MP48-05 CHANGES IN PITUITARY–GONADAL HORMONES AFTER ENZALUTAMIDE OR ABIRATERONE PLUS PREDNISONE IN MEN WITH CASTRATION-RESISTANT PROSTATE CANCER (HEAT): RESULTS FROM A RANDOMISED CLINICAL TRIAL

Abstract

You have accessJournal of UrologyCME1 May 2022MP48-05 CHANGES IN PITUITARY–GONADAL HORMONES AFTER ENZALUTAMIDE OR ABIRATERONE PLUS PREDNISONE IN MEN WITH CASTRATION-RESISTANT PROSTATE CANCER (HEAT): RESULTS FROM A RANDOMISED CLINICAL TRIAL Klara Ternov, Jens Sønksen, Mikkel Fode, Henriette Lindberg, Caroline Kistorp, Rasmus Bisbjerg, Jens Faber, Ganesh Palapattu, and Peter Busch Østergren Klara TernovKlara Ternov More articles by this author , Jens SønksenJens Sønksen More articles by this author , Mikkel FodeMikkel Fode More articles by this author , Henriette LindbergHenriette Lindberg More articles by this author , Caroline KistorpCaroline Kistorp More articles by this author , Rasmus BisbjergRasmus Bisbjerg More articles by this author , Jens FaberJens Faber More articles by this author , Ganesh PalapattuGanesh Palapattu More articles by this author , and Peter Busch ØstergrenPeter Busch Østergren More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002619.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Enzalutamide (ENZ) and abiraterone acetate plus prednisone (AAP) are both androgen receptor targeting treatments for metastatic castration-resistant prostate cancer (mCRPC). AAP inhibits the androgen production, whereas ENZ blocks the androgen receptor signalling. Herein, we compare treatment changes between ENZ and AAP in hormones of the pituitary–gonadal axis. METHODS: First-line ENZ (160 mg/day) and AAP (1000 mg abiraterone acetate and 10 mg prednisone/day) for mCRPC were compared in this randomised (1:1) phase IV trial. Eligible patients had progressive metastatic prostate cancer castrate levels of testosterone (<1.7 nmol/L). Fasting serum hormones, including testosterone, free-testosterone, sexual hormone binding globulin (SHGB), follicle-stimulating hormone (FSH) and luteinizing hormone (LH), were measured by the gold standard assay liquid chromatography – tandem mass spectrometry before 11 am at baseline and at 12-week post-intervention. The treatment difference in changed hormones was compared with logarithmic mixed models analysis, and the within-subject change for each treatment group was analysed with logarithmic paired samples t-test. RESULTS: From June 2017 to September 2019, 170 participants were randomized to receive ENZ (n=84 analysed) or AAP (n=85 analysed). A 19.9% higher increase in FSH was found for ENZ than AAP. A larger decline in testosterone and SHGB was found for AAP than ENZ. More patients had lower than detectable levels of free-testosterone in the AAP group (83/85) than the ENZ group (6/84) (chi-square test p <0.001). CONCLUSIONS: In men with castrate-levels of testosterone, ENZ and AAP both inhibit the androgen stimulation of prostate cancer, but by different mechanism of action resulting in different pituitary–gonadal hormonal profiles. Source of Funding: Herlev and Gentofte University Hospital © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e821 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Klara Ternov More articles by this author Jens Sønksen More articles by this author Mikkel Fode More articles by this author Henriette Lindberg More articles by this author Caroline Kistorp More articles by this author Rasmus Bisbjerg More articles by this author Jens Faber More articles by this author Ganesh Palapattu More articles by this author Peter Busch Østergren More articles by this author Expand All Advertisement PDF DownloadLoading ...