Core message:
Hormone therapy doesn’t just palliate; it changes natural history when used correctly and long enough.
(EBCTCG 2023; NCCN 2025)
| Setting | Typical survival gain | Notes |
|---|---|---|
| ER + Breast (AI vs Tamoxifen) | ~30 % ↓ recurrence / ~15 % ↓ mortality | 5 y AI > 5 y Tamoxifen |
| Breast, extended AI 10 y | Additional ~3–5 % DFS benefit | Bone loss doubles |
| Locally advanced Prostate (ADT + RT vs RT alone) | ~20 % ↑ 15-y OS | Max benefit with 24–36 mo ADT |
| Metastatic Prostate (ADT + AR blocker) | +12–24 mo median OS | Largest modern improvement |
Predictors of benefit
-
Receptor expression level (>10 % cells = best).
-
Early PSA/estradiol nadir.
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Longer time to biochemical relapse.
-
Absence of visceral metastases.
