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Deferred combined androgen blockage therapy using
bicaultamide [80mg/d] in patients with hormone-refractory prostate
cancer during androgen deprivation monotherapy
(October 2006)
Although
LH-RH agonist products carry marketing designations of 3, 4, or 12
months duration, clinicians are well aware that the duration of
testosterone suppression usually lasts far longer than the implied
period. A March 2006 report in PROSTATE from Japan quantified the
prolongation of suppression that followed a 30 month median duration of
treatment in 32 men who exhibited castrate levels at the end of therapy.
Testosterone and lutenizing hormone levels were measured at 3 months
intervals. Results: "Median duration of castrate T levels following
cessation was 6 months. Median time to normalization of T levels was 24
months", whereas LH levels recovered in 3 months. Men older than 65
recovered at a slower rate [some never recovering fully].
Abstract
No.90 presented at the 2006 Prostate Cancer Symposium reported on "the
time course of recovery of serum testosterone levels after a short
course of LH-RH analogue and radical radiotherapy to the prostate".
Fifty nine men were measured at baseline, and at 6 weeks, 12, 18, 24 and
>40 weeks after the last injection. The median treatment period was
about 3 months. Conclusion: at 6 weeks after LH-RH cessation no patient
showed testosterone recovery. Recovery was seen in 35% at 12 weeks, 85%
at 18 weeks, 89% at 24 weeks, and 96% at 1 year, and "the mean
testosterone level at 52 weeks was similar to the baseline level".
Both studies offer perspective to the interpretation of
PSA levels following treatment with LH-RH agonists.
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