(UroToday.com) At the 2021 American Urologic Association (AUA) annual meeting, the advanced prostate cancer session included Dr. Fred Saad discussing the effect of relugolix versus leuprolide on castration resistance-free survival (CRFS) among men included in the phase 3 HERO study. Androgen deprivation therapy is a foundational therapy for achieving castration levels for men with advanced prostate cancer and usually consists of gonadotropin-releasing hormone (GnRH) agonists and antagonists. Relugolix, an FDA-approved, oral GnRH receptor antagonist, is given once daily with an effective half-life of 25 hours. In the phase 3 HERO study, relugolix demonstrated suppression of testosterone to castrate levels in 96.7% of men, which was superior to leuprolide (88.8%).1 Relugolix was also well-tolerated and had a 54% lower risk of major adverse cardiovascular events relative to leuprolide. To further characterize the efficacy of relugolix, the HERO study assessed CRFS, a clinically relevant indicator of disease progression in the final analysis, in the overall modified intention-to-treat population as well as the metastatic disease cohort.