (ADT) options like relugolix fit seamlessly into various prostate cancer treatment scenarios, from unfavorable intermediate-risk localized disease requiring radiation therapy to advanced metastatic cases. Kelly L. Stratton, MD, FACS, emphasizes that the versatility of oral agents makes them particularly valuable for patients with high-volume metastatic hormone-sensitive disease, where immediate testosterone suppression is crucial and the risk of testosterone flare with traditional agonists is most concerning.

The convenience factor becomes especially relevant in modern prostate cancer care, where patients increasingly receive combination therapies including androgen receptor pathway inhibitors. Since patients are already managing oral medications like abiraterone or enzalutamide, adding an oral ADT simplifies the overall treatment regimen and reduces the complexity of coordinating multiple therapies. This streamlined approach can improve patient adherence and reduce the burden of frequent clinic visits for injections.

For patients with prostate-specific antigen recurrence after local therapy, oral ADT offers particular advantages in terms of rapid recovery. The HERO study demonstrated that over 50% of patients had normalized testosterone within 90 days of stopping relugolix, compared with potentially months or even permanent suppression with injectable agents. This rapid recovery capability makes oral ADT ideal for intermittent therapy approaches and patients who desire to minimize the duration of treatment-related side effects while maintaining treatment efficacy.