• LHRH agonists such as leuprolide in daily or depot preparations. (These agents may be associated with tumor flare when used alone; therefore, the initial concomitant use of antiandrogens should be considered in the presence of liver pain, ureteral obstruction, or impending spinal cord compression.)[18,20,21,41][Level of evidence: 1iiA] 3.Leuprolide plus flutamide;[42] however, the addition of an a