OncLive® On Air S14 Ep38: Ongoing ADT Use and Research Emphasizes the Importance of Shared Decision-Making in Prostate Cancer Care: With Neal Shore, MD, FACS
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Oct 31, 2025 
Neal Shore, MD, FACS, is a GU oncologist and medical director of the Carolina Urologic Research Center, specializing in prostate cancer management. In this engaging discussion, he elaborates on the latest guidelines for androgen deprivation therapy (ADT) and emphasizes the critical nature of shared decision-making in treatment. Dr. Shore highlights the safety and quality of life impacts of ADT, including strategies to mitigate its adverse effects and the role of a multidisciplinary team in ensuring optimal care.
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Counsel Before Starting ADT
- Obtain a baseline testosterone and counsel patients on the full range of ADT adverse effects before starting therapy.
- Discuss hot flashes, sexual dysfunction, weight gain, sarcopenia, bone loss, and cardiometabolic risks as part of shared decision-making.
Potential Cardio Benefit Of Antagonists
- Emerging data suggest antagonists like relugolix may reduce major adverse cardiovascular events versus agonists.
- Definitive phase 3 evidence is pending, but multiple trials and real-world data point in this direction.
Consider Relugolix For Flexibility And Risk
- Consider relugolix for patients who need flexibility, rapid testosterone recovery, or who have cardiovascular risk factors.
- Monitor for drug–drug interactions in polypharmacy but note trials show acceptable DDI and tolerability with AR pathway inhibitors.