Androgen Deprivation Therapy (ADT) is the foundational treatment for metastatic hormone-sensitive prostate cancer (mHSPC). It works by suppressing testosterone production, which slows or stops the growth of prostate cancer cells that still depend on androgens.

In mHSPC, ADT is almost always combined with additional systemic therapy to improve survival. These combinations include:

-ADT + Docetaxel chemotherapy (especially for high-volume disease)

-ADT + Abiraterone (with prednisone)

-ADT + Enzalutamide or Apalutamide

The choice of agent and combination depends on disease volume, patient age, comorbidities, and treatment goals. While effective, long-term ADT can cause side effects such as fatigue, hot flashes, sexual dysfunction, and metabolic changes.