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

2012 ◽  
Vol 19 (3) ◽  
pp. R93-R98 ◽  
Author(s):  
Leonardo Oliveira Reis
Keyword(s):  
Prostate Cancer ◽  
Serum Testosterone ◽  
Response To Treatment ◽  
Serum Testosterone Level ◽  
World Population ◽  
Releasing Hormone ◽  
Testosterone Levels ◽  
Hormonal Manipulation ◽  
Lh Releasing Hormone ◽  
The Impact

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.

The association of polymorphism in gonadotropin releasing hormone with serum testosterone level during androgen-deprivation therapy and prognosis in metastatic prostate cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16570-e16570
Author(s):  
Masaki Shiota ◽  
Naohiro Fujimoto ◽  
Ario Takeuchi ◽  
Eiji Kashiwagi ◽  
Takashi Dejima ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gene Polymorphism ◽  
Androgen Deprivation Therapy ◽  
Metastatic Prostate Cancer ◽  
Serum Testosterone ◽  
Gonadotropin Releasing Hormone ◽  
Androgen Deprivation ◽  
Serum Testosterone Level ◽  
Releasing Hormone ◽  
Testosterone Levels

e16570 Background: Serum testosterone suppression during androgen-deprivation therapy (ADT) have been reported to affect ADT efficacy. However, the factor affecting hormonal variations during ADT was less explored. Therefore, in this study, we investigated the missense polymorphisms in gonadotropin releasing hormone (GNRH) and hormonal variations during ADT as well as the prognosis among men treated with primary ADT for metastatic prostate cancer. Methods: This study included 80 Japanese patients with metastatic prostate cancer, whose serum testosterone levels during ADT were available. The association of the GNRH1 gene polymorphism (rs6185, S20W) and the GNRH2 gene polymorphism (rs6051545, A16V) with clinicopathological parameters including serum testosterone levels during ADT as well as the prognosis including progression-free survival and overall survival was examined. Results: The CT allele and the CT/TT alleles in the GNRH2 gene (rs6051545) were associated with higher serum testosterone levels during ADT compared with the CC allele. Consequently, the CT alleles was associated with higher progression risk after adjustment with age and serum testosterone levels during ADT [hazard ratio (95% confidence interval), 1.73 (1.00-3.00), P = 0.049]. Conclusions: Taken together, these findings suggested that genetic variation in rs6051545 ( GNRH2) may result in the inadequate suppression of on serum testosterone during ADT, which may lead to detrimental effect of ADT on prognosis among men with metastatic prostate cancer.

Serum testosterone level and overall survival in first-line abiraterone and enzalutamide for metastatic castration-resistant prostate cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17545-e17545
Author(s):  
Maysa Tamara Silveira Vilbert ◽  
Marcelle Goldner Cesca ◽  
Natasha Carvalho Pandolfi ◽  
Vinicius Fernando Calsavara ◽  
Bruno Cezar de Mendonça Uchôa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Testosterone Level ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Testosterone Levels ◽  
Castration Resistant ◽  
Low Serum

e17545 Background: Androgen receptor-targeted agents Abiraterone and Enzalutamide (Abi/Ez) prolonged overall survival in metastatic castration resistant prostate cancer (mCRPC). Patients with very-low serum testosterone levels seem to have less benefit from these therapies as well as more aggressive prostate cancer. Methods: A retrospective observational cohort study was conducted to evaluate whether a serum testosterone measured at time of start first-line therapy with Abi/Ez is related to overall survival (OS) and time-to-treatment failure (TTF) in mCRPC patients. Kaplan-Meier survival estimates and Cox-regression models were used for time-to-event analyses. The best cut-off for testosterone was defined using Log-rank statistics (Lausen and Schumacher). X² test and Mann-Whitney U-test were applied to compare categorical and continuous variables, respectively. Logistic regression was used to assess characteristics related to serum testosterone levels. Statistical significance was fixed at 0.05. Results: From May 2012 to February 2017, 100 patients were assessed. Median follow-up was 27.8 months (range 2.23 to 68.26). Pts with a high testosterone level ( > 28.2; n = 20) achieved a significantly higher OS (median 66.0 vs 31.9 mo, testosterone > 28.2 HR: 0.206, 95% CI 0.074 to 0.571, p = 0.002) and TTF (median 30.6 vs 11.8 mo, testosterone > 28.2 HR: 0.408, 95%CI 0.219 to 0.762, p = 0.005) than pts with a low serum testosterone level ( < 28.2; n = 80), regardless of receiving therapy with either Abi (n = 69) or Ez (n = 31). Pts with a higher testosterone level were younger (median 67.7 vs 73.6 years; p = 0.026), had a higher body mass index (BMI) (28.5 vs 25.9, p = 0.023) and a lower PSA at start Abi/Ez (12 vs 26, p = 0.031) than pts with lower values. Age (OR 0.93, 95%CI 0.8 to 0.9, p = 0.021), BMI (OR 1.21, 95%CI 1.1 to 1.4, p = 0.006) and baseline PSA (OR 1.2, 95%CI 1.03 to 1.4, p = 0.020) were significantly associated with testosterone > 28.2. After 4 months of Abi/Ez treatment, PSA decrease > 50% of baseline was seen more frequently in high testosterone levels group than in low testosterone levels pts (90% vs 57.5% of pts, respectively, p = 0.007). Conclusions: Pts with high levels of testosterone ( > 28.2) achieved a better OS and TTF when treated with Abi/Ez in first-line mCRPC than those with low levels. Testosterone can be considered a prognostic and predictive biomarker in this scenario, and could be used in treatment decision for this population.

Percutaneous orchiectomy: A noninvasive method of castration beyond percutaneous testicular sclerosis

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16153-e16153
Author(s):  
E. C. Nepomuceno ◽  
F. Quintiliano ◽  
F. S. Lima ◽  
E. Café ◽  
P. Boente
Keyword(s):  
Prostate Cancer ◽  
Serum Testosterone ◽  
Serum Levels ◽  
Serum Testosterone Level ◽  
Control Group ◽  
Ischemic Lesion ◽  
Alcohol Injection ◽  
Percutaneous Injection ◽  
Testosterone Levels ◽  
Percutaneous Administration

e16153 Background: Surgical castration is the gold standard for hormonal deprivation in metastatic prostate cancer, nevertheless this simple procedure may involve on psychological consequences. According to many studies, it's possible to achieve ischemic lesion in liver tissue beyond sclerosants agents (like alcohol or glycerol), however there are very few reports about the effects of such agents in testicles. These study objectives evaluating histological and morphological characteristics of rat testicles submitted to percutaneous administration of sclerosants agents and also, to compare serum testosterone levels between rats submitted to a surgical orchiectomy or percutaneous injection. Methods: Twenty four rats have been shared in four groups with eight animals each. In group O, rats were submitted to bilateral orchiectomy. In the other groups, rats were submitted to percutaneous administration of a sclerosant agent and orquiectomy after thirty days as follows: Group A, Alcohol injection; Group G - Glycerol; Group S - Saline solution (control group). Serum testosterone level was measured after 15 and 30 days in each animal. Results: There is no complication or death in this series. Rats of groups A and G comparing to control group (group S) had smaller testicular weight (0,8±0,1g; 1±0,2g versus 3,15±0,1g p<0,0000001) and smaller testicular volume (0,16±0,05mL; 0,23±0,11mL versus 2,38±0,05mL p<0,0000001). Testosterone serum levels were as similar in groups A and G (sclerosis) as in group O (orchiectomy). After 15 days testosterone levels were A=2,9±0,74 ng\dL; G=2,8±0,39 ng\dL versus O=2,91±1,46ng\dL p=0,99; and after 30 days were A=2,58±0,4ng\mL, G=2,78±0,3ng\mL versus O=2,7±0,95ng\mL p=0,895). Histological findings show extensive necrosis beyond macrophagic infiltration and no Leydig cells visualized.There is no significantly statistical difference between Alcohol and Glycerol groups. Conclusions: Percutaneous administration of alcohol or glycerol in rats testicles causes atrophy and reduces testosterone serum levels like it occurs after surgical castration. More studies are necessary to evaluate if this minimally invasive procedure may be an alternative to surgical orchiectomy in advanced prostate cancer. No significant financial relationships to disclose.

Correction

1992 ◽  
Vol 30 (23) ◽  
pp. 92-92
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Advanced Breast Cancer ◽  
Advanced Prostate Cancer ◽  
Serum Testosterone ◽  
Gnrh Analogue ◽  
Releasing Hormone ◽  
Testosterone Levels ◽  
Menopausal Women ◽  
Gonadotrophin Releasing Hormone

In our article Gonadotrophin releasing hormone analogues for advanced prostate cancer (17 August, page 65) we warned that testosterone levels might rebound above normal if a dose of a depot preparation of a GnRH analogue missed. In fact if the dose is delayed by 2 weeks, serum testosterone concentrations may rise above the castration range in about 30% of patients but do not rise above normal.1 In the Practice Synopsis included in the article we mentioned that goserelin (Zoladex) was licensed for advanced prostate cancer and endometriosis but omitted to mention that it was also licensed for advanced breast cancer in pre- and peri-menopausal women.

Maintenance of the suppressed level of serum testosterone by administration of three-monthly formulations of luteinizing hormone-releasing hormone agonists at six-month intervals in Japanese patients with prostate cancer: A prospective study.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 159-159
Author(s):  
Y. Fujii ◽  
S. Yoshida ◽  
M. Yokoyama ◽  
Y. Iimura ◽  
N. Numao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Serum Testosterone ◽  
Japanese Patients ◽  
Serum Testosterone Level ◽  
Testosterone Levels ◽  
Serum Lh ◽  
One Year ◽  
Lh Rh ◽  
Prospective Longitudinal

159 Background: Treatment with an LH-RH agonist is a standard alternative to surgical castration for prostate cancer patients. The serum testosterone level is kept at castrate levels continuously during LH-RH agonist therapy in almost all patients (Fujii Y, BJU Int 2008). LH- RH agonists, however, are more expensive than surgical castration, with drugs costing between US $300 and $500 per month in Japan. Recent studies suggest that 3-monthly formulations of LH-RH agonists suppress the serum testosterone levels far longer than the 3-month dosing interval. Methods: A total of 43 Japanese patients with prostate cancer who were treated with 3-monthly LH-RH agonists (23 with 11.25mg leuprolide, and 20 with 10.8 mg goserelin) for one year or longer and whose testosterone levels were kept at castrate level (defined as < 50 ng/dL) were entered into this prospective, longitudinal study. After entry, the 43 men received the same 3-monthly LH-RH agonists at 6-month intervals, and had serum LH and testosterone tests performed at 3-month intervals. Bicalutamide was combined with the LH-RH agonists in 12 of the patients. Results: At entry, median patient age was 74 years (range 59 to 89), median duration of LH-RH agonists treatment was 26 months (12 to 125), and median LH and testosterone levels were <10 ng/dL (<10 to 60) and 5 ng/dL (<5 to 18), respectively. The 43 patients received a total of 162 administrations (median 5, range 1 to 6) of the LH-RH agonists at 6-month intervals, and had a total 335 hormonal tests (median 10, range 2 to12) performed during the median followup period of 30 months. Serum LH and testosterone levels were kept suppressed during the treatment. Of the 43 patients, two had serum testosterone just above the castrate level (54 and 56 ng/dL) once each among their 12 and 8 hormonal assays, respectively. Conclusions: Administration of 3-monthly LH-RH agonists, either leuprolide or goserelin, at 6-month intervals could maintain the castrate level of serum testosterone at least in Japanese prostate cancer patients who have received LH-RH agonists treatment for one year or longer. No significant financial relationships to disclose.

scholarly journals Long-Term Efficacy and Tolerability of Abdominal Once-Yearly Histrelin Acetate Subcutaneous Implants in Patients with Advanced Prostate Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sean Woolen ◽  
Cameron Holzmeyer ◽  
Emily Nesbitt ◽  
Paul F. Siami
Keyword(s):  
Prostate Cancer ◽  
Advanced Prostate Cancer ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Serious Adverse Events ◽  
Testosterone Levels ◽  
Administration Method ◽  
The Mean ◽  
Androgen Independent

Objectives.Long-term assessment of the efficacy and tolerability of subcutaneous abdominal histrelin acetate implants that have been inserted for more than two years.Materials and Methods.Retrospective data collected over a six-year period at a single center from charts of 113 patients who received the subcutaneous abdominal histrelin acetate implant.Results.Following insertion of the first implant, 92.1% and 91.8% of patients had a serum testosterone level of ≤30 ng/dL at 24 and 48 weeks, respectively. Serum testosterone levels remained at <30 ng/dL for 96% of patients at two years and for 100% of patients at 3, 4, and 5 years. The testosterone levels remained significantly less than baseline(P<0.05). Six patients (5.3%) had androgen-independent progression when followed up on the long term, increasing the mean serum PSA at 3, 4, and 5 years to 35.0 µg/L(n=22), 30.7 µg/L(n=13), and 132.9 µg/L(n=8), respectively. The mean serum PSA was significantly greater than baseline during these years(P<0.05). Eight patients (7.1%) experienced minor, but not serious, adverse events from the histrelin acetate.Conclusion.Subcutaneous abdominal histrelin acetate implants are an effective long-term and well-tolerated administration method for treating patients with advanced prostate cancer.

Testosterone kinetics after proton therapy for low- and intermediate-risk prostate cancer.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 237-237
Author(s):  
Romaine Charles Nichols ◽  
Christopher G. Morris ◽  
Bradford S. Hoppe ◽  
Randal H. Henderson ◽  
William M. Mendenhall ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Proton Therapy ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Intermediate Risk ◽  
University Of Florida ◽  
Testosterone Levels ◽  
Median Serum ◽  
Risk Prostate Cancer ◽  
The University

237 Background: Evaluate long term changes in serum testosterone levels in patients with low and intermediate risk prostate cancer treated with proton therapy (PT) on two prospective clinical trials. Methods: Between August, 2006 and October, 2007, 171 patients with low and intermediate risk prostate cancer were enrolled and treated on the University of Florida Proton Therapy Institute institutional review board (IRB) approved PR01 and PR02 protocols. Of the 171 patients, 20 were excluded for having received hormonal therapy prior to PT. The pretreatment serum testosterone level was available for 149 of the remaining 151 patients. These 149 patients were included in the present study. Proton doses ranged from 78 Cobalt Gray Equivalent (CGE) to 82 CGE to the prostate using passively scattered protons. No patient underwent pelvic nodal irradiation. Results: The median baseline serum testosterone level was 358ng/dL (range 112 to 791ng/dL). Immediately after completion of PT, median serum testosterone was 365ng/dL which was not significantly different from the pre-PT level (p=0.2039). Subsequent median testosterone levels with associate P-Values are shown in the Table. At no point in the 60 month follow up period was the median serum testosterone value significantly different from the baseline value. Conclusions: Conformal proton therapy to the prostate, as delivered using the University of Florida Proton Therapy Institute PR01 and PR02 protocols, did not appear to significantly affect serum testosterone levels within 60 months after PT. [Table: see text]

Low serum testosterone levels are predictive of prostate cancer

2011 ◽  
Vol 31 (2) ◽  
pp. 247-252 ◽  
Author(s):  
Luigi Mearini ◽  
Alessandro Zucchi ◽  
Elisabetta Nunzi ◽  
Tommaso Villirillo ◽  
Vittorio Bini ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Serum Testosterone ◽  
Testosterone Levels ◽  
Low Serum
Sign in / Sign up

Export Citation Format

Share Document