Given that outcomes in lower risk patients with non-metastatic disease were similar between degarelix and the LH-RH agonists (goserelin or leuprorelin), and there were no differences in PSA response between these agents, the seemingly inferior outcomes of degarelix in this study are unlikely to be due to its antitumor efficacy, but more likely reflect the real-world prescription pattern of PADT for HSPC. Here, KLK3 is linked to metastatic neoplasm.