Androgen deprivation decreases prostate specific antigen in the absence of tumor: implications for interpretation of PSA results.

Abstract:

BACKGROUND:Prostate-specific antigen (PSA) is used as an outcome measure for relapsed disease in prostate cancer. Nonetheless, there are considerable concerns about its indiscriminate use as a surrogate endpoint for cell growth or survival. We hypothesized that treatment with a luteinizing hormone releasing hormone (LHRH) analog would decrease PSA levels even in the absence of malignant disease. METHODS:We determined testosterone and PSA levels in 30 healthy volunteers after a single intramuscular injection of a LHRH depot formulation. Testosterone and PSA levels were quantified by radioimmunoassay and electrochemi-luminescence immunoassay, respectively. RESULTS:After an initial flare-up during the first 3 days testosterone decreased reaching castration levels in 18 of the 30 young men (60%). After the nadir on day 28, testosterone levels increased to normal again. Changes in PSA paralleled those of testosterone. Castration reduced PSA levels by 29% (95% CI 19%-39%) compared to baseline (p<0.0001). CONCLUSIONS:LHRH superagonists decrease PSA levels by testosterone deprivation. Conferring these findings to tumor patients, decreases in PSA after treatment with LHRH analogs might not only reflect disease regression but also a direct testosterone mediated effect on PSA. Thus, PSA levels should be cautiously interpreted when patients receive hormonal therapy.

journal_name

Clin Chem Lab Med

authors

Wenisch JM,Mayr FB,Spiel AO,Radicioni M,Jilma B,Jilma-Stohlawetz P

doi

10.1515/cclm-2013-0535

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

431-6

issue

3

eissn

1434-6621

issn

1437-4331

pii

/j/cclm.ahead-of-print/cclm-2013-0535/cclm-2013-05

journal_volume

52

pub_type

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