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. 2009 Spring;11(2):52-60.

Effective testosterone suppression for prostate cancer: is there a best castration therapy?

Leonard G Gomella  1
Affiliations

Effective testosterone suppression for prostate cancer: is there a best castration therapy?

Leonard G Gomella. Rev Urol. 2009 Spring.

Abstract

Achieving and maintaining effective suppression of serum testosterone levels in men treated with androgen ablation is one of the essential strategies in the management of prostate cancer. Historically, a serum testosterone below 50 ng/dL was considered to be the castrate level. Current data suggest that the new target for either surgical or chemical castration is a serum testosterone level of lower than 20 ng/dL in an attempt to maximize therapeutic outcomes. Testosterone breakthrough and the acute-on-chronic effects of administration of a luteinizing hormone-releasing hormone analogue may cause testosterone levels to periodically rise, sometimes to noncastrate levels. The goal of androgen ablation is to identify those agents that will most consistently achieve and maintain the lowest testosterone levels possible.

Keywords: Androgen ablation; LHRH analogues; LHRH antagonists; Prostate cancer; Testosterone.

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Figures

Figure 1
Figure 1
Mean (SD) testosterone serum levels in men treated with triptorelin pamoate 3.75 mg (green dashed line) or leuprolide acetate 7.5 mg (red solid line) for 253 days. The black dashed line shows the castrate level of 1.735 nmol/L. Reproduced with permission from Heyns CF et al.
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