Rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone-sensitive prostate cancer

Abstract The testosterone (TT)/androgen receptor axis plays a crucial role in the initiation and progression of prostate cancer (PCa). We aimed to investigate the predictive value of serum TT levels on metastatic PCa progression. A total of 219 patients with metastatic PCa were included in this stud...

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Main Authors: Ze Wang, Haiyang Xiao, Chongliang Zheng, Jian Chen, Qiming Chen, Zhenzhen Chen, Dianzheng Zhang, Luofu Wang, Weihua Lan, Qiuli Liu, Jun Jiang
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13480-8
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author Ze Wang
Haiyang Xiao
Chongliang Zheng
Jian Chen
Qiming Chen
Zhenzhen Chen
Dianzheng Zhang
Luofu Wang
Weihua Lan
Qiuli Liu
Jun Jiang
author_facet Ze Wang
Haiyang Xiao
Chongliang Zheng
Jian Chen
Qiming Chen
Zhenzhen Chen
Dianzheng Zhang
Luofu Wang
Weihua Lan
Qiuli Liu
Jun Jiang
author_sort Ze Wang
collection DOAJ
description Abstract The testosterone (TT)/androgen receptor axis plays a crucial role in the initiation and progression of prostate cancer (PCa). We aimed to investigate the predictive value of serum TT levels on metastatic PCa progression. A total of 219 patients with metastatic PCa were included in this study. Analyses performed included Pearson’s correlation test, Wilcoxon rank test, Chi-square test, Cox regression, and Kaplan-Meier analysis. High serum TT levels (> 405 ng/dL) before ADT treatment, deep testosterone reduction (DTR) within the first year of ADT, rapid DTR within 3 months of ADT, and sustained DTR in the first year of ADT are associated with longer CRPC progression-free time. Low serum TT levels before abiraterone treatment are a risk factor for early PSA progression. We constructed a nomogram model based on the DTR within the first year of ADT. Calibration curve and decision curve analyses suggest the model has a high predictive ability for 1-, 1.5-, and 2-year CRPC progression and well clinical utility. Serum TT levels before and during ADT, as well as before abiraterone treatment, can predict metastatic PCa progression. Monitoring serum TT levels throughout the entire course of treatment is crucial for patient follow-up and prognosis.
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spelling doaj-art-1556b99ec86d4c9fa3f5e09203f57ba32025-08-20T03:45:56ZengNature PortfolioScientific Reports2045-23222025-08-011511810.1038/s41598-025-13480-8Rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone-sensitive prostate cancerZe Wang0Haiyang Xiao1Chongliang Zheng2Jian Chen3Qiming Chen4Zhenzhen Chen5Dianzheng Zhang6Luofu Wang7Weihua Lan8Qiuli Liu9Jun Jiang10Department of Urology, Daping Hospital, Army Medical UniversityDepartment of Urology, Daping Hospital, Army Medical UniversityDepartment of Urology, Daping Hospital, Army Medical UniversityDepartment of Urology, Daping Hospital, Army Medical UniversityDepartment of Urology, Daping Hospital, Army Medical UniversityDepartment of Urology, Daping Hospital, Army Medical UniversityDepartment of Bio-Medical Sciences, Philadelphia College of Osteopathic MedicineDepartment of Urology, Daping Hospital, Army Medical UniversityDepartment of Urology, Daping Hospital, Army Medical UniversityDepartment of Urology, Daping Hospital, Army Medical UniversityDepartment of Urology, Daping Hospital, Army Medical UniversityAbstract The testosterone (TT)/androgen receptor axis plays a crucial role in the initiation and progression of prostate cancer (PCa). We aimed to investigate the predictive value of serum TT levels on metastatic PCa progression. A total of 219 patients with metastatic PCa were included in this study. Analyses performed included Pearson’s correlation test, Wilcoxon rank test, Chi-square test, Cox regression, and Kaplan-Meier analysis. High serum TT levels (> 405 ng/dL) before ADT treatment, deep testosterone reduction (DTR) within the first year of ADT, rapid DTR within 3 months of ADT, and sustained DTR in the first year of ADT are associated with longer CRPC progression-free time. Low serum TT levels before abiraterone treatment are a risk factor for early PSA progression. We constructed a nomogram model based on the DTR within the first year of ADT. Calibration curve and decision curve analyses suggest the model has a high predictive ability for 1-, 1.5-, and 2-year CRPC progression and well clinical utility. Serum TT levels before and during ADT, as well as before abiraterone treatment, can predict metastatic PCa progression. Monitoring serum TT levels throughout the entire course of treatment is crucial for patient follow-up and prognosis.https://doi.org/10.1038/s41598-025-13480-8Metastatic prostate cancerAndrogen deprivation therapyDeep testosterone reductionCastration-resistantPSA progression
spellingShingle Ze Wang
Haiyang Xiao
Chongliang Zheng
Jian Chen
Qiming Chen
Zhenzhen Chen
Dianzheng Zhang
Luofu Wang
Weihua Lan
Qiuli Liu
Jun Jiang
Rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone-sensitive prostate cancer
Scientific Reports
Metastatic prostate cancer
Androgen deprivation therapy
Deep testosterone reduction
Castration-resistant
PSA progression
title Rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone-sensitive prostate cancer
title_full Rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone-sensitive prostate cancer
title_fullStr Rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone-sensitive prostate cancer
title_full_unstemmed Rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone-sensitive prostate cancer
title_short Rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone-sensitive prostate cancer
title_sort rapid and sustainable deep testosterone reduction predicts effective androgen deprivation therapy for metastatic hormone sensitive prostate cancer
topic Metastatic prostate cancer
Androgen deprivation therapy
Deep testosterone reduction
Castration-resistant
PSA progression
url https://doi.org/10.1038/s41598-025-13480-8
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