The first diagnosis of failure of definitive treatment, as motivated according to the PSA level, subjects asymptomatic men to many years of androgen deprivation otherwise, adversely affecting their quality of life. Compelling laboratory evidence from pet models has suggested that reexposure to androgens over time of androgen ablation helps preserve hormonal responsiveness, and a number of phase 2 and 3 clinical studies with different inclusion criteria and treatment schedules have shown that the cyclic method of androgen deprivation is feasible and is connected with a decrease in toxic effects . However, evaluation of the effect on overall survival requires a randomized trial with sufficient duration and power of follow-up. For these reasons, the NCIC Clinical Trials Group undertook this stage 3 study in 1999, enrolling 1386 individuals over an interval of 6 years within an international cooperative work.This delayed advantage was subsequently quantified in a sensitivity analysis that included patients who had not had disease progression or passed away at 6 months; the median progression-free survival was much longer with nivolumab than with everolimus in this subgroup of patients. These patients most likely contributed to the overall survival advantage that was noticed with nivolumab in this research. We observed prolonged survival with nivolumab consistently, as compared with everolimus, regardless of the MSKCC prognostic score, number of previous antiangiogenic therapies, or region.