Prolactin & Abiraterone

[pjoshea13]

Interesting new paper from Shanghai [1].

"Conclusions: Serum PRL levels are predictive of response to AA in patients with mCRPC. Serum PRL levels are positively correlated with the volume of metastatic bone disease."

"The study included 61 patients with a median follow-up of 19.0 months. Patients with lower baseline PRL levels (median) responded better to AA than those with higher baseline PRL levels as indicated by:

... "prostate-specific antigen (PSA) reduction (PSA90, 66.7% vs. 25.8% ...),

... "PFS {progression-free survival} (19.6 vs. 7.9 months), and

... "OS {overall survival } (52.8 vs. 19.2 months)."

Quite a difference.

Coincidentally, there was a post on prolactin a few days ago:

healthunlocked.com/advanced...

& 3 years ago:

healthunlocked.com/advanced....

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/357...

Prostate

. 2022 Jun 23. doi: 10.1002/pros.24402. Online ahead of print.

Serum prolactin level as a predictive factor for abiraterone response in patients with metastatic castration-resistant prostate cancer

Tao Yang 1 , Ying Liu 1 , Shuzhen Chen 2 , Jiale Tian 3 , Xuyou Zhu 4 , Long Zhang 4 , Wei Wang 5 , Yingyi Qin 6 , Jens Richter 7 , Aseem Anand 7 , Chengdang Xu 1 , Yongnan Chi 1 , Chenyang Wang 1 , Cuidong Bian 1 , Denglong Wu 1 , Zhenfei Li 1 8 , Shengsong Huang 1

Affiliations collapse

Affiliations

1 Department of Urology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

2 Department of Nuclear Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

3 Department of Laboratory Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

4 Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

5 Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

6 Department of Health Statistics, Naval Medical University, Shanghai, China.

7 Department of Digital Imaging Biomarkers, EXINI Diagnostics AB, Lund, Sweden.

8 State Key Laboratory of Cell Biology, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, China.

PMID: 35747943 DOI: 10.1002/pros.24402

Abstract

Background: To investigate the prognostic value and potential therapeutic target of the baseline serum hormones in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone.

Methods: This retrospective study was performed in patients with mCRPC receiving abiraterone acetate (AA) from July 2016 to September 2020. Patients who had serum hormone tests within 2 weeks before AA treatment were included. Univariate analysis and Cox regression were performed to evaluate the correlation of sex hormones with progression-free survival (PFS) and overall survival (OS). Prolactin (PRL) expression in the clinical specimens was evaluated by immunohistochemistry. Bone metastases were quantified by automated Bone Scan Index (aBSI).

Results: The study included 61 patients with a median follow-up of 19.0 months. Patients with lower baseline PRL levels (median) responded better to AA than those with higher baseline PRL levels as indicated by prostate-specific antigen (PSA) reduction (PSA90, 66.7% vs. 25.8%, p = 0.001), PFS (19.6 vs. 7.9 months), and OS (52.8 vs. 19.2 months). Cox regression adjusted for clinical factors also confirmed that baseline PRL level was an independent predictive factor for PFS (hazard ratio = 1.096, p = 0.007). Prostatic PRL expression increased as the disease progressed. PRL expression was also detected in biopsy samples from bone metastasis but not in normal bone tissue, and the serum PRL levels were positively correlated with aBSIs (r = 0.28, p = 0.037).

Conclusions: Serum PRL levels are predictive of response to AA in patients with mCRPC. Serum PRL levels are positively correlated with the volume of metastatic bone disease.

Keywords: abiraterone; castration resistant; prognosis; prolactin; prostate cancer.

© 2022 Wiley Periodicals LLC.

[LearnAll]

Cabergoline is prescription med and certainly lowers Serum Prolactin. I lower my prolactin by VITEX FRUIT, an inexpensive supplement by Natures Way available on Amazon.

[pjoshea13 in reply to LearnAll]

I came across Vitex (Chasteberry) years ago. It is also known as Monk's Pepper & was used by celibate males to dampen the sex drive.

Used more by females during menstruation.

-Patrick

[LearnAll in reply to pjoshea13]

True. One other issue with high prolactin levels is slow decline in bone mineral density...In PCa..most of us are already at risk of losing our bone mineral density which lowering prolactin can prevent partially. As for loss of sexual desire... most men on PCa meds do not have any sex drive any way.

Repeat sex offenders and serial rapists should be on Cabergoline to keep their prolactin very very low to save other people from them ...But unfortunately the system does not allow use of meds to control criminal behavior.

[LearnAll]

12 months ago, Prolactin was 3.8 (range 2 to 18 ng/ml) when I was taking Vitex Fruit Capsules. I am scheduled to check serum prolactin in July.

[MateoBeach]

OK. but it appears that a 90% PSA response when started on abiraterone is strongly (positively) correlated with much better PFS and OS. No surprise there. Not sure a baseline prolactin level adds much to that. Unless one is willing to intervene and reduce prolactin with cabergoline. Then what happens? That is the pre-trial series or phase 1 clinical trial that is missing. What about those with BCR or CRPC who are progressing with PSADT <6 months trying cabergoline and monitor prolactin levels and PSA dynamics? It would be a start. Very interested to know.