OBJECTIVE: • Androgen stimulation of prostate cancer (PCa) cells has been extensively studied. The increasing trend of using serum testosterone as an absolute surrogate for castration state means that the diagnostic measurement of testosterone and the values potentially influencing prognosis must be better understood. This is especially important when PCa progresses from an endocrine to an intracrine status. PATIENTS AND METHODS: • We performed a literature review using the MEDLINE database for publications on: (i) hormonal changes with androgen deprivation therapy (ADT); (ii) monitoring hormonal therapy with testosterone measurement; (iii) the efficacy of intermittent androgen deprivation (IAD) compared with continuous androgen deprivation; (iv) the underlying mechanisms of castration-resistance; and (v) novel treatments for castration-resistant PCa (CRPCa). RESULTS: • The optimum serum castration levels to be achieved with ADT are still debated. Recently, the 50 ng/dL threshold has been questioned because of reports indicating worse outcomes when levels between 20 and 50 ng/dL were studied. Instead, a 20 ng/dL threshold for serum testosterone after ADT in patients with advanced prostate cancer was recommended. CONCLUSION: • Understanding the mechanisms of androgen biosynthesis relating to PCa as well as prognostic implications might achieve a consensus regarding the role of ADT for both the androgen-sensitive and -insensitive disease state.
OBJECTIVE: • Androgen stimulation of prostate cancer (PCa) cells has been extensively studied. The increasing trend of using serum testosterone as an absolute surrogate for castration state means that the diagnostic measurement of testosterone and the values potentially influencing prognosis must be better understood. This is especially important when PCa progresses from an endocrine to an intracrine status. PATIENTS AND METHODS: • We performed a literature review using the MEDLINE database for publications on: (i) hormonal changes with androgen deprivation therapy (ADT); (ii) monitoring hormonal therapy with testosterone measurement; (iii) the efficacy of intermittent androgen deprivation (IAD) compared with continuous androgen deprivation; (iv) the underlying mechanisms of castration-resistance; and (v) novel treatments for castration-resistant PCa (CRPCa). RESULTS: • The optimum serum castration levels to be achieved with ADT are still debated. Recently, the 50 ng/dL threshold has been questioned because of reports indicating worse outcomes when levels between 20 and 50 ng/dL were studied. Instead, a 20 ng/dL threshold for serum testosterone after ADT in patients with advanced prostate cancer was recommended. CONCLUSION: • Understanding the mechanisms of androgen biosynthesis relating to PCa as well as prognostic implications might achieve a consensus regarding the role of ADT for both the androgen-sensitive and -insensitive disease state.
Authors: Kyle O Rove; E David Crawford; Massimo Perachino; Juan Morote; Laurence Klotz; Paul H Lange; Gerald L Andriole; Alvin M Matsumoto; Samir S Taneja; Mario A Eisenberger; Leonardo O Reis Journal: Urology Date: 2014-04-06 Impact factor: 2.649
Authors: Christopher M Pieczonka; Przemyslaw Twardowski; Joseph Renzulli; Jason Hafron; Deborah M Boldt-Houle; Stuart Atkinson; Scott Eggener Journal: Rev Urol Date: 2018
Authors: Aaron Spitz; Marc Gittelman; Lawrence I Karsh; Sanja Dragnic; Ahmed M Soliman; Aditya Lele; Damian Gruca; Michael Norton Journal: Res Rep Urol Date: 2016-08-23
Authors: E David Crawford; Axel Heidenreich; Nathan Lawrentschuk; Bertrand Tombal; Antonio C L Pompeo; Arturo Mendoza-Valdes; Kurt Miller; Frans M J Debruyne; Laurence Klotz Journal: Prostate Cancer Prostatic Dis Date: 2018-08-21 Impact factor: 5.554