Reversing the effects of androgen-deprivation therapy in men with metastatic castration-resistant prostate cancer.

Abstract

OBJECTIVE:

To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life.

PATIENTS AND METHODS:

Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy - Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life.

RESULTS:

The 60 included patients lost a mean (sd) of 7.8 (8.2)% of subcutaneous fat, 9.8 (18.2)% of visceral fat, and gained 12.2 (6.7)% muscle mass. Changes in subcutaneous and visceral fat were positively correlated with each other (Spearman's correlation coefficient 0.58, 95% confidence interval 0.35-0.71) independent of the effects of age, body mass index, and duration of androgen-deprivation therapy. Energy, physical function, and measures of limitations due to physical health were all significantly improved at 3 months. The improvements in body composition were not correlated with decreases in lipid levels or observed improvements in quality of life.

CONCLUSIONS:

In the present study, BAT was associated with significant improvements in body composition, lipid parameters, and quality of life. This has promising implications for the long-term health of men with mCRPC.

• Authors: Catherine H Marshall, Jessa Tunacao, Varun Danda, Hua-Ling Tsai, John Barber, Rakhee Gawande, Clifford R Weiss, Samuel R Denmeade, Corinne Joshu
• Journal: BJU international (BJU Int) Vol. 128 Issue 3 Pg. 366-373 (09 2021) ISSN: 1464-410X [Electronic] England
• PMID: 33765326 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: © 2021 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International.

Chemical References

• Androgen Antagonists
• Androgens
• Testosterone

Topics

• Aged
• Aged, 80 and over
• Androgen Antagonists (therapeutic use)
• Androgens (administration & dosage)
• Body Composition
• Humans
• Lipid Metabolism
• Male
• Middle Aged
• Prostatic Neoplasms, Castration-Resistant (drug therapy, metabolism, physiopathology)
• Quality of Life
• Testosterone (administration & dosage)