Impact of surgical and medical castration on serum testosterone level in prostate cancer patients.
BACKGROUND
The paper aims at evaluating the role of testosterone levels and their cut-off points in the treatment of prostate cancer with androgen deprivation therapy.


METHODS
We performed a non-systematic review of the literature, searching Medline using the following key words: 'Prostatic neoplasms/therapy' [MeSH], 'Buserelin' [MeSH], 'Goserelin' [MeSH], 'Leuprolide' [MeSH], 'Triptorelin' [MeSH], 'prostate cancer*' [tiab], and 'testoster*' [tiab].


RESULTS
The most commonly used cut-off point of testosterone to define castration was 50 ng/dl. In this respect, GnRH agonists allowed castration in a very high percentage of patients (87.5-100%). Specifically, triptorelin was reported to yield castration level of testosterone in 98.8%, the classical formulation of leuprolide in 95-98.8% of the cases, and Eligard, a novel formulation of leuprolide, in 99-100%. With regard to the 20-ng/dl breakpoint, available data suggest that goserelin yields castration level of testosterone in 96%, the classical formulation of leuprolide in 87-92% of the patients, and the novel formulation in 88-97.5%.


CONCLUSIONS
The clinical significance of different levels of testosterone yielded during androgen deprivation therapy is still unknown. Considering the standard cut-off point of 50 ng/dl, GnRH agonists allowed castration in a very high percentage of patients.
IRCCS Istituto Oncologico Veneto (IOV), University of Padua, Padua, Italy. giacomonovara@gmail.com
Giacomo
G
Novara
Antonio
A
Galfano
Silvia
S
Secco
Vincenzo
V
Ficarra
Walter
W
Artibani
D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D016903:Drug Monitoring; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008297:Male; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D013739:Testosterone / Q000097:blood*; D016896:Treatment Outcome
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone