Serum testosterone measured by liquid chromatography-tandem mass spectrometry is an independent predictor of response to castration in metastatic hormone-sensitive prostate cancer

•High castration testosterone levels were associated with shorter PFS.•High testosterone levels and poor PSA response was associated with shorter PFS.•High testosterone levels and high tumor volume was associated with poor PFS. Although testosterone levels have been associated with progression-free...

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Bibliographic Details
Published in:Clinica chimica acta 2023-01, Vol.539, p.34-40
Main Authors: van Winden, Lennart J., Lanfermeijer, Mirthe, Dezentje, Vincent, Bergman, Andries M., van der Poel, Henk G., van Rossum, Huub H.
Format: Article
Language:English
Subjects:
Castration
Chromatography, Liquid
Gonadotropin-Releasing Hormone
Hormone-sensitve prostate cancer
Humans
LC-MS/MS
Male
Prostatic Neoplasms - drug therapy
Prostatic Neoplasms - surgery
Retrospective Studies
Serum testosterone
Survival
Tandem Mass Spectrometry
Testosterone
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Summary:•High castration testosterone levels were associated with shorter PFS.•High testosterone levels and poor PSA response was associated with shorter PFS.•High testosterone levels and high tumor volume was associated with poor PFS. Although testosterone levels have been associated with progression-free survival (PFS) in metastatic hormone-sensitive prostate cancer (mHSPC) patients, this has primarily been investigated using inaccurate immunoassays (IA). Here, we investigated whether castrate testosterone levels determined by a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay is an independent risk factor for treatment response in mHSPC. In total, 106 mHSPC patients treated with luteinizing-hormone releasing-hormone (LHRH) agonists were retrospectively analyzed between March 2018 and August 2021. Testosterone levels in serum samples were quantitated using an LC-MS/MS assay. In a subset of patients, IA (Roche Cobas Pro) values were compared with LC-MS/MS results. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazard models. Median PFS was shorter for high testosterone levels (>0.231 nmol/L, 18.4 v. 42.6 months, HR 1.7, p = 0.018). Low testosterone levels and a PSA response below 4 ng/mL was associated with longer median PFS (46.2 months) than the remaining combinations (13.8–19.3 months, 3.4–5.8, overall p 
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cca.2022.11.027