Endpoint Breast (Endocrine vs Chemo) Prostate (ADT combinations)
Overall Survival (OS) Similar for low-risk ER+; AI + targeted > AI alone ADT + AR antagonist ↑ OS 30–35% vs ADT alone
Disease-Free Survival (DFS) ↑ ~40–50% with endocrine therapy vs none ↑ ~20–30% with long-term ADT vs short-term
QoL impact Hot flushes, arthralgia, sexual dysfunction, osteopenia Fatigue, loss of libido, metabolic changes
Bone health loss AIs > SERMs ADT (esp. > 12 mo)
Mitigation DEXA + bisphosphonates / denosumab Same + exercise / vitamin D

Patient-reported scores

  • FACT-P: maintained better QoL with intermittent ADT.

  • EORTC QLQ-C30: most domains recover within 6 months post-therapy pause.

  • IPSS: often improves when prostate volume shrinks after ADT.

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