Role of Luteinising Hormone Releasing Hormone (LHRH) Agonists and Hormonal Treatment in the Management of Prostate Cancer

Mongiat-Artus, Pierre; Teillac, P.

doi:10.1016/j.eursup.2005.04.003

Cited by 11 publications

(2 citation statements)

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“…Androgen‐deprivation therapy (ADT) is frequently used in patients with prostate cancer and is the reference standard for treating metastatic disease, but it is also used in association with radiotherapy in high‐risk local disease, and in many patients with biochemical failure after radical therapies [1]. The behaviour of serum testosterone during ADT is important, because ineffective testosterone suppression can result in increased mortality from prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

Individual variations of serum testosterone in patients with prostate cancer receiving androgen deprivation therapy

Moróte¹,

Planas²,

Salvador³

et al. 2009

BJU International

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luteinizing hormone-releasing hormone agonist over 6-48 months. Serum testosterone was measured using a chemiluminescent assay with a lower sensitivity level of 15 ng/dL and interassay coefficient of variation of 25% at low testosterone concentrations. RESULTSIndividual variations could not be explained by the interassay variation coefficient in 26% of the patients. The rate of breakthrough increases > 50 ng/dL increased from 12.3% at the first determination to 24.7% at the third, then remaining stable. The rate of breakthrough increases of 20-50 ng/dL increased from 27.4% at the first determination to 31.5% at the second, and then remained stable. A first determination of < 20 ng/dL provided an 11.4% probability for future increases of > 50 ng/dL, with a 5.7% probability if two consecutive determinations were < 20 ng/dL and a null probability when three consecutive determinations were < 20 ng/dL. CONCLUSIONS Individual variations in serum testosteronelevel cannot be explained by the coefficient of variation of the assay in a quarter of patients who are medically castrated. Breakthrough increases over castrate levels increase over time and those of > 50 ng/dL can be predicted from the previous levels. KEYWORDSandrogen suppression, prostate cancer, serum testosterone Study Type -Aetiology (case series) Level of Evidence 4

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Section: Introductionmentioning

confidence: 99%

Individual variations of serum testosterone in patients with prostate cancer receiving androgen deprivation therapy

Moróte¹,

Planas²,

Salvador³

et al. 2009

BJU International

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“…Now, the guidelines by the American Society of Clinical Oncology recommend bilateral orchiectomy or LHRH agonists as initial treatment for metastatic, recurrent or progressive prostate cancer [8]. Both treatment modalities display similar efficacy and safety profiles, with response rates ranging from 17% to 70% and a median overall survival (OS) of 1.1 to 2.6 years [9].…”

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The Mechanism of Androgen Deprivation and the Androgen Receptor

Bayraktar¹

2010

TOPCANJ

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Prostate cancer is a major cause of cancer-related deaths in American men. The development and growth of prostate cancer depends on the androgen receptor (AR) and its high-affinity binding of dehydrotestosterone (DHT), which derives from testosterone (T). Most prostate tumors regress after therapy to prevent testosterone production by the testes, but the tumors eventually recur and cause death. The AR, a member of the steroid receptor family that is activated by testicular androgens, is the major regulatory transcription factor in normal prostate growth and development and in the growth of androgen-dependent prostate cancer. Recent evidence suggests that the AR may also contribute to prostate cancer growth during its recurrence in the androgen-deprived patient. A role for AR-mediated gene activation in recurrent prostate cancer is supported by its expression together with the expression of androgen-regulated genes.This review highlights the different mechanisms of the available androgen deprivation therapies and also focuses on the novel targeted therapies in advanced or metastatic prostate cancer. Furthermore, we provide a molecular basis for the AR and its role in activation and progression in recurrent or castration resistant prostate cancer.Keywords: Prostate cancer, dihydrotestosterone, androgen receptor, gene expression, androgen-regulated genes. SCIENTIFIC RATIONALE FOR ANDROGEN DEPRIVATION IN PROSTATE CANCERLuteinizing hormone-releasing hormone (LHRH) is a linear decapeptide synthesized from a precursor polypeptide in the neurovascular terminals of the hypothalamus and secreted in a pulsatile pattern (every 30 -120 min) directly into the hypophyseal portal circulation, binding and activating the cell surface LHRH receptor (LHRH-R) on the gonadotrope cells located in the anterior pituitary. The frequency and amplitude of these LHRH secretions control the synthesis and excretion of the two pituitary gonadotropins (LH and FSH), which then enter the systemic circulation and bind to receptors in the gonads where they stimulate sex steroidogenesis (regulated mainly by LH) and gametogenesis (regulated mainly by FSH) in the testes and ovaries. More specifically in males LH acts on testicular Leydig cells and stimulates de novo synthesis and subsequent release of androgens, mainly testosterone (T), into the blood circulation [1]. Free T enters prostate cells and 90% is converted by the enzymatic action of 5 -reductase to dehydrotestosterone (DHT), which has a four-to five-fold higher affinity for the androgen receptor (AR) than T [2,3]. The adrenal glands also produce androgens, including T, androstenedione and dehydroepiandrosterone (DHEA), which contribute to intraprostatic DHT production by increasing the substrate concentration. In addition, inactive metabolites of steroid hormone synthesis in the testes such as DHEA and dehydroepiandrosterone sulfate, can act as precursors in the formation of active androgens in prostate tissue [4,5]. Inside the prostate cancer cell DHT

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Novel multifunctional nanocarrier-mediated codelivery for targeting and treatment of prostate cancer

Arya

Ahmad

Khandelwal

et al. 2019

Nanomaterials for Drug Delivery and Therapy

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Role of Luteinising Hormone Releasing Hormone (LHRH) Agonists and Hormonal Treatment in the Management of Prostate Cancer

Cited by 11 publications

References 82 publications

Individual variations of serum testosterone in patients with prostate cancer receiving androgen deprivation therapy

Individual variations of serum testosterone in patients with prostate cancer receiving androgen deprivation therapy

The Mechanism of Androgen Deprivation and the Androgen Receptor

Novel multifunctional nanocarrier-mediated codelivery for targeting and treatment of prostate cancer

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