Androgen deprivation therapy in castrate-resistant prostate cancer: how important is GnRH agonist backbone therapy?

Background: A growing number of treatment options exist to treat metastatic castrate-resistant prostate cancer (mCRPC), and with these newer options, many questions about optimising treatment remain unanswered. One recommendation that may potentially be overlooked by practitioners is that androgen deprivation therapy (ADT) should be maintained when CRPC develops and when treatment with any of the newer agents is initiated. Aim: However, to emphasise this recommendation, it is valuable to interrogate the evidence for maintaining ADT in different clinical situations. Outcome: This statement, reflecting the views of the authors, provides a discussion of this evidence and the rationale behind the recommendation that ADT should be continued in CRPC.