Follicle Stimulating Hormone Levels During Androgen Deprivation Therapy Are Not Associated With Survival or Development of Castration-Resistant Prostate Cancer
Background: Follicle-stimulating hormone (FSH) dysregulation plays a potential role in prostate cancer progression.
The objective of this study was to evaluate whether higher FSH levels during androgen deprivation therapy (ADT) for
recurrent prostate cancer could predict the development of castration-resistant prostate cancer (CRPC), prostate
cancer-specific survival (CSS), and overall survival (OS).
Methods: Serum FSH levels were measured in cryopreserved samples of the continuous ADT arm of the PR.7 trial,
supplemented with analogous samples from a large contemporaneous biobank. Univariate and multivariate analyses
assessed the relationship between FSH tertiles and time to CRPC, as well as CSS, and OS.
Results: A total of 172 patients were included in our analysis. Of these, 54 patients (31%) developed CRPC during
the 9-year follow-up. Median FSH for the tertiles was 4.35, 6.13, and 11.32 mIU/mL. FSH tertiles were not significantly
associated with the time to CRPC, or with CSS or OS. FSH levels were not a significant prognostic factor for these
Conclusion: As previously reported, the use of gonadotropin-releasing hormone (GnRH) antagonists for ADT
has significantly more suppression of FSH levels than GnRH agonists. Our results do not suggest that differences in
circulating FSH 1 year following ADT initiation influence long-term oncologic outcomes or development of CRPC.
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