Androgen Deprivation Therapy (Adt) and Testosterone

Perachino, M.; Cavalli, V.; Ferraris, V.

doi:10.1016/s1569-9056(08)60529-1

Cited by 4 publications

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“…In addition, a retrospective review of 129 consecutive patients with a histological diagnosis of metastatic bony‐only prostate cancer and previously untreated with ADT by Perachino et al (2008) suggested a direct correlation between the risk of death and testosterone levels achieved during ADT. Data were analysed using Cox's proportional hazards models, with the primary endpoint being cancer‐specific survival.…”

Section: Current Androgen Deprivation Therapy—gnrh Agonistsmentioning

confidence: 99%

GnRH blockers: a changing paradigm in the management of prostate cancer

Drudge-Coates¹

2009

Int J of Uro Nursing

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For more than 60 years, androgen deprivation therapy, first with orchidectomy and more recently with gonadotrophin‐releasing hormone (GnRH) agonists, has been a key treatment approach in the management of advanced prostate cancer. In spite of showing comparable survival benefits, these two treatments are associated with both physical and psychological issues, with notable effects on patient quality of life. The development of GnRH blockers provides a new class of hormonal agent with a different, direct mode of action. Degarelix, a newly approved GnRH blocker, has displayed a fast, profound and sustained suppression of testosterone and prostate‐specific antigen levels without subsequent tumour flare effects. This paper considers the current evidence for this new treatment approach and how this may impact on current urology nursing practice.

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Section: Current Androgen Deprivation Therapy—gnrh Agonistsmentioning

confidence: 99%

GnRH blockers: a changing paradigm in the management of prostate cancer

Drudge-Coates¹

2009

Int J of Uro Nursing

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Testosterone levels in patients with metastatic prostate cancer treated with luteinizing hormone‐releasing hormone therapy: prognostic significance?

2010

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previously untreated with ADT. They were treated with 3 months of goserelin. Testosterone and prostate-specific antigen (PSA) levels were measured in all patients every 3 months for the duration of the follow-up. The following variables were recorded: age, stage, Gleason score, basal PSA level, basal testosterone level, PSA nadir, time to PSA nadir, testosterone after 6 months, testosterone nadir and time to testosterone nadir. Data were analysed using Cox's proportional hazards models, with the primary endpoint being cancer-specific survival. RESULTSThe mean ( SD ) basal PSA level was 185.8 (344.1) ng/mL, and the mean nadir PSA level 2.7 (8.6) ng/mL. The mean testosterone levels at baseline, 6 months and the nadir were 440 (200), 40 (40) and 21 (15) ng/dL. With a mean follow-up of 47.5 (29.7) months, 71 patients were dead (55%) and 78 were alive (45%) at the time of analysis. Statistical analysis using Cox's model showed that in these patients the risk of death was directly correlated not only to Gleason score ( P < 0.01) and to the 6-month PSA level ( P < 0.01), but also to the 6-month serum testosterone level (hazard ratio 1.32, P < 0.05). CONCLUSIONThese results suggest a direct correlation between the risk of death and testosterone levels achieved during ADT. Based on the present results, lowering the testosterone level as much as possible should be the goal of ADT in patients with metastatic prostate cancer, as this might affect patient survival. KEYWORDStestosterone, prostate cancer, survival, LHRH Study Type -Prognosis (case series) Level of Evidence 4 OBJECTIVE To determine if the testosterone level achieved with androgen-deprivation therapy (ADT) is directly related to survival and risk of death in men with metastatic prostate cancer, as agonistic analogues of luteinizing hormone-releasing hormones (LHRH) are indicated for palliative treatment of these patients, but there is no consensus about the utility of serum testosterone measurements during the follow-up, and their possible prognostic value. PATIENTS AND METHODSWe retrospectively reviewed 129 consecutive patients with a histological diagnosis of metastatic bony-only prostate cancer and

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Should we follow-up serum testosterone in patients with advanced prostate cancer?

Perachino

2010

Expert Review of Anticancer Therapy

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Agonistic analogs of luteinizing hormone-releasing hormones are indicated for the palliative treatment of metastatic prostate cancer. While the prognostic role of prostate-specific antigen in patients submitted to androgen-deprivation therapy has been extensively investigated in these patients, there is no consensus about the utility of serum testosterone measurements during follow-up and about their possible prognostic value. Recent reports have shown that testosterone levels might be directly related to survival and risk of death. These results need to be confirmed by further prospective studies. Given this concept, lowering testosterone as much as possible should be the goal of androgen-deprivation therapy in patients with metastatic prostate cancer, as this may have an impact on patient survival.

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Androgen Deprivation Therapy (Adt) and Testosterone

Cited by 4 publications

References 0 publications

GnRH blockers: a changing paradigm in the management of prostate cancer

GnRH blockers: a changing paradigm in the management of prostate cancer

Testosterone levels in patients with metastatic prostate cancer treated with luteinizing hormone‐releasing hormone therapy: prognostic significance?

Should we follow-up serum testosterone in patients with advanced prostate cancer?

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