Volume 20, Number 2Original ResearchEffectiveness of Subcutaneously Administered Leuprolide Acetate to Achieve Low Nadir Testosterone in Prostate Cancer PatientsScott EggenerChristopher M PieczonkaJason HafronJoseph Renzulli IIPrzemyslaw TwardowskimDeborah M Boldt-HouleStuart AtkinsonEvidence suggests lower nadir testosterone levels during the first year of androgen deprivation therapy improve advanced prostate cancer clinical outcomes. We evaluated pivotal trials for subcutaneously administered leuprolide acetate (1-, 3-, 4-, and 6-month doses) to determine nadir testosterone levels. Pooled analysis showed 99%, 97%, and 91% of patients reached nadir testosterone ≤20, ≤10, and ≤5 ng/dL respectively (median ≤3 ng/dL). Across all available categories, ≥88% of patients reached nadir testosterone ≤5 ng/dL, and <3% experienced a microsurge. Achievement and maintenance of low nadir testosterone levels may improve progression-free survival and time to onset of castrate-resistant prostate cancer. [Rev Urol. 2018;20(2):63–68 doi: 10.3909/riu0798] © 2018 MedReviews®, LLCProstate cancerAndrogen deprivation therapyLHRH agonistsLeuprolide acetateNadir testosterone
Volume 22, Number 3Review ArticlesCurrent and Future Management of Locally Advanced and Metastatic Prostate CancerOriginal ResearchNeal D ShoreWith increasing treatment options available, the management of locally advanced and metastatic prostate cancer (PCa) is growing more complex, nuanced, and individualized. Strategies for combining surgery, radiation, chemotherapy, and androgen deprivation therapy (ADT) continue to evolve, as do ADT and immunotherapy options. Additionally, multiple adjunctive agents for metastatic PCa have been recently approved or are pending approval. As the number of locally advanced and metastatic prostate cancers being diagnosed rises, so does the need to consider patients’ clinical situations and personal preferences. This review discusses current and potential future approaches to managing locally advanced and metastatic PCa. [Rev Urol. 2020;22(3):110-123] © 2020 MedReviews®, LLCProstate cancerChemotherapyAndrogen deprivation therapyMetastatic prostate cancerLocally advanced prostate cancer