Dr. Graham Discusses High-Dose Testosterone in Treating Prostate Cancer
Dec 22, 2022When identified and treated early, prostate cancer is considered curable. However, if prostate cancer becomes metastatic, spreading to other organs, it is no longer curable and requires novel treatment strategies. A common and highly effective treatment for metastatic prostate cancer is androgen deprivation therapy, which lowers testosterone levels significantly. However, in addition to the number of serious side effects caused by low testosterone, the cancer will continue to grow in some patients. When this occurs, it is known as castration-resistant prostate cancer (CRPC).
Assistant professor, Dr. Laura Graham, is currently leading a phase 2 trial studying whether high doses of testosterone are a feasible treatment against castration-resistant prostate cancer (CRPC) leading to a reduction in prostate cancer growth as well as improved quality of life. Dr. Graham aims to recruit a total of 30 participants who will receive a standardized dose of testosterone gel administered on the skin and enzalutamide, a non-steroidal anti-androgen that blocks testosterone from binding to its receptor.
“This used to be a somewhat heretical idea, there are a variety of hypotheses for why this treatment might work, but the bottom line is there is a lot of pre-clinical evidence that once you have castration-resistant prostate cancer cells, this therapy has the potential to be effective.” |
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Dr. Graham explains that the hope is that transdermal application will ensure testosterone levels remain constant thereby correlating with quality of life benefits. The hypothesis is that transdermal application be an effective way to administer testosterone, with a significant portion of participants seeing a reduction in their prostate-specific antigen levels while also making the enzalutamide more effective. Within this trial, all participants will receive the same doses of testosterone and enzalutamide and will have tumor samples drawn before and after treatment with testosterone. The tumor samples will be analyzed in the Flaig laboratory for DNA and RNA changes to determine which participants might respond best to this type of therapy.
According to Dr. Graham, administering the testosterone on the skin also has the potential to contribute to participants’ safety because if any problems with the testosterone are visible, patients can stop applying it immediately. Because this idea was first proposed nearly a decade ago, earlier clinical trials have shown that it is safe, there is no evidence of significant prostate cancer progression and quality of life appears to be significantly improved.