Future prospects for luteinizing hormone-releasing hormone analogues in prostate cancer treatment

Luteinizing hormone-releasing hormone (LHRH) analogues play a pivotal role in hormonal therapy regimens for the treatment of prostate cancer. Hormonal therapy has traditionally been used as a palliative treatment for patients with advanced disease, and international treatment guidelines do not recommend its use as a first-line therapy at earlier disease stages. However, there appears to be a gap between international guideline recommendations and actual clinical practice regarding the use of primary androgen deprivation therapy (PADT) for prostate cancer therapy. Despite limited evidence to date for the impact on clinical outcomes, the use of PADT in patients with localized or locally advanced prostate cancer has increased in many countries, most notably Japan. Clinical evidence is now accumulating to confirm the valuable role of PADT, both as monotherapy but particularly when used as part of a maximal androgen blockade regimen, on the long-term control of both localized and locally advanced disease, and importantly on survival outcomes in these patients.