Testosterone & Docetaxel in CRPC.

[pjoshea13]

Interesting new study from Japan [1].

Higher serum testosterone was defined as ≥13 ng/dL.

"... higher serum testosterone was associated with visceral metastasis, high volume, and prostate-specific antigen", but the study conclusion singled out "higher serum testosterone (≥13 ng/dL) as a significant prognostic factor in castration-resistant prostate cancer patients treated with docetaxel therapy."

"Higher serum testosterone levels predict poor prognosis in castration-resistant prostate cancer patients treated with docetaxel."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/318...

Prostate. 2019 Dec 9. doi: 10.1002/pros.23938. [Epub ahead of print]

Higher serum testosterone levels predict poor prognosis in castration-resistant prostate cancer patients treated with docetaxel.

Ando K1, Sakamoto S1, Takeshita N1, Fujimoto A1, Maimaiti M1, Saito S2, Sanjyon P3, Imamura Y1, Sato N2, Komiya A1, Akakura K4, Ichikawa T1.

Author information

1

Department of Urology, Chiba University Hospital, Chiba, Japan.

2

Department of Urology, Funabashi Municipal Medical Center, Chiba, Japan.

3

Department of Urology, Chiba Cancer Center, Chiba, Japan.

4

Department of Urology, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Chiba, Japan.

Abstract

BACKGROUND:

The role of testosterone as a prognostic factor for castration-resistant prostate cancer treated with docetaxel in Japan was investigated.

METHODS:

A total of 164 patients with castration-resistant prostate cancer who received docetaxel treatment at Chiba University Hospital and an affiliated hospital were retrospectively analyzed. Testosterone and other clinical factors at the start of docetaxel treatment were evaluated with respect to overall survival and progression-free survival.

RESULTS:

Of the 164 patients, 69 had high-volume tumors. The median prostatic-specific antigen was 27.0 ng/mL. The median testosterone was 13.0 ng/dL. The rates of bone and visceral metastases were 80.1% and 8.8%, respectively. For progression-free survival, testosterone ≥13 ng/dL was an independent prognostic factor only on univariate analysis (hazard ratio, 1.81; P = .0108). For overall survival, testosterone ≥ 1.3 ng/dL (hazard ratio, 3.37; P < .0001), high volume (hazard ratio, 3.06; P = .0009), and prostate-specific antigen ≥ 27.0 ng/mL (hazard ratio, 2.75; P = .0013) were independent prognostic factors on multivariate analysis. When assessing related clinical factors, higher serum testosterone was associated with visceral metastasis, high volume, and prostate-specific antigen. Based on three prognostic factors (testosterone, high volume, prostate-specific antigen), a risk classification was developed. The high-risk group (3 risk factors) showed a significantly shorter overall survival compared to the moderate-risk (2 risk factors) and low-risk (0-1 risk factor) groups (P < .0001).

CONCLUSIONS:

The present study identified higher serum testosterone (≥13 ng/dL) as a significant prognostic factor in castration-resistant prostate cancer patients treated with docetaxel therapy.

© 2019 Wiley Periodicals, Inc.

KEYWORDS:

abiraterone; androgen receptor; chemotherapy; enzalutamide; prostate-specific antigen

PMID: 31816126 DOI: 10.1002/pros.23938

[tom67inMA]

Hmm, is that 1.3 in "For overall survival, testosterone ≥ 1.3 ng/dL" a typo? The one time I had my T tested the test didn't even go that low, it just said <7.

[6357axbz in reply to tom67inMA]

Mine does too. <7.

[pjoshea13 in reply to 6357axbz]

I think they intended "13" - not "1.3". -Patrick

[tallguy2]

Wow. Many doctors use T <50 ng/dL as the high water mark. I've always thought being down around 10 ng/dL was low enough. We need a way to move the decimal point to the left.

[Hidden]

My research MO used <5.0 as the goal back in 2004. I maintained the goal and in 2011 had to add low dose Androgel to raise T.

GD