TABLE 6.

Treatment Recommendations for Newly Diagnosed Metastatic Hormone-sensitive Prostate Cancer

National Comprehensive Cancer Network	European Association of Urology
GnRH agonist + first-generation anti-androgen (nilutamide, flutamide, bicalutamide) ± docetaxel GnRH agonist + abiraterone GnRH antagonist ± docetaxel GnRH antagonist ± abiraterone Orchiectomy ± abiraterone	Immediate systemic treatment (ADT) for symptomatic or asymptomatic disease Orchiectomy or ADT + docetaxel if fit enough for chemotherapy Surgery and or local radiotherapy if evidence of impending complications such as spinal cord compression or bone fracture Castration + abiraterone + prednisone if fit enough for this regimen No anti-androgen monotherapy LHRH antagonists, especially if impending spinal cord compression or bladder outlet obstruction Short-term anti-androgens for patients treated with LHRH agonist to reduce risk of flare	Strong
		Weak

ADT, androgen deprivation therapy.