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Christie DRH, Mitina N, Sharpley CF. A prospective study of the effect of testosterone escape on preradiotherapy prostate-specific antigen kinetics in prostate cancer patients undergoing neoadjuvant androgen deprivation therapy. Curr Urol. 2021;15(1):63-67doi: 10.1097/CU9.0000000000000008.
Christie, D. R. H., Mitina, N., & Sharpley, C. F. (2021). A prospective study of the effect of testosterone escape on preradiotherapy prostate-specific antigen kinetics in prostate cancer patients undergoing neoadjuvant androgen deprivation therapy. Current urology, 15(1), 63-67. https://doi.org/10.1097/CU9.0000000000000008
Christie, David R H, et al. "A prospective study of the effect of testosterone escape on preradiotherapy prostate-specific antigen kinetics in prostate cancer patients undergoing neoadjuvant androgen deprivation therapy." Current urology vol. 15,1 (2021): 63-67. doi: https://doi.org/10.1097/CU9.0000000000000008
Christie DRH, Mitina N, Sharpley CF. A prospective study of the effect of testosterone escape on preradiotherapy prostate-specific antigen kinetics in prostate cancer patients undergoing neoadjuvant androgen deprivation therapy. Curr Urol. 2021 Mar;15(1):63-67. doi: 10.1097/CU9.0000000000000008. Epub 2021 Mar 29. PMID: 34084124; PMCID: PMC8137000.
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Curr Urol. 2021 Mar;15(1):63-67. doi: 10.1097/CU9.0000000000000008. Epub 2021 Mar 29.

A prospective study of the effect of testosterone escape on preradiotherapy prostate-specific antigen kinetics in prostate cancer patients undergoing neoadjuvant androgen deprivation therapy.

Current urology

David R H Christie, Natalia Mitina, Christopher F Sharpley

Affiliations

  1. Genesiscare, Inland Drive, Tugun, Queensland, Australia.
  2. Brain-Behaviour Research Group, University of New England, Armidale, Australia.
  3. University of Queensland, St Lucia, Queensland, Australia.

PMID: 34084124 PMCID: PMC8137000 DOI: 10.1097/CU9.0000000000000008

Abstract

INTRODUCTION: Prostate-specific antigen (PSA) kinetic patterns during neoadjuvant androgen deprivation therapy have been shown to predict unfavorable long-term outcomes.

OBJECTIVE: To investigate the effect of testosterone escape (TE) on these kinetic patterns, as this had not been previously reported.

METHODS: There were 50 consecutive prostate cancer patients who received 6 months of triptorelin prior to definitive radiotherapy (RT). Testosterone and PSA levels were measured at baseline and every 6 weeks. Clinical factors were tested for their ability to predict for TE and unfavorable PSA kinetic patterns. The effects of TE, at both 1.7 and 0.7 nmol/L levels, were analyzed.

RESULTS: TE occurred in at least one reading for 14% and 34% of the patients at the 1.7 and 0.7 nmol/L levels, respectively. No baseline factors predicted TE. The median PSA halving time was 25 days and the median pre-RT PSA level was 0.55 ng/mL. The only factor significantly associated with a higher pre-RT PSA level was a higher baseline PSA level. The only factor that significantly predicted a longer PSA halving time was TE at the 1.7 nmol/L level.

CONCLUSIONS: TE and higher baseline PSA levels may adversely affect PSA kinetics and other outcomes for patients undergoing neoadjuvant hormone therapy prior to radiotherapy. Studies investigating the tailoring of neoadjuvant therapy by extending the duration in those patients with a higher baseline PSA level or by the addition of anti-androgens in those demonstrating TE, should be considered.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc.

Keywords: Gonadotropin-releasing hormone; Prostate-specific antigen; Prostatic neoplasm; Radiotherapy; Testosterone

Conflict of interest statement

The authors declare that they have no financial conflict of interest with regard to the content of this report.

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