Testosterone (T) Level Correlates With Survival in PTS With Advanced Prostate Cancer (Apc): The Lower Is Really the Better

Perachino, M.; Cavalli, V.

doi:10.1016/s0022-5347(08)60520-0

Cited by 6 publications

(4 citation statements)

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“…Oefelein et al [3] reported that the median testosterone value after bilateral orchidectomy was 15 ng/dL and they considered a castrate level as <20 ng/dL (1 nmol/L). Other studies have highlighted the possibility that lower testosterone levels may be associated with improved outcomes, including increased time to the development of castrate-resistant disease and overall survival [20,21]. In a series of 162 men with metastatic prostate cancer treated with LHRH agonist, Perachino et al [20] reported that the prognosis was found to be related to 6-month testosterone levels, with longer survival with lower testosterone levels.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have highlighted the possibility that lower testosterone levels may be associated with improved outcomes, including increased time to the development of castrate-resistant disease and overall survival [20,21]. In a series of 162 men with metastatic prostate cancer treated with LHRH agonist, Perachino et al [20] reported that the prognosis was found to be related to 6-month testosterone levels, with longer survival with lower testosterone levels. Similarly, Morote et al [21] strongly suggested that patients experiencing a breakthrough testosterone during LHRH agonist therapy have a reduced progression-free survival rate compared with those who did not experience testosterone breakthroughs.…”

Section: Discussionmentioning

confidence: 99%

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Is there still a role for bilateral orchidectomy in androgen-deprivation therapy for metastatic prostate cancer?

Atta

Elabbady

Sameh

et al. 2019

Arab Journal of Urology

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Objective: To compare bilateral orchidectomy, as the classical 'gold standard' androgendeprivation therapy (ADT), and ADT using a luteinising hormone-releasing hormone (LHRH) antagonist (degarelix) for the treatment of metastatic prostate cancer regarding their shortterm biochemical efficacy, testosterone castrate level, tolerability, and effect on health-related quality of life (HRQoL). Patients and methods: A total of 60 patients with newly diagnosed metastatic prostate cancer were managed by either bilateral orchidectomy or degarelix injection as ADT. Both groups were compared according to their prostate-specific antigen (PSA) nadir and testosterone level at the 6-month follow-up. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) after 12 months. Results: Bilateral orchidectomy and degarelix showed comparable results for PSA reduction, but there was a statistically significantly lower castrate level of testosterone in the bilateral orchidectomy group. Using the EROTC QLQC-30, bilateral orchidectomy was associated with better HRQoL, better global health status, and better functional status. Conclusion: Bilateral orchidectomy resulted in lower castrate levels of testosterone, which may be associated with better disease control, together with better HRQoL and general health status compared to LHRH antagonist (degarelix). These results indicate that we should consider revisiting bilateral orchidectomy as a valuable and effective treatment option for ADT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is there still a role for bilateral orchidectomy in androgen-deprivation therapy for metastatic prostate cancer?

Atta

Elabbady

Sameh

et al. 2019

Arab Journal of Urology

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“…13 Medical or surgical castration is defined as testosterone levels <50 ng/dL (with contemporary data favouring testosterone levels <20 ng/dL). 14 , 15 In the United States, medical castration is preferred, primarily to avoid surgical complications and psychological trauma as well as due to the convenience, efficacy and reversibility of the available treatments. 16 …”

Section: Androgen Deprivation Therapymentioning

confidence: 99%

Volume matters and intensification is needed: emerging trends in the management of advanced prostate cancer

Sheng¹,

Barata²,

Alameddine³

et al. 2021

DIC

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Significant changes in the management of patients with de novo metastatic prostate cancer have led to the use of novel oral agents and docetaxel-based chemotherapy earlier in the natural history of their disease. Our main challenge is the lack of prospective randomized data comparing these regimens. It is clear that treatment intensification is needed. Yet, the heterogeneity of this patient population coupled with the lack of understanding of the specific biology for a given individual makes treatment selection challenging. The aim of this narrative review is to discuss the importance of defining advanced disease by volume, the necessity for treatment intensification, and the current and future landscape of metastatic hormone-sensitive prostate cancer management.

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“…Future studies are warranted to label and classify LHRH agonists from a regulatory perspective in different classes according to their efficacy now there is rapidly growing evidence that the depth of the testosterone nadir is associated with a survival advantage in men with metastatic PCa (Morote et al 2007, Perachino & Cavalli 2008, Perachino et al 2010.…”

Section: Introductionmentioning

confidence: 99%

Variations of serum testosterone levels in prostate cancer patients under LH-releasing hormone therapy: an open question

Reis

2012

Endocrine-Related Cancer

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The hypothesis ‘the lower the better when achieving castration levels of testosterone’ is based on the data from second-line hormonal manipulation and its molecular basis, and on better oncological results reported for lower castration levels in prostate cancer (PCa) patients, including those achieved with maximal androgen blockade. In this regard, the equivalence of surgical and different pharmacological castrations has been controversial. The modified amino acid structure that makes LH-releasing hormone (LHRH) analogs more potent than LHRH, and the method of delivering the analogs impacts on bioavailibility and potentially causes differences in androgen levels and in its final oncological efficacy. In addition to this, there is a myriad of circumstances, such as those related to ethnic variations and co-morbidities, which uniquely impact on the pharmacological approach in a highly heterogeneous population of castration-resistant prostate cancer (CRPC) patients. Ineffective testosterone suppression through hormonal escape is currently poorly recognized and may result in increased PCa mortality. Until now, the optimal serum testosterone level in patients under castration, and the impact of its variations in patients under LHRH therapy, remain open questions and have been merged to a broad spectra of patients who are highly heterogeneous. This heterogeneity relates to a number of mechanisms regarding response to treatment, which influences the biology of the relapsing tumor and the sensitivity to subsequent therapies in the individual patient. The rationale to achieve testosterone levels below 20–50 ng/dl warrant further investigation as these levels have recently rescued CRPC patients. In the last few years and months, important advancements in prostate cancer treatment have been achieved. Nevertheless, these advances are measured in a few months of additional survival and under high costs, not available to most of the world population, compared with the benefits of hormonal manipulation that are measured in years, there is a huge potential for accessible and durable effect expansion and optimization of treatment, particularly with the current tendency of a more individual approach.

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Testosterone (T) Level Correlates With Survival in PTS With Advanced Prostate Cancer (Apc): The Lower Is Really the Better

Cited by 6 publications

References 0 publications

Is there still a role for bilateral orchidectomy in androgen-deprivation therapy for metastatic prostate cancer?

Is there still a role for bilateral orchidectomy in androgen-deprivation therapy for metastatic prostate cancer?

Volume matters and intensification is needed: emerging trends in the management of advanced prostate cancer

Variations of serum testosterone levels in prostate cancer patients under LH-releasing hormone therapy: an open question

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