Current Role of Neoadjuvant and Adjuvant Systemic Therapy for High-risk Localized Prostate Cancer

Purpose of review While most men are diagnosed with readily curable localized prostate cancer, those with high risk features face a significant mortality risk. Androgen deprivation therapy (ADT) is a standard adjunct to radiotherapy for high-risk prostate cancer, but its role around prostatectomy has not been as clearly defined, and concerns over cardiovascular toxicity have led to decreasing use. The use of chemotherapy for localized disease remains experimental. We review the most recently published trials of neoadjuvant or adjuvant systemic therapy for prostate cancer.