Testosterone suppression in the treatment of recurrent or metastatic prostate cancer - A Canadian consensus statement

被引:0
作者
Klotz, Laurence [1 ]
Shayegan, Bobby [2 ]
Guillemette, Chantal [3 ,4 ]
Collins, Loretta L. [5 ]
Gotto, Geoffrey [6 ]
Guerette, Dominique [3 ,4 ]
Jammal, Marie-Paule [7 ]
Pickles, Tom [8 ]
Richard, Patrick O. [9 ]
Saad, Fred [10 ]
机构
[1] Univ Toronto, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada
[2] McMaster Univ, Hamilton, ON, Canada
[3] Univ Laval, Quebec City, PQ, Canada
[4] Univ Laval, CHU Quebec, Quebec City, PQ, Canada
[5] Kaleidoscope Strateg, Toronto, ON, Canada
[6] Univ Calgary, Calgary, AB, Canada
[7] Univ Montreal, Laval, PQ, Canada
[8] BC Canc, Vancouver, BC, Canada
[9] CHU Sherbrooke, Ctr Rech, Sherbrooke, PQ, Canada
[10] Ctr Hosp Univ Montreal, Montreal, PQ, Canada
来源
CUAJ-CANADIAN UROLOGICAL ASSOCIATION JOURNAL | 2018年 / 12卷 / 02期
关键词
ANDROGEN-DEPRIVATION THERAPY; CHROMATOGRAPHY-MASS SPECTROMETRY; SERUM TESTOSTERONE; RADICAL PROSTATECTOMY; NADIR TESTOSTERONE; NORMAL WOMEN; CASTRATION; MEN; IMMUNOASSAYS; MANAGEMENT;
D O I
10.5489/cuaj.5206
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Testosterone suppression, achieved through orchiectomy or medically induced androgen-deprivation therapy (ADT), is a standard treatment for men with recurrent and metastatic prostate cancer. Current assay methods demonstrate the capacity for testosterone suppression to <0.7 nmol/l, and clinical data support improved outcomes from ADT when lower levels are achieved. Practical clinical guidelines are warranted to facilitate adoption of 0.7 nmol/l as the new standard castrate testosterone level. A pan-Canadian group of experts, representing diverse clinical specialties, identified key clinical issues, searched and reviewed relevant literature, and developed consensus statements on testosterone suppression for the treatment of prostate cancer. The expert panel found that current evidence supports the clinical benefit of achieving low testosterone levels during ADT, and encourage adoption of <= 0.7 nmol/l as a new castrate level threshold. The panel recommends regular monitoring of testosterone (e.g., every 3-6 months) and prostate-specific antigen (PSA) levels as clinically appropriate (e.g., every 3-6 months) during ADT, with reassessment of therapeutic strategy if testosterone is not suppressed or if PSA rises regardless of adequate testosterone suppression. The panel also emphasizes the need for greater awareness and education regarding testosterone assay specifications, and strongly promotes the use of mass spectrometry-based assays to ensure accurate measurement of testosterone at castrate levels.
引用
收藏
页码:30 / 37
页数:8
相关论文
共 49 条
[1]   Effects of Serum Testosterone Levels After 6 Months of Androgen Deprivation Therapy on the Outcome of Patients With Prostate Cancer [J].
Bertaglia, Valentina ;
Tucci, Marcello ;
Fiori, Cristian ;
Aroasio, Emiliano ;
Poggio, Massimiliano ;
Buttigliero, Consuelo ;
Grande, Susanna ;
Saini, Andrea ;
Porpiglia, Francesco ;
Berruti, Alfredo .
CLINICAL GENITOURINARY CANCER, 2013, 11 (03) :325-+
[2]   Serum testosterone levels measured by isotope dilution-liquid chromatography-tandem mass spectrometry in postmenopausal women versus those in women who underwent bilateral oophorectomy [J].
Bui, Hong N. ;
Struys, Eduard A. ;
Martens, Frans ;
de Ronde, Willem ;
Thienpont, Linda M. ;
Kenemans, Peter ;
Verhoeven, Marieke O. ;
Jakobs, Cornelis ;
Dijstelbloem, Hilde M. ;
Blankenstein, Marinus A. .
ANNALS OF CLINICAL BIOCHEMISTRY, 2010, 47 :248-252
[3]   DETERMINATION OF TESTOSTERONE IN HUMAN PERIPHERAL + ADRENAL VENOUS PLASMA [J].
BURGER, HG ;
KELLIE, AE ;
KENT, JR .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1964, 24 (05) :432-+
[4]  
Canadian Cancer Society's Advisory Committee on Cancer Statistics, CAN CAN STAT 2017
[5]   Accuracy-based proficiency testing for testosterone measurements with immunoassays and liquid chromatography-mass spectrometry [J].
Cao, Zhimin ;
Botelho, Julianne Cook ;
Rej, Robert ;
Vesper, Hubert .
CLINICA CHIMICA ACTA, 2017, 469 :31-36
[6]  
Centers for Disease Control and Prevention, HORM VIT D STAND PRO
[7]  
Clinical and Laboratory Standards Institute, LIQ CHROM MASS SPECT
[8]  
Clinical and Laboratory Standards Institute, MASS SPECTR ANDR EST
[9]   EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part II: Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer [J].
Cornford, Philip ;
Bellmunt, Joaquim ;
Bolla, Michel ;
Briers, Erik ;
De Santis, Maria ;
Gross, Tobias ;
Henry, Ann M. ;
Joniau, Steven ;
Lam, Thomas B. ;
Mason, Malcolm D. ;
van der Poel, Henk G. ;
van der Kwast, Theo H. ;
Rouviere, Olivier ;
Wiegel, Thomas ;
Mottet, Nicolas .
EUROPEAN UROLOGY, 2017, 71 (04) :630-642
[10]   Defining a new testosterone threshold for medical castration: Results from a prospective cohort series [J].
Dason, Shawn ;
Allard, Christopher B. ;
Tong, Justin ;
Shayegan, Bobby .
CUAJ-CANADIAN UROLOGICAL ASSOCIATION JOURNAL, 2013, 7 (5-6) :E263-E267