Objectives
To examine the duration of serum testosterone and prostate-specific antigen suppression
after each dose of a 4-month depot leuprolide acetate for 18 months and to assess
the potential for using serum testosterone as a guide for redosing the luteinizing
hormone-releasing hormone analogs instead of using fixed dosing intervals. Luteinizing
hormone-releasing hormone analogs are well established for the treatment of prostate
cancer (PCa). However, many open questions remain regarding the optimal dosing.
Methods
Thirteen patients with PCa were enrolled in a longitudinal study. Serum testosterone
levels were obtained at baseline and then monthly beginning 4 months after the first
injection and every 2 months after the subsequent injections, for a total of 18 months.
The median number of days from injection to the first serum testosterone level ≥50
ng/dL was estimated using the Kaplan-Meier product-limit method.
Results
The median duration of effect was 159, 189, and 163 days for the first, second, and
third treatment cycle, respectively. The prostate-specific antigen values from entry
to completion decreased in all subjects. The total number of injections was reduced
in all but one subject who completed the 18-month trial. One patient developed hormone-refractory
PCa.
Conclusions
Serum testosterone measurement might be a useful method for redosing luteinizing hormone-releasing
hormone analogs. Using testosterone levels to determine the time of reinjection has
a significant economic impact. Monitoring serum testosterone not only helps to identify
patients who fail to achieve testosterone suppression but also provides close monitoring
for the potential development of hormone-refractory PCa.
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Article info
Publication history
Published online: December 24, 2008
Accepted:
August 18,
2008
Received:
February 25,
2008
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Re: Greil et al.: Efficacy Over Time of LHRH Analogs in the Treatment of PCa—A Prospective Analysis Using Serum Testosterone to Determine Dosing Intervals (Urology 2009;73:631-634)UrologyVol. 73Issue 6
- PreviewHormonal therapy is one of the most effective treatment strategies available for prostate cancer. Despite using hormone manipulation for decades, many questions are still unanswered with regard to its proper use.1,2 The authors of the article studied the use of hormonal therapy using testosterone levels as a guide to determine the timing of the next hormonal treatment.
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