Interpreting Testosterone and Concomitant Prostate Specific Antigen Values during Androgen Deprivation Therapy for Recurrent Prostate Cancer

No AccessJournal of UrologyAdult Urology1 Nov 2021Interpreting Testosterone and Concomitant Prostate Specific Antigen Values during Androgen Deprivation Therapy for Recurrent Prostate CancerThis article is commented on by the following:Editorial CommentEditorial Comment Samuel Tremblay, Lily Summers-Trasiewicz, Frédéric Pouliot, Juanita M. Crook, Keyue Ding, Laurence Klotz, and Paul Toren Samuel TremblaySamuel Tremblay http://orcid.org/0000-0002-0982-655X Department of Surgery, Faculty of Medicine, Université Laval; Centre de recherche CHU de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada , Lily Summers-TrasiewiczLily Summers-Trasiewicz Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada , Frédéric PouliotFrédéric Pouliot Department of Surgery, Faculty of Medicine, Université Laval; Centre de recherche CHU de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada , Juanita M. CrookJuanita M. Crook http://orcid.org/0000-0003-0711-3318 Department of Surgery, Division of Radiation and Developmental Radiotherapeutics, University of British Columbia, BC Cancer Center for the Southern Interior, Kelowna, British Columbia, Canada , Keyue DingKeyue Ding Canadian Clinical Trials Group, Queen’s University, Kingston, Ontario, Canada , Laurence KlotzLaurence Klotz http://orcid.org/0000-0003-1001-2235 Department of Surgery, Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada , and Paul TorenPaul Toren ‡Correspondence: Université Laval, CHU de Québec-Université Laval Research Center, 10 McMahon, Room 0877, Québec, Québec , Canada, G1R 3S1 E-mail Address: [email protected] http://orcid.org/0000-0002-5762-5787 Department of Surgery, Faculty of Medicine, Université Laval; Centre de recherche CHU de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada View All Author Informationhttps://doi.org/10.1097/JU.0000000000001946AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Measurement of testosterone levels during androgen deprivation therapy (ADT) is broadly recommended, but how therapy should be altered in response to testosterone values during ADT remains controversial. Our objective was therefore to evaluate the relation between testosterone and concomitant prostate specific antigen (PSA) levels during ADT on clinical outcomes. Materials and Methods: Patients from the continuous androgen deprivation arm of the PR.7 trial of intermittent ADT for biochemically recurrent prostate cancer following radiotherapy were included. Statistical analyses evaluated the prognostic importance of testosterone levels during ADT relative to concomitant PSA levels. We similarly evaluated whether the number of testosterone breakthroughs >1.7 nmol/l predicted the time to castrate-resistant prostate cancer (CRPC), cancer specific survival (CSS) or overall survival (OS) with Kaplan-Meier and Cox regression analyses. Results: Overall, the prognostic importance of testosterone on outcomes was eclipsed by the prognostic value of concomitant PSA values. The occurrence of testosterone values >0.7 nmol/l in the first year of therapy was associated with subsequent rises >1.7 nmol/l, but the number of testosterone breakthroughs per patient had no relationship to the risk of CRPC, CSS or OS. A time-dependent adjusted analysis indicated as expected that PSA values were prognostic, but there was no association of relative cumulative testosterone exposure with outcomes. Conclusions: In this large-scale trial with long followup, breakthrough testosterone was unrelated to time to CRPC, CSS or OS. Castrate testosterone values during ADT for recurrent prostate cancer provides prognostic information that must be considered alongside the time since ADT initiation and concomitant PSA values. References 1. : Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. 1941. J Urol 2002; 168: 9. 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Google Scholar Funding: Funding for this project was provided by a clinician-scientist award from Fonds de Recherche du Québec–Santé (No. 32774) and an unrestricted grant from Sanofi Canada (PT). Original trial was supported by Canadian Cancer Society Research Institute Grants 021039 and 015469, U.S. NCI Grant CA077202 and Hoescht Marion Roussel Research (JMC). Additional support was provided by a grant from Ontario Cancer Research Institute (KD). © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of Urology12 Aug 2021Editorial CommentJournal of Urology12 Aug 2021Editorial Comment Volume 206Issue 5November 2021Page: 1166-1176Supplementary Materials Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordsandrogen antagoniststestosteroneprostatic neoplasmsrecurrenceandrogensMetricsAuthor Information Samuel Tremblay Department of Surgery, Faculty of Medicine, Université Laval; Centre de recherche CHU de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada More articles by this author Lily Summers-Trasiewicz Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada More articles by this author Frédéric Pouliot Department of Surgery, Faculty of Medicine, Université Laval; Centre de recherche CHU de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada Financial interest and/or other relationship with TerSera, Astellas and Janssen. More articles by this author Juanita M. Crook Department of Surgery, Division of Radiation and Developmental Radiotherapeutics, University of British Columbia, BC Cancer Center for the Southern Interior, Kelowna, British Columbia, Canada More articles by this author Keyue Ding Canadian Clinical Trials Group, Queen’s University, Kingston, Ontario, Canada More articles by this author Laurence Klotz Department of Surgery, Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada More articles by this author Paul Toren Department of Surgery, Faculty of Medicine, Université Laval; Centre de recherche CHU de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada ‡Correspondence: Université Laval, CHU de Québec-Université Laval Research Center, 10 McMahon, Room 0877, Québec, Québec , Canada, G1R 3S1 E-mail Address: [email protected] Financial interest and/or other relationship with AstraZeneca, Bayer, Bristol-Myers-Squibb Canada, Ferring, TerSera and Abbvie. More articles by this author Expand All Funding: Funding for this project was provided by a clinician-scientist award from Fonds de Recherche du Québec–Santé (No. 32774) and an unrestricted grant from Sanofi Canada (PT). Original trial was supported by Canadian Cancer Society Research Institute Grants 021039 and 015469, U.S. NCI Grant CA077202 and Hoescht Marion Roussel Research (JMC). Additional support was provided by a grant from Ontario Cancer Research Institute (KD). Advertisement PDF downloadLoading ...