## 5 Discussion  
The last part of this study was an exhaustive search of the official databases of the American Society of Clinical Oncology for clinical trials of neoadjuvant and adjuvant therapy for prostate cancer to find the contribution of these trials to clinical practice regarding prostate cancer management [146]. Enzalutamide, abiraterone, and apaltamide were the most frequently investigated drugs in neoadjuvant conventional androgen deprivation therapy. Abiraterone and prednisone were the most studied drugs in adjuvant therapy. This observation may mean that drugs whose efficacy has been proven are investigated in neoadjuvant therapy for cancers with a poor prognosis. However, effectiveness of these drugs was also examined in phase I trials. Therefore, using these drugs earlier may help manage the disease and increase the quality of life due to better control of symptoms or improving pathological outcomes of patients, as proven in another meta-analysis [147]. On the other hand, leuprolide was maintained in adjuvant therapies as a basal treatment in hormone therapy while abiraterone was the most investigated new drug in the adjuvant therapy group (43.84%). Another meta-analysis by [PERSON] et al. [148] showed that adjuvant androgen hormone therapy improved overall survival and reduced recurrences and specific mortality. Whether or not this improvement was related to a particular molecule is unclear, given that more than one molecule was included in their analysis, much like our own research. Another meta-analysis compared the efficacy of these drugs concluding that there were no significant differences between these new molecules [149]. Target therapies were investigated in both fields (neoadjuvant and adjuvant). Still, we observed an interesting contrast in the type of drug used in each group. In neoadjuvant therapies, drugs targeting GnRH and LHRH receptors were more frequently investigated, while in adjuvant therapies the androgen receptor and CYP17 were the most frequent. It should be highlighted that both phase I (trials to evaluate drug safety) and phase II (first efficacy evaluation) were more frequently found in neoadjuvant therapy trials. In contrast, phase III, which is used to compare efficacy with the standard treatment, was more frequently found in adjuvant trials. The average length of trials was 3.125 years, consistent with the established length of an average of 8 years for developing phases I, II and III within clinical trials [150]. As for the sponsors of clinical trials of this study, approximately half were funded by pharmaceutical companies and the other half by public entities, with a slight predominance of the latter. This is probably due to the lack of information, especially from clinical trials in the early stages, since the sponsor is usually a pharmaceutical company. Clinical trials were mainly carried out in the U.S.A., followed by Canada. This makes sense since our search was performed in the American Society for Clinical Oncology database [146]. The mean number of patients included was 178.68, ranging from 11 to 1273 patients. These data are consistent with those estimated for each phase: phase I (between 10-30 patients), phase II (less than 100 patients) and phase III (between hundreds and thousands of patients) [151]. Not having any masking was the most common in both groups; that is, all parties (both patients and professionals) were aware of the treatment received by patients [152]. In GA, successive assignment was the most frequent allocation technique used, whereas random assignment was most frequent in GB. This means that there were more risks using random assignment in GB, including trials with lower survival probability.