MP40-16 CAN CLOMIPHENE CITRATE BE USED TO TREAT HYPOGONADISM IN TESTICULAR CANCER PATIENTS FOLLOWING CHEMOTHERAPY?

Abstract

You have accessJournal of UrologyPenile & Testicular Cancer I (MP40)1 Sep 2021MP40-16 CAN CLOMIPHENE CITRATE BE USED TO TREAT HYPOGONADISM IN TESTICULAR CANCER PATIENTS FOLLOWING CHEMOTHERAPY? Aisha Siebert, Jake Miller, Evan Panken, Gregory Auffenberg, Richard Fantus, Joshua Halpern, Nelson Bennett, Robert Brannigan, Brian Myre, and James Wren Aisha SiebertAisha Siebert More articles by this author , Jake MillerJake Miller More articles by this author , Evan PankenEvan Panken More articles by this author , Gregory AuffenbergGregory Auffenberg More articles by this author , Richard FantusRichard Fantus More articles by this author , Joshua HalpernJoshua Halpern More articles by this author , Nelson BennettNelson Bennett More articles by this author , Robert BranniganRobert Brannigan More articles by this author , Brian MyreBrian Myre More articles by this author , and James WrenJames Wren More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002055.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testicular cancer is the most common cancer in males aged 15-39, yet curative treatment with radical orchiectomy and chemotherapy renders 38% of males hypogonadal. Clomiphene is used in an off-label fashion to treat hypogonadism in males with infertility but despite being an inexpensive oral alternative testosterone replacement therapy, it is not commonly used to treat hypogonadal testicular cancer survivors following chemotherapy. To assess the use of clomiphene in hypogonadal testicular cancer survivors treated with radical orchiectomy and chemotherapy. METHODS: Following IRB approval, we performed a retrospective chart analysis of all patients who had undergone a radical orchiectomy from 2004 to 2020. Inclusion criteria were males >18 years of age who had undergone a radical orchiectomy and chemotherapy for testicular cancer who were subsequently treated with clomiphene due to symptomatic hypogonadism (testosterone<300ng/dL). Mean testosterone levels were compared using a paired, two-tailed t-test. Luteinizing hormone (LH) levels were compared using a one-tailed, two-sample t-test assuming equal variance. RESULTS: In total, 476 radical orchiectomies were performed with 10 patients meeting the inclusion criteria (Table 1). Clomiphene was associated with a 273 ng/dL mean increase in testosterone (215 ng/dL to 486 ng/dL), in post chemotherapy patients (Fig 1, A). No side effects or evidence of disease recurrence occurred. No false positive elevation of HCG tumor markers related to clomiphene induced LH increase occurred (7.0 IU/L to 13.8 IU/L) (Fig 1, B). CONCLUSIONS: This is the first study to assess the use of clomiphene in hypogonadal testicular cancer survivors following chemotherapy. Clomiphene was associated with an increase in testosterone levels with no associated side effects or evidence of disease recurrence. Further studies are needed to define the role of clomiphene use in hypogonadal testicular cancer survivors. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e720-e721 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aisha Siebert More articles by this author Jake Miller More articles by this author Evan Panken More articles by this author Gregory Auffenberg More articles by this author Richard Fantus More articles by this author Joshua Halpern More articles by this author Nelson Bennett More articles by this author Robert Brannigan More articles by this author Brian Myre More articles by this author James Wren More articles by this author Expand All Advertisement Loading ...