Intermittent vs. Continuous Androgen Deprivation Therapy for Nonmetastatic Prostate Cancer

Following the introduction and subsequent ubiquitous use of prostate-specific antigen (PSA) testing in the late 1980s, a number of “new” clinical states of prostate cancer were first appreciated, such as in patients with biochemical failure (rising PSA levels after definitive local radiotherapy). Although patients experiencing failure after local therapy represent a heterogeneous population with a variable and often long natural history, many were managed with androgen deprivation therapy (ADT) despite the lack of definitive evidence to support that approach.

In contrast to patients with metastatic disease, patients with PSA-only disease are often exposed to prolonged courses of ADT, which increases the risk for development of osteoporosis a…