PD11-07 CHRONOLOGY OF ENDOGENOUS TESTOSTERONE RECOVERY FOLLOWING ADT CESSATION – RESULTS FROM A PROSPECTIVE ANALYSIS

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You have accessJournal of UrologyCME1 Apr 2023PD11-07 CHRONOLOGY OF ENDOGENOUS TESTOSTERONE RECOVERY FOLLOWING ADT CESSATION – RESULTS FROM A PROSPECTIVE ANALYSIS Bruno Nascimento, Rubens Pedrenho Neto, Pedro C.E. Zandoná, Diogo Assed Bastos, Rafael F. Coelho, Jose Bessa, Feira De Santana, William C. Nahas, Jorge Hallak, Cristiano M. Gomes, and John P. Mulhall Bruno NascimentoBruno Nascimento More articles by this author , Rubens Pedrenho NetoRubens Pedrenho Neto More articles by this author , Pedro C.E. ZandonáPedro C.E. Zandoná More articles by this author , Diogo Assed BastosDiogo Assed Bastos More articles by this author , Rafael F. CoelhoRafael F. Coelho More articles by this author , Jose BessaJose Bessa More articles by this author , Feira De SantanaFeira De Santana More articles by this author , William C. NahasWilliam C. Nahas More articles by this author , Jorge HallakJorge Hallak More articles by this author , Cristiano M. GomesCristiano M. Gomes More articles by this author , and John P. MulhallJohn P. Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003251.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testosterone (T) recovery after androgen deprivation therapy (ADT) is reported variably in the literature (7 to 96%), due to variable definitions, follow up periods and with data coming mainly from restrospective studies. Age, diabetes and baseline T are reported as associated factors with recovery. Our aim was to report the chronology of T recovery following ADT cessation. METHODS: This is a secondary analysis of an oncological study with a prospective design evaluating the neoadjuvant use of ADT in combination with abiraterone acetate and prednisone with or without apalutamide in high-risk localized patients. Both regimens were administered for 3 m before radical prostatectomy (RP). Early morning Total T (TT) levels were collected at baseline and periodically (3, 6 and 12 m) after ADT cessation. 3 outcomes for T recovery were evaluated: return to non-castrate level (TT > 50 ng/dL), to normal (TT ≥ 300 ng/dL) and back to baseline level (BTB –TT≥ baseline level). We performed a time-to-event analysis and reported the cumulative incidence of each outcome. Multivariable analysis was conducted to investigate predictors of recovery. RESULTS: In this preliminary report, from 64 initially enrolled patients, 1 year follow-up T data from 50 pts were available. Mean age was 64,6y (± 5,89), 28% had type 2 diabetes (DM) and 61% hypertension (HTN). Mean baseline TT was 450ng/dl (± 170) ng/dL, 112,7 at 3m ( ± 96,9), 208,5 ( ±197) at 6m, 337,7 ( ± 170) at 9m and 378,2 (± 166) at 12 m. Figure 1 represents the cumulative incidence of each outcome according to time. Median time to achieve T>50 was 5 m, to achieve T>300 was 9,1 m and BTB 13,13 m. At 1 year, 98% had return back from castrate-level, 76% had TT normalized and only 42% had return BTB. In multivariable analysis including DM, HTN, age and baseline T, only baseline T was significantly associated with a greater chance of recovery, with 88,5% and 46,9% achieving normal T at 1y for patients with baseline T greater and lower than 450 ng/dl (HR: 3,56, p=0,0008) CONCLUSIONS: In this prospective analysis of a population exposed to neoadjuvant short-term ADT, T recovery rates were relatively high at1 year, with 98% having TT>50 ng/dl, about 2/3 third having TT back to TT>300 ng/dl, but with less than half with BTB level. An effort should be made to measure TT before starting ADT. Source of Funding: Janssen-Cilag Farmacêutica Ltda © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e334 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bruno Nascimento More articles by this author Rubens Pedrenho Neto More articles by this author Pedro C.E. Zandoná More articles by this author Diogo Assed Bastos More articles by this author Rafael F. Coelho More articles by this author Jose Bessa More articles by this author Feira De Santana More articles by this author William C. Nahas More articles by this author Jorge Hallak More articles by this author Cristiano M. Gomes More articles by this author John P. Mulhall More articles by this author Expand All Advertisement PDF downloadLoading ...