Comparison of Testosterone and Prostate-Specific Antigen Nadir Value between Castration Resistant Prostate Cancer and Non-Castration Resistant Prostate Cancer Patients after Androgen Deprivation Therapy - A Single Center Study in Indonesia
DOI:
https://doi.org/10.3889/oamjms.2022.9388Keywords:
Castration-resistant prostate cancer, Androgen deprivation therapy, Testosterone, Prostate-specific antigen, Prostate cancerAbstract
BACKGROUND: Prostate cancer is the second most commonly occurring cancer in adult males worldwide. Androgen deprivation therapy (ADT) is the mainstay treatment for patients with advanced prostate cancer. However, despite the low testosterone level (indicative of ADT success), most advanced prostate cancers progress into an androgen unresponsive or castrate resistant state; such cases are defined as castrate-resistant prostate cancer (CRPC) and were associated with worse outcomes and more rapid prostate cancer progression. This study aimed to compare the value of nadir testosterone level and nadir PSA in CRPC and non-CRPC patients who received ADT.
AIM: This study was aimed to compare value of nadir testosterone level and nadir PSA in CRPC and non-CRPC patients who received ADT.
METHODS: Prostate cancer patients receiving ADT in dr. Hasan Sadikin Bandung General Hospital in September 2018–September 2020 without previous history of CRPC and surgical castration, and prostate cancer with histopathological confirmation were included to the study. The patients prior had received complete blockade ADT with luteinizing hormone agonist (LHRH) goserelin acetate 10.8 mg injected subcutaneously per 3 months and oral anti-androgen bicalutamide 50 mg orally daily. Testosterone and PSA levels were assessed on 1st, 3rd, 6th, and 12th month. Patients then were grouped into CRPC group and non-CRPC group and further subdivided according testosterone levels (<20 and 20–500 ng/dL). Paired t-test and Chi-square test were used to analyze statistical difference (p < 0.05 deemed significant).
RESULTS: Significantly higher baseline PSA (p = 0.002) and nadir PSA (p = 0.013) were found on the CRPC group. Nadir testosterone in CRPC group was higher than non-CRPC group but statistically insignificant (p = 0.849). Time to CRPC is faster in nadir testosterone 20–50 ng/dl group than in <20 ng/dl group but statistically insignificant (p = 0.837).
CONCLUSION: Prostate cancer patients who had high baseline PSA and nadir PSA after ADT need a longer follow-up time and more frequent testing of the testosterone and PSA values. It can predict the incidence of CRPC and to ensure that prostate cancer patients receive adequate therapy.Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Culp MB, Soerjomataram I, Efstathiou JA, Bray F, Jemal A. Recent global patterns in prostate cancer incidences and mortality rates. Eur Urol. 2020;77(1):38-52. https://doi.org/10.1016/j.eururo.2019.08.005 PMid:31493960 DOI: https://doi.org/10.1016/j.eururo.2019.08.005
Rawla P. Epidemiology of prostate cancer. World J Oncol. 2019;10(2):63-89. https://doi.org/10.14740/wjon1191 PMid:31068988 DOI: https://doi.org/10.14740/wjon1191
Wallace K, Landsteiner A, Bunner S, et al. Epidemiology and mortality of metastatic castration resistant prostate cancer (mCRPC) in a managed care population in the United States. J Clin Oncol. 2020;38:15. DOI: https://doi.org/10.1200/JCO.2020.38.15_suppl.e13592
Safriadi F, Novesar AR. Five year profiles of prostate cancer patients in a tertiary hospital in Indonesia. Majalah Kedokteran Bandung. 2019;53(2):101-6. DOI: https://doi.org/10.15395/mkb.v53n2.2212
Crawford ED, Heidenreich A, Lawrentschuk N, Tombal B, Pompeo AC, Mendoza-Valdes A, et al. Androgen targeted therapy in men with prostate cancer: Evolving practice and future considerations. Prostate Cancer Prostatic Dis. 2019;22(1):24-38. https://doi.org/10.1038/s41391-018-0079-0 PMid:30131604 DOI: https://doi.org/10.1038/s41391-018-0079-0
Joel B, Nelson M. Hormonal therapy for prostate cancer. In: Wein AJ, editor. Campbell-Walsh Urology. 11th ed. Philadelphia: Elsevier, 2016. p. 2786-803.
Sayyid RK, Sayyid AK, Klaassen Z, Fadaak K, Goldberg H, Chandrasekar T, et al. Testosterone responders to continuous androgen deprivation therapy show considerable variations in testosterone levels on followup: Implications for clinical practice. J Urol. 2018;199(1):251-6. https://doi.org/10.1016/j.juro.2017.07.078 PMid:28751266 DOI: https://doi.org/10.1016/j.juro.2017.07.078
Pinthus JH. Follicle-stimulating hormone: A potential surrogate marker for androgen deprivation therapy oncological and systemic effects. Can Urol Assoc J. 2015;9(3-4):226-7. DOI: https://doi.org/10.5489/cuaj.2874
Crowley F, Sterpi M, Buckley C, Margetich L, Handa S, Dovey Z. A review of the pathophysiological mechanisms underlying castration-resistant prostate cancer. Res Rep Urol. 2021;30:457-72. https://doi.org/10.2147/RRU.S264722 PMid:34235102 DOI: https://doi.org/10.2147/RRU.S264722
Sasaki T, Sugimura Y. The importance of time to prostate-specific antigen (PSA) nadir after primary androgen deprivation therapy in hormone-naïve prostate cancer patients. J Clin Med. 2018;7(12):565. https://doi.org/10.3390/jcm7120565 PMid:30567361 DOI: https://doi.org/10.3390/jcm7120565
Yamamoto S, Sakamoto S, Minhui X, Tamura T, Otsuka K, Sato K, et al. Testosterone reduction of ≥ 480 ng/dL predicts favorable prognosis of Japanese men with advanced prostate cancer treated with androgen-deprivation therapy. Clin Genitourin Cancer. 2017;15(6):e1107-15. https://doi.org/10.1016/j.clgc.2017.07.023 PMid:28882738 DOI: https://doi.org/10.1016/j.clgc.2017.07.023
Hamano I, Hatakeyama S, Narita S, Takahashi M, Sakurai T, Kawamura S, et al. Impact of nadir PSA level and time to nadir during initial androgen deprivation therapy on prognosis in patients with metastatic castration resistant prostate cancer. World J Urol. 2019;37(11):2365-73. https://doi.org/10.1007/s00345-019-02664-3 PMid:30729312 DOI: https://doi.org/10.1007/s00345-019-02664-3
Morote J, Orsola A, Planas J, Trilla E, Raventós CX, Cecchini L, et al. Redefining clinically significant castration levels in patients with prostate cancer receiving continuous androgen deprivation therapy. J Urol. 2007;178(4):1290-5. https://doi.org/10.1016/j.juro.2007.05.129 PMid:17698136 DOI: https://doi.org/10.1016/j.juro.2007.05.129
Shore ND, Morgans AK, Ryan CJ. Resetting the bar of castration resistance – Understanding androgen dynamics in therapy resistance and treatment choice in prostate cancer. Clin Genitourin Cancer. 2021;19(3):199-207. https://doi.org/10.1016/j.clgc.2020.08.008 PMid:33129718 DOI: https://doi.org/10.1016/j.clgc.2020.08.008
Wang Y, Dai B, Ye DW. Serum testosterone level predicts the effective time of androgen deprivation therapy in metastatic prostate cancer patients. Asian J Androl. 2017;19(2):178-83. https://doi.org/10.4103/1008-682X.174856 PMid:26975487 DOI: https://doi.org/10.4103/1008-682X.174856
Downloads
Published
How to Cite
License
Copyright (c) 2022 Ferry Safriadi, Sawkar Vijay Pramod, Bernard Partogu, Zola Wijayanti (Author)
![Creative Commons License](http://i.creativecommons.org/l/by-nc/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0