Kishan AU, et al. - In this systematic review and meta-analysis of 992 patients with Gleason grade group (GG) 4 (formerly Gleason score 8) to GG 5 (formerly Gleason score 9-10) disease, researchers determined whether the effectiveness of androgen deprivation therapy (ADT) duration differs between patients with GG 4 vs GG 5 prostate cancer (PCa). In this analysis, they identified 593 male patients with GG 4 and 399 with GG 5. In patients with GG 4 disease, short-term ADT and long-term ADT only improved overall survival, and lifelong ADT only improved overall survival in patients with GG 5 disease. Overall, findings suggested that prolonged durations of ADT improve survival outcomes in both GG 4 and GG 5 disease, although with different optimal durations. Strategies should be explored that best maintain the effectiveness of ADT while minimizing its duration (potentially with enhanced potency agents).