Testosterone recovery after androgen deprivation therapy

Area of Science:

• Oncology
• Endocrinology
• Urology

Background:

• Androgen deprivation therapy (ADT) is a standard treatment for prostate cancer.
• Testosterone (T) recovery timing after ADT can be unpredictable.
• Oral GnRH antagonists like relugolix show faster T recovery than injectable GnRH agonists.

Purpose of the Study:

• To evaluate patient characteristics associated with testosterone recovery after a defined duration of ADT.
• To compare T recovery rates between different ADT agents and treatment durations.

Main Methods:

• Retrospective analysis of 388 prostate cancer patients who completed ADT.
• Testosterone levels were assessed post-treatment to define recovery (partial: >150 ng/dl, full: ≥300 ng/dl).
• Multivariable Cox regression analysis identified factors influencing T recovery.

Main Results:

• GnRH antagonist use was associated with significantly higher rates of partial T recovery (HR=3.74, P≤0.001).
• Younger age was a key factor in achieving partial T recovery (HR for 1-year increase=0.96, P<0.001).
• Extended ADT courses (>12 months) with GnRH agonists correlated with lower partial T recovery rates (HR=0.58, P=0.001).

Conclusions:

• Testosterone recovery post-ADT is variable, with approximately 16% of men remaining castrate.
• GnRH antagonist therapy and younger patient age are favorable predictors of T recovery.
• Longer durations of ADT negatively impact T recovery rates.