Does Degree of Androgen Suppression Matter in Hormone-Sensitive Prostate Cancer?
Menée à partir des données portant sur 696 patients recevant un traitement anti-androgénique continu après récidive biochimique d'un cancer de la prostate traité par radiothérapie en combinaison ou non avec une intervention chirurgicale, cette étude met en évidence une association entre le niveau maximal de testostérone durant la première année du traitement anti-androgénique et la durée de la réponse à ce traitement
In men with metastatic prostate cancer, androgen-deprivation therapy (ADT) is the mainstay of therapy. Through reduction of serum testosterone from normal levels (approximately 250 to 950 ng/dL [8 to 32 nmol/L]) to castrate levels, ADT has been shown to reduce tumor burden and alleviate symptoms and may improve survival. Although ADT can suppress circulating testosterone levels by 90% to 95%, not all men achieve a testosterone level in the castrate range; others may initially achieve castrate levels but then experience testosterone breakthrough above that level. Castration has historically been defined as serum testosterone of less than 20 ng/dL (0.7 nmol/L), although a threshold of less than 50 ng/dL (1.7 nmol/L) was adopted by the Prostate Cancer Working Group 2 for the purposes of clinical trial accrual. However, this was essentially an arbitrary threshold, and the clinical significance of the testosterone level and the optimal degree of testosterone suppression following ADT remain in question.
Journal of Clinical Oncology , éditorial en libre accès, 2015