BAT

[podsart]

Some of us have been interested in BAT. I can’t get access to the full article, however, some of you seem to be good at that and perhaps can get us the full article

practiceupdate.com/content/...

Published in Advanced Prostate Cancer and 1 other channel

Journal Scan / Review · August 31, 2020

Bipolar Androgen Therapy in Prostate Cancer

Critical Reviews in Oncology / Hematology

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The authors of this review summarize the results of several phase I and II studies utilizing bipolar androgen therapy, the combination of regular androgen deprivation therapy (ADT) and testosterone injections to reach transitory supra-physiologic testosterone levels thereby opposing the adaptive response of tumor cells to ADT. In theory, this may maintain metastatic prostate cancer cells in a prolonged hormone-sensitive state.

Many of the early trials reviewed show promising results regarding the delay or reversion of progression to castrate resistance. However, phase III trials are needed to further support the validity of this interesting treatment strategy.

– Emily Miller, MD

Abstract

This abstract is available on the publisher's site.

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Testosterone suppression by androgen deprivation therapy is the cornerstone of prostate cancer treatment. New-generation hormone therapies improved overall survival in castration-resistant prostate cancer. More recent trials showed a further increase in overall survival when enzalutamide or abiraterone are associated with androgen deprivation therapy in hormone-sensitive disease. However, a higher clonal pressure may lead to the upregulation of alternative pathways for cancer progression and to dedifferentiated diseases that would probably respond poorly to subsequent treatments. In this contest, new strategies that could be able to delay or even revert resistance are needed. The bipolar androgen therapy is an under-investigation treatment that consists in periodical oscillation between castration levels and supraphysiological levels of testosterone in order to prevent the adaptation of prostate cancer cells to a low-androgen environment. This review aims to underline the biological rationale of bipolar androgen therapy and gather evidences from the most recent clinical trials.

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[pjoshea13]

sci-hub.tw/10.1016/j.critre...

[podsart in reply to pjoshea13]

Thanks again for your help!

[kaptank in reply to podsart]

Thanks to both of you. I was looking for that.

I think BAT is firming up as a useful management tool rather than a stand-alone primary treatment. The evidence is accumulating that it reverses resistance and allows longer use of ADT/antiandrogen treatments, immuno therapies and PARP inhibitors. Its easy, cheap and generally safe.

Things to watch out for are existing bone pain and making sure you get to true physiological levels (patches and gels cannot do it. intramuscular injection needed). Another thing not widely realised is that PSA tests during the BAT phase are not very reliable and can fluctuate. They are OK in the rechallenge phase.