PD05-12 PERSISTENT TESTOSTERONE SUPPRESSION AFTER CESSATION OF ANDROGEN DEPRIVATION THERAPY FOR LOCALIZED PROSTATE CANCER: AN ELECTRONIC HEALTH RECORDS NETWORK STUDY OF 66 MILLION PEOPLE

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) I (PD05)1 Sep 2021PD05-12 PERSISTENT TESTOSTERONE SUPPRESSION AFTER CESSATION OF ANDROGEN DEPRIVATION THERAPY FOR LOCALIZED PROSTATE CANCER: AN ELECTRONIC HEALTH RECORDS NETWORK STUDY OF 66 MILLION PEOPLE Joshua Bitran, Daniel Gonzalez, Jesse Ory, Maxwell Towe, and Ranjith Ramasamy Joshua BitranJoshua Bitran More articles by this author , Daniel GonzalezDaniel Gonzalez More articles by this author , Jesse OryJesse Ory More articles by this author , Maxwell ToweMaxwell Towe More articles by this author , and Ranjith RamasamyRanjith Ramasamy More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001969.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Temporary use of Androgen Deprivation Therapy (ADT) is a cornerstone in the treatment of localized prostate cancer. While ADT is typically used for a defined period of time in these patients, the ability for testosterone to recover afterwards is not well understood. The aim of this study was to investigate the kinetics of testosterone recovery following varying types and lengths of temporary ADT. METHODS: We used a global federated health research network (TriNetX) to identify men with a diagnosis of prostate cancer who underwent temporary use of ADT. Three cohorts were identified: LHRH agonist only, combined ADT (LHRH agonist and antiandrogens), and LHRH antagonist only. In each cohort, testosterone levels were gathered for patients that underwent ADT therapy for at least 2 years. Men were excluded if they received ADT after this time period. Testosterone levels for men in the same age group at time of diagnosis of prostate cancer who never received ADT were used as a control. RESULTS: A total of 34,079 men received LHRH agonists, 16,054 men received combined ADT with LHRH agonist and antiandrogen, and 2307 men received LHRH antagonist. Mean age was similar in all three cohorts (71+/-10 years). 70% of patients were white, 14% African American, 2% Asian, and 14% unknown race. None of the men who received either LHRH agonist or combined ADT for 2 years or longer recovered to eugonadal levels (T>300ng/dL) even after 5 years of cessation (mean T levels = 159 ng/dL or 169 ng/dL, respectively). However, 50% of men who received LHRH antagonist for 2 years recovered T levels to eugonadal range after 5 years of cessation (mean T = 382 ng/dL). The control group consisted of 5727 men with prostate cancer who never received ADT or testosterone therapy (mean age at diagnosis, 71 years). Mean testosterone levels ranged from 340 at diagnosis to 402 5 years after diagnosis. CONCLUSIONS: Five years after ADT cessation, incomplete testosterone recovery persists in majority of the men. Testosterone deficiency will lead to metabolically adverse changes in body composition, increased insulin resistance, impaired bone health, and poor quality of life and needs to be closely followed-up in men receiving ADT and should continue after cessation of treatment. Source of Funding: Clinician Scientist Development Award from American Cancer Society © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e61-e61 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Bitran More articles by this author Daniel Gonzalez More articles by this author Jesse Ory More articles by this author Maxwell Towe More articles by this author Ranjith Ramasamy More articles by this author Expand All Advertisement Loading ...