AUA 2017: Does baseline serum testosterone influence androgen deprivation therapy outcomes for advanced prostate cancer patients?

Boston, MA (UroToday.com) Dr. Patel pooled data from two published phase 3 trials (NCT00295570 and NCT00928434) to examine the impact of baseline testosterone level on ADT outcomes in advanced prostate cancer patients. In summary, testosterone levels were stratified by low (<250 ng/dl) versus normal (>250 ng/dl) and by quartile to examine time to PSA rise, progression free survival and overall survival.

838 men were included in analysis, with 16.5% having a baseline testosterone level <250ng/ml. Cohorts had comparable Gleason scores, PSA>20ng/ml and metastatic staged patients. Analyses demonstrated statistically significant survival advantages for patients with low baseline testosterone (Progression Free Survival HR 1.86 and Overall Survival HR 4.85). In discussion, the author states that a multivariate analysis is the next step to try to account for possible confounders.

This study advocates for serum testosterone evaluation prior to initiation of ADT to help predict survival outcomes and possibly better counsel patients. This abstract is hypothesis generating in that it suggests that patients with lower testosterone may harbor prostate cancers with more aggressive local tumor biology. Does this result from stronger autocrine and paracrine tumors factors? Future studies will hopefully help delineate these findings.

Authors: Anup Patel

Presenter: Anup Patel, MS, FRCS

Institution: Spire Roding Hospital, London, UK

Written By: David B. Cahn, DO, MBS, Fox Chase Cancer Center
Twitter: @dbcahn

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA
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