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Background <p>Abiraterone acetate/prednisone (AAP) plus a luteinizing hormone releasing hormone agonist or antagonist (LHRH-A) is commonly used for treating high risk M0 or oligometastatic prostate cancer, but prolonged LHRH-A can be associated with delayed and incomplete testosterone (T) recovery after discontinuation.</p> Methods <p>We assessed impact of earlier LHRH-A discontinuation prior to stopping AAP on testosterone recovery (TR) to ≥150 ng/dl in an institutional cohort of patients who received 500–800 days of treatment.</p> Results <p>100% (89/89) had testosterone &lt;20 ng/dl at AAP end of treatment, and discontinuing LHRH-A ≥ 12 months prior to stopping AAP demonstrated improvement in 6-month TR (76.9%, 95% CI 39.7–92.8) compared to &lt;3 months prior to stopping AAP (13.0%, 95% CI 4.7–25.8; HR 0.27[0.11–0.66], <i>p</i> &lt; 0.01).</p> Conclusions <p>Early LHRH-A discontinuation 12 months or more prior to stopping AAP is associated with faster and more frequent T recovery compared to LHRH-A discontinuation within 3 months of AAP cessation, with T levels remaining appropriately suppressed during abiraterone monotherapy.</p>

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Testosterone suppression and recovery with abiraterone/prednisone monotherapy after early discontinuation of LHRH-A in hormone sensitive prostate cancer

  • 期刊论文

  • 发表日期：

    2025年10月27日

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  • Autumn Gagnon,
  • Caiwei Zhong,
  • Wanling Xie,
  • Lynne Morlock,
  • Dory Freeman,
  • Rachel Trowbridge,
  • Kerry L. Kilbridge,
  • Bradley A. McGregor,
  • Mary-Ellen Taplin,
  • Atish D. Choudhury

摘要

Background

Abiraterone acetate/prednisone (AAP) plus a luteinizing hormone releasing hormone agonist or antagonist (LHRH-A) is commonly used for treating high risk M0 or oligometastatic prostate cancer, but prolonged LHRH-A can be associated with delayed and incomplete testosterone (T) recovery after discontinuation.

Methods

We assessed impact of earlier LHRH-A discontinuation prior to stopping AAP on testosterone recovery (TR) to ≥150 ng/dl in an institutional cohort of patients who received 500–800 days of treatment.

Results

100% (89/89) had testosterone <20 ng/dl at AAP end of treatment, and discontinuing LHRH-A ≥ 12 months prior to stopping AAP demonstrated improvement in 6-month TR (76.9%, 95% CI 39.7–92.8) compared to <3 months prior to stopping AAP (13.0%, 95% CI 4.7–25.8; HR 0.27[0.11–0.66], p < 0.01).

Conclusions

Early LHRH-A discontinuation 12 months or more prior to stopping AAP is associated with faster and more frequent T recovery compared to LHRH-A discontinuation within 3 months of AAP cessation, with T levels remaining appropriately suppressed during abiraterone monotherapy.