Related Experiment Video
Updated: Apr 9, 2026
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Serum follicle-stimulating hormone levels predict time to development of castration-resistant prostate cancer
Dylan Hoare1, Thomas A A Skinner1, Angela Black1
1Department of Urology, Centre for Applied Urological Research, Queen's University, Kingston, ON;
Introduction:
Treatment of advancing prostate cancer focuses on blocking the activation of the androgen receptor with resultant prolonged perturbation of the hypothalamic-pituitary-gonadal axis. Androgen deprivation therapy (ADT) is marked, however, by eventual progression to castration- resistant prostate cancer (CRPC). Emerging evidence has postulated that follicle-stimulating hormone (FSH) may lead to proliferative and mutagenic responses of prostate cancer. We investigated the association of serum FSH and time to castration resistance.
Methods:
This was a single-centre retrospective study assessing serum FSH levels of patients undergoing ADT for advancing prostate cancer. The primary outcome was time of ADT initiation to the development of CRPC. For each patient on treatment and with castrate levels of testosterone, the maximum FSH value between ADT commencement and CRPC was identified and recorded. FSH was analyzed as a continuous and categorical variable. Cox multivariate regression in a step-wise fashion was used to explore the association between FSH levels and time to CRPC.
Results:
From a database of 323 prostate cancer patients actively managed with ADT, 103 men had a documented FSH value while castrate, with 45 men progressing to CRPC. The mean ± standard deviation maximum FSH value of these patients was 6.66 ± 4.22 mIU/mL (range: 1.5-28.1). The mean duration from ADT commencement to CRPC was 3.03 ± 0.34 years (range: 0.36-9.71). Univariate analysis suggested a trend of a negative correlation between FSH values and time to castrate resistance. A FSH value of less than or equal to the lowest tertile (4.8 mIU/mL) was associated with a longer time to CRPC (hazard ratio 0.46; p = 0.006). In the Cox regression analysis, elevated FSH was associated with a shorter duration time to CRPC (p = 0.03).
Conclusions:
This retrospective, single-centre study would suggest there may be an association between serum FSH levels and time to CRPC for men treated palliatively with ADT for advancing prostate cancer. Further clinical investigation in a larger cohort of men is required to determine any clinical utility of FSH as a biomarker of progression or target for therapy.
Insights
Elevated follicle-stimulating hormone (FSH) levels in men with advanced prostate cancer correlate with a faster progression to castration-resistant prostate cancer (CRPC). Lower FSH levels may indicate a longer time to CRPC during androgen deprivation therapy (ADT).
Area of Science:
- Urology
- Endocrinology
- Oncology
Background:
- Advanced prostate cancer treatment often involves androgen deprivation therapy (ADT) to inhibit the androgen receptor.
- ADT can lead to eventual progression to castration-resistant prostate cancer (CRPC).
- Emerging research suggests follicle-stimulating hormone (FSH) may influence prostate cancer growth and mutation.
Purpose of the Study:
- To investigate the association between serum FSH levels and the time to development of CRPC in patients undergoing ADT.
- To explore FSH as a potential biomarker for predicting progression in prostate cancer patients.
Main Methods:
- A retrospective, single-centre study analyzed serum FSH levels in patients with advanced prostate cancer receiving ADT.
- The primary outcome measured was the time from ADT initiation to CRPC development.
- Cox multivariate regression was employed to assess the relationship between FSH levels and time to CRPC.
Main Results:
- Of 103 patients with castrate FSH levels, 45 progressed to CRPC. The mean maximum FSH was 6.66 ± 4.22 mIU/mL.
- Univariate analysis indicated a trend towards a negative correlation between FSH values and time to castrate resistance.
- Lower FSH levels (≤ 4.8 mIU/mL) were associated with a longer time to CRPC (HR 0.46, p=0.006), while elevated FSH correlated with shorter time to CRPC (p=0.03).
Conclusions:
- This study suggests a potential association between serum FSH levels and the time to CRPC in men with advanced prostate cancer on palliative ADT.
- Further research in larger cohorts is needed to validate FSH as a clinical biomarker for progression or a therapeutic target.
