Low nadir serum testosterone in the first year of androgen deprivation therapy was associated with improved survival and time to progression in men with recurrent prostate cancer, reported Dr. Laurence Klotz and his coauthors at the University of Toronto Sunnybrook Health Sciences Centre.
In a study of prostate cancer patients who experienced biochemical failure after radiation therapy, surgery plus radiation therapy, or androgen deprivation, a nadir testosterone value of < 0.7 mmol/L was associated with improved cause-specific survival (P = .015) and time to progression (P = .02) compared with patients who had higher testosterone levels, the authors said.
“Prospective randomized trials comparing standard ADT with more potent androgen suppression” are needed before recommending androgen deprivation to a greater degree in these men, Dr. Daniel L. Suzman and Dr. Emmanuel S. Antonarakis of Johns Hopkins Sidney Kimmel Comprehensive Cancer Center cautioned in an editorial . “Until these or similar results are available, we should not recommend deeper androgen suppression in the first-line setting for men with (metastatic or nonmetastatic) hormone-sensitive prostate cancer,” they wrote.
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