Low pre-adt testosterone level is related to earlier castration resistance in metastatic prostate cancer: a multicentre cohort study

You have accessJournal of UrologyCME1 Apr 2023MP29-06 LOW PRE-ADT TESTOSTERONE LEVEL IS RELATED TO EARLIER CASTRATION RESISTANCE IN METASTATIC PROSTATE CANCER: A MULTICENTRE COHORT STUDY Ho Ming Chris Wong, Peter Ka-Fung Chiu, Ignacio Puche-Sanz, Zhao Xue, Dong Ning Chen, Enrique Gomez-Gomez, Isabel Heidegger, Mona Kafka, Yong Wei, Shinichi Sakamoto, and Chi Fai Ng Ho Ming Chris WongHo Ming Chris Wong More articles by this author , Peter Ka-Fung ChiuPeter Ka-Fung Chiu More articles by this author , Ignacio Puche-SanzIgnacio Puche-Sanz More articles by this author , Zhao XueZhao Xue More articles by this author , Dong Ning ChenDong Ning Chen More articles by this author , Enrique Gomez-GomezEnrique Gomez-Gomez More articles by this author , Isabel HeideggerIsabel Heidegger More articles by this author , Mona KafkaMona Kafka More articles by this author , Yong WeiYong Wei More articles by this author , Shinichi SakamotoShinichi Sakamoto More articles by this author , and Chi Fai NgChi Fai Ng More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003257.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Androgen deprivation therapy (ADT) is key to the treatment of metastatic prostate cancer (mHSPC). The evidence of baseline testosterone prior to ADT on mHSPC outcomes is scarce in the era of concurrent therapy.We aim to investigate the effect of baseline testosterone on time to castration resistant prostate cancer (CRPC) in a cohort of mHSPC. METHODS: This is a multicentre review of prospectively maintained databases from China, Japan, Austria and Spain, including patients with pre-ADT testosterone levels. 249 cases of mHSPC with ADT initiated from 2002 to 2021, with histologically proven Ca Prostate were analysed.Baseline testosterone was divided into high and low with a cutoff of 12 nmol/L. Kaplan-Meier was used to evaluate the correlation between baseline testosterone level and time to CRPC. Subgroup analysis was performed to elucidate the effect of volume of metastasis (by criteria adopted in CHAARTED trial) and use of concurrent treatment (use of chemotherapy or novel hormonal agent at the beginning of ADT). The primary outcome is time to CRPC (PSA progression of >25% rise above the nadir). RESULTS: The median age was 71 (IQR 10). Median follow up time was 30 months. Median pre-ADT PSA level was 156 ng/mL. The portion of cases of ISUP grade 1-3, 4 and 5 respectively was 6.3%, 30.8% and 62.9%. 150 patients (60.2%) had high volume metastasis at diagnosis. 170 patients (67.7%) received concurrent therapy. 115 patients (45.8%) developed CRPC at the end of data collection. The mean time to CRPC of the cohort is 20.0 months (SEM: 2.1). Overall there was no correlation between baseline testosterone and time to CRPC.In the subgroup of cases without concurrent therapy, a lower baseline testosterone level was associated with significantly shorter time to CRPC (p=0.015), so was in the subgroup of low volume metastasis (p=0.009). In the subgroup of high volume metastasis or men with concurrent therapy, baseline testosterone was not associated with time to CRPC. CONCLUSIONS: In low volume mHSPC or in the absence of concurrent therapy, a lower baseline testosterone level was associated with shorter time to CRPC. Pre-treatment testosterone level may predict prognosis in mHSPC. mHSPC patients with low baseline testosterone should be encouraged to use concurrent therapy to delay progression to CRPC. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e382 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ho Ming Chris Wong More articles by this author Peter Ka-Fung Chiu More articles by this author Ignacio Puche-Sanz More articles by this author Zhao Xue More articles by this author Dong Ning Chen More articles by this author Enrique Gomez-Gomez More articles by this author Isabel Heidegger More articles by this author Mona Kafka More articles by this author Yong Wei More articles by this author Shinichi Sakamoto More articles by this author Chi Fai Ng More articles by this author Expand All Advertisement PDF downloadLoading ...