Doehn et al death (adjusted HR: 1.16; p 0.003). In 6.9% of patients an orchiectomy was performed for androgen deprivation therapy. It is noteworthy that in these patients a greater risk for diabetes (adjusted HR: 1.34; p 0.001) compared to no therapy was also found but this was not the case for coro- nary heart disease (adjusted HR 0.99; p = 0.74), myocardial infarction (adjusted HR: 0.94; p = 0.44), and sudden cardiac death (adjusted HR: 1.91; p = 0.85).28 In summary, degarelix is associated with a rapid, profound, and sustained suppression of testosterone in patients with prostate cancer. Antiandrogens to prevent testosterone surge and prevent clinical ﬂare are not required. This may reduce costs and adverse events from the antiandrogen. Thus, a GnRH antagonist rather than a GnRH agonist may be used in patients with high tumor burden and/or acute problems such as spinal cord compression. In contrast to other GnRH antagonists degarelix was not associated with systemic allergy reaction. In the phase III trial, however, two adverse events occurred more often with degarelix compared to leurolide: injection site reactions (40% vs 1%) and unexplained chills following the application degarelix (4% vs 0%). Beside adverse events there is currently no three- month formulation of degarelix available. A three-month interval for the application of GnRH agonists is convenient for the patient and currently the most often applied regimen. The phase III trial by Klotz and colleagues was not blinded and all patients “in whom androgen deprivation therapy was indicated” were included. What we don’t have for degarelix is data on cancer-speciﬁc survival and overall survival as well as any data in patients undergoing intermittent androgen deprivation therapy and complete androgen blockade. 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