ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cancer Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1652941
This article is part of the Research TopicAdvances in Targeted Therapy and Biomarker Research for Endocrine-Related Cancers, Volume IIView all 5 articles
Sustained testosterone suppression: prognostic indicator in advanced hormone sensitive prostate cancer
Provisionally accepted
- 1Department of Reproductive Medicine, The Affiliated Bozhou Hospital of Anhui Medical University, Bozhou, China
- 2Department of Reproductive Medicine, The People's Hospital Bozhou, Bozhou, China
- 3Department of Urology, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- 4Department of Urology, Central Hospital of Chongqing University, Chongqing, China
- 5Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Objective: To investigate the relationship between sustained testosterone suppression and clinical outcomes in advanced hormone sensitive prostate cancer (aHSPC), which integrates longitudinal testosterone with castration duration to predict tumor progression and prognosis. Results: The cohort demonstrated median TTP of 18 months and overall survival of 6.17 years. Testosterone sustained response group patients showed significantly better outcomes than non-sustained response group patients, with longer median survival (7.58 vs 3.00 years; P<0.001) and time to progress (23.70±14.66 vs 13.68±7.84 months; P<0.001). Inverse correlations emerged between minimum testosterone and TTP (r=-0.238, P<0.001) and between average testosterone and TTP (r=-0.220, P<0.001). Multivariate analysis identified visceral metastases (adjusted OR 0.45, 95% CI 0.21-0.98; P=0.043) and high tumour load (adjusted OR 0.53, 95% CI 0.33-0.85; P=0.008) as negative predictors of testosterone stabilization. Testosterone sustained-response group status predicted reduced mortality risk (adjusted HR 0.605, 95% CI 0.369-0.990; P=0.045), while higher minimum testosterone increased mortality risk (adjusted HR 1.358, 95% CI 1.116-1.654; P=0.002). Conclusion: Sustained testosterone suppression provides a clinically applicable method for assessing treatment efficacy and predicting prognosis in aHSPC.
Keywords: Testosterone suppression, Castration, advanced hormone sensitive prostate cancer, androgen deprivation therapy, testosterone monitoring
Received: 24 Jun 2025; Accepted: 04 Sep 2025.
Copyright: © 2025 Ma, Zhuo, Huang and Xi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jianhong Xi, Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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