Correlation Between Testosterone and PSA Kinetics in Metastatic Prostate Cancer Patients Treated With Diverse Chemical Castrations

Reis, Leonardo Oliveira; Denardi, Fernandes; Faria, Eliney Ferreira; Silva, Élcio Dias

doi:10.1177/1557988314552468

Cited by 7 publications

(9 citation statements)

References 32 publications

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“…A possible change in the threshold makes it important to find out whether the currently available LHRH agonists differ in effectiveness for obtaining chemical castration at a new, lower threshold. In comparing the potency for lowering serum testosterone levels of different LHRH agonist, a recent study reported mean serum testosterone levels after 3 months of treatment were the lowest with leuprolide 7.5 mg, followed by goserelin 3.7 mg and leuprolide 3.75 mg [19]. Another study found that maintenance of castration was better with triptorelin pamoate 3.75 mg than leuprolide acetate 7.5 mg, but the difference was not statistically significant [7].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of three different luteinizing hormone-releasing hormone agonists in the chemical castration of patients with prostate cancer: Goserelin versus triptorelin versus leuprolide

Shim

Bang

et al. 2019

Investig Clin Urol

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Purpose To investigate the changes in testosterone levels and rates of chemical castration following androgen-deprivation therapy (ADT) with goserelin, triptorelin, and leuprolide. Materials and Methods We retrospectively reviewed the medical records of 125 patients with prostate cancer treated with luteinizing hormone-releasing hormone (LHRH) agonists between January 2009 and December 2015. Changes in testosterone concentration during 9 months of ADT with goserelin 11.34 mg, triptorelin 11.25 mg, and leuprolide 11.25 mg were analyzed using a mixed model. The number of patients with serum testosterone below castration levels defined as various values (<50 ng/dL, <20 ng/dL, or <10 ng/dL) at 3, 6, and 9 months were also evaluated. Results Of the 125 patients, 59 received goserelin, 44 received triptorelin, and 22 received leuprolide, respectively. The lowest mean testosterone levels during 9 months of treatment were achieved in patients treated with triptorelin, followed by those treated with leuprolide, and then by those treated with goserelin (p=0.001). Significant differences in chemical castration levels were observed only at <10 ng/dL, with 54.2% of goserelin, 93.2% of triptorelin, and 86.4% of leuprolide treated patients (p<0.001). Conclusions Three LHRH agonists showed comparable efficacy for achieving castration when the castration threshold was 50 or 20 ng/dL. However, triptorelin was the most potent LHRH agonist, achieving the lowest mean testosterone levels and the highest rate of chemical castration at <10 ng/dL testosterone.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of three different luteinizing hormone-releasing hormone agonists in the chemical castration of patients with prostate cancer: Goserelin versus triptorelin versus leuprolide

Shim

Bang

et al. 2019

Investig Clin Urol

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“…, 3 months after the first injection, patients with metastatic prostate cancer treated with 1‐month goserelin had significantly lower PSA levels than patients treated with 1‐month leuprorelin 3.75 mg or 1‐month leuprorelin 7.5 mg. However, the reduction in PSA level did not correlate with the reduction in testosterone in this study . In all, 20 patients were included in each group in this study, and therefore, larger scale studies would be needed to determine if goserelin suppressed PSA more effectively than leuprorelin (Level 3).…”

Section: Resultsmentioning

confidence: 88%

“…) . Median testosterone levels were also lower in the higher dose (7.5 mg) leuprorelin group than in the lower dose (3.75 mg) leuprorelin group (Level 2) . However, this difference must be considered with caution as a simultaneous comparison of the three groups did not reach the established significance level.…”

Section: Resultsmentioning

confidence: 89%

“…In the study of Reis et al. , 3 months after the first injection, patients with metastatic prostate cancer treated with 1‐month goserelin had significantly lower PSA levels than patients treated with 1‐month leuprorelin 3.75 mg or 1‐month leuprorelin 7.5 mg. However, the reduction in PSA level did not correlate with the reduction in testosterone in this study .…”

Section: Resultsmentioning

confidence: 93%

“…1). From these, 16 direct comparison studies met the inclusion criteria; 12 reported efficacy outcomes (Table 3) [31][32][33][34][35][36][37][38][39][40][41][42], four reported safety and tolerability data (Table 4) [35,36,40,43], and five reported on the convenience of administration/user perceptions of GnRH agonists (Table 5) [35,[43][44][45][46].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Are all gonadotrophin‐releasing hormone agonists equivalent for the treatment of prostate cancer? A systematic review

Bolton

Lynch

2018

BJU International

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To review direct comparative studies of the gonadotrophin-releasing hormone (GnRH) agonists goserelin, triptorelin, and leuprorelin for the treatment of prostate cancer, and identify whether there are meaningful clinical differences between these agents. In June 2017, the following searches were performed independently by two reviewers in PubMed: (i) 'prostate cancer' and 'triptorelin' and 'leuprorelin', (ii) 'prostate cancer' and 'triptorelin' and 'goserelin', and (iii) 'prostate cancer' and 'goserelin' and 'leuprorelin', without time restriction. Duplicates were deleted. Relevant conference abstracts were also screened. A total of 16 direct comparative trials were identified: 12 reported on efficacy outcomes, four on safety/tolerability, and five on the convenience of administration/user perceptions. These studies are restricted in terms of patient numbers, formulations assessed, and endpoints measured; none were adequately powered for survival outcome measures. Studies reporting on efficacy endpoints did not show major differences in the ability of these GnRH agonists to reduce levels of testosterone or prostate-specific antigen. Some studies suggest differences in short- or long-term testosterone control, the rate of injection site adverse events, and patient/healthcare professional perceptions, but definitive conclusions cannot be drawn from the existing evidence. Few direct comparative trials of GnRH agonists have been conducted. Whilst GnRH agonists provide a similar castration effect, there is not enough evidence to show that GnRH agonists are equivalent.

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Steroid Hormone Receptors as Potential Mediators of the Clinical Effects of Dutasteride

et al. 2016

Self Cite

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This study characterizes the clinical and morphofunctional effects of a 5α-reductase inhibitor on steroid hormone receptors in normal human prostate tissue, as potential mediators of the clinical effects of dutasteride. This work was a prospective, double-blind, and randomized study that evaluated 49 men aged between 45 and 70 years, with no alterations in a digital rectal examination and prostate-specific antigen measurements between 2.5 and 4.0 ng/mL. These patients underwent prostate biopsy guided by transretal ultrasound with prostate neoplasia being ruled out, and the patients were divided into two groups, with one group receiving dutasteride (n = 25) and one group receiving a placebo (n = 24). The patients were clinically assessed each quarter, and at the end of 12 months they underwent new laboratory tests, prostate rebiopsy, and histopathological, immunohistochemical and clinical analyses. The estrogen receptor-beta (ERβ) and androgen receptor immunoreactivities were higher, and the proliferation/apoptotic ratio was significantly lower with predominance of the apoptotic process, followed by a significant reduction in the prostate volume and the total serum prostate-specific antigen levels in the dutasteride group when compared with the placebo group, with a clear supremacy of ERβ. There were no significant variations in the serum estrogen and testosterone levels, in the body mass index, or in the ERα immunoreactivities in the dutasteride and placebo groups. The results demonstrated the importance of the ERβ pathway in the activation mechanisms of apoptosis, exerting a protective effect in the normal prostate, indicating that this receptor might be an important mediator of the clinical effects of dutasteride.

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Correlation Between Testosterone and PSA Kinetics in Metastatic Prostate Cancer Patients Treated With Diverse Chemical Castrations

Cited by 7 publications

References 32 publications

Effectiveness of three different luteinizing hormone-releasing hormone agonists in the chemical castration of patients with prostate cancer: Goserelin versus triptorelin versus leuprolide

Effectiveness of three different luteinizing hormone-releasing hormone agonists in the chemical castration of patients with prostate cancer: Goserelin versus triptorelin versus leuprolide

Are all gonadotrophin‐releasing hormone agonists equivalent for the treatment of prostate cancer? A systematic review

Steroid Hormone Receptors as Potential Mediators of the Clinical Effects of Dutasteride

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