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. 2020 Dec;51(6):552-556.
doi: 10.1055/a-1121-7400. Epub 2020 Mar 18.

[Current data on the target value of testosterone lowering and the associated research since the first administration of LHRH (GnRH) analogues to patients 40 years ago]

[Article in German]
Peter Hammerer  1 , Walther Grohmann  2 , Axel S Merseburger  3
Affiliations

[Current data on the target value of testosterone lowering and the associated research since the first administration of LHRH (GnRH) analogues to patients 40 years ago]

[Article in German]
Peter Hammerer et al. Aktuelle Urol. 2020 Dec.

Abstract
in English, German

When LH-RH (now: GNRH) analogues were first used for the treatment of prostate cancer, the castration level was arbitrarily defined as a testosterone level of less than 50 ng/dl. Since then, numerous studies have shown that a permanent lowering of the testosterone level, e. g. by buserelin, to values lower than 20 ng/dl is associated with a significant improvement in outcomes. This has been proven in recent studies. Therefore, a castration level with testosterone values of less than 20 ng/dl is required. In addition, hormone withdrawal with GNRH analogues continues to provide the basic therapy for new treatment options, e. g. with abiraterone, enzalutamide or apalutamide.

Beim ersten Einsatz eines LH-RH (heute: GnRH)-Analogon zur Therapie des Prostatakarzinoms war das Kastrationsniveau von unter 50 ng/dl willkürlich festgelegt. Seither zeigen zahlreiche Untersuchungen, dass mit einer dauerhaften Senkung des Testosteronspiegels, wie z. B. durch Buserelin, auf Werte von unter 20 ng/dl eine deutliche Verbesserung des Outcome einhergeht. Dies wird in aktuellen Studien belegt, sodass der Kastrationsspiegel mit Werten von unter 20 ng/dl zu fordern ist. Darüber hinaus stellt der Hormonentzug mit GnRH-Analoga weiterhin die Basistherapie für neue Therapieoptionen wie z. B. mit Abirateron, Enzalutamid bzw. Apalutamid dar.

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Conflict of interest statement

Prof. Peter Hammerer: Mitglied Vorstand: AUO, SIU, WUOF; Berater: Janssen, Sanofi, Bayer Takeda, MSD; Vortragstätigkeit: Apogepha , Astellas, Janssen, Sanofi, Bayer Takeda, MSD, Ipsen, BMS, AmgenProf. Axel Merseburger: Klinische Studien: Amgen, Astellas, Bayer, Ferring, Ipsen, Janssen, Roche, BMS, Merck; Referent, Speaker, Vorträge: Amgen, Apogepha, Astellas, Bayer, Ferring, Hexal, Ipsen, Janssen, Novartis, Roche, Sanofi, TEVA; Beratertätigkeit: GBA, TEVA, UEG, Janssen, BMS, Novartis, Merck, Roche, Takeda; Firmenbeteiligungen: KeineDr. Walther Grohmann: Beratertätigkeit: Apogepha

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