Please use this identifier to cite or link to this item: https://hdl.handle.net/1959.11/31818
Title: A prospective study of the effect of testosterone escape on preradiotherapy prostate-specific antigen kinetics in prostate cancer patients undergoing neoadjuvant androgen deprivation therapy
Contributor(s): Christie, David R H  (author); Mitina, Nataliaa (author); Sharpley, Christopher F  (author)orcid 
Publication Date: 2021-03
Open Access: Yes
DOI: 10.1097/CU9.0000000000000008
Handle Link: https://hdl.handle.net/1959.11/31818
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.

Publication Type: Journal Article
Source of Publication: Current Urology, 15(1), p. 63-67
Publisher: Wolters Kluwer Health
Place of Publication: United States of America
ISSN: 1661-7657
1661-7649
Fields of Research (FoR) 2020: 320803 Systems physiology
Socio-Economic Objective (SEO) 2020: 200105 Treatment of human diseases and conditions
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Science and Technology

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