An Expert Discussion of Testosterone Nadir and Clinical Outcomes in Patients with Advanced Prostate Cancer: A Post Hoc Analysis of Triptorelin Pamoate Phase III Studies

In a program supported by Verity Pharmaceuticals, Neal D. Shore, MD, FACS, Medical Director for the Carolina Urologic Research Center and Chief Medical Officer, Strategic Growth and Pharmacy, GenesisCare US, Myrtle Beach, South Carolina, and Laurence Klotz, MD, FRCSC, Professor of Surgery at the University of Toronto and the Sunnybrook Chair of Prostate Cancer Research in Toronto, Ontario, Canada, discuss Dr. Klotz’s paper published in January 2024 entitled, “Testosterone Nadir and Clinical Outcomes in Patients with Advanced Prostate Cancer: Post Hoc Analysis of Triptorelin Pamoate Phase III Studies.”
Dr. Klotz describes the objective of the study was to evaluate whether low nadir testosterone during treatment with triptorelin pamoate, a luteinizing hormone-releasing hormone (LHRH) agonist, is associated with improved clinical outcomes in patients with advanced prostate cancer using a retrospective analysis of clinical trial data. He discusses how data was pooled from three prospective, 9–12-month Phase III studies of triptorelin monotherapy in patients with advanced prostate cancer

Dr. Klotz also addresses the overall survival (OS) and disease-specific survival (DSS) by testosterone suppression group, assessed by Kaplan–Meier analysis with a log-rank test. He concludes the review by describing how, in the sample size comprised of 592 patients, low nadir testosterone achieved during treatment with the LHRH agonist triptorelin was associated with improved OS and DSS in patients with advanced prostate cancer.

Dr. Klotz and Dr. Shore then discuss the impact of the results from this trial and the potential future direction of treatment options for men with prostate cancer.

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ABOUT THE AUTHOR

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Neal D. Shore, MD, FACS, graduated from Duke University and Duke University Medical School. He completed his general surgery/urology residency at New York Hospital-Cornell Medical Center/Memorial Sloan Kettering Cancer Center. He serves as the Medical Director for the Carolina Urologic Research Center and is the Chief Medical Officer, Strategic Growth and Pharmacy, GenesisCare, US.

Dr. Shore has conducted more than 400 clinical trials, focusing mainly on genitourinary oncology, and has authored or coauthored more than 350 peer-reviewed publications and numerous book chapters. He serves on the Society for Immunotherapy of Cancer (SITC) Guidelines Committee for Bladder Cancer, as well as the boards of the Bladder Cancer Advocacy Network, Maple Tree Alliance, and the Duke Global Health Institute. He is the Chair of both the Prostate Cancer Academy and the Bladder/Kidney Cancer Academy for the Large Urology Group Practice Association (LUGPA) Specialty Network. He also co-chairs the annual AUA International Prostate Forum. He has served/serves on the editorial boards of Reviews in Urology, Urology Times, Chemotherapy Advisor, OncLive, PLOS ONE, Urology Practice, JUOP and World Journal of Urology, and he also serves as an editor of Everyday Urology-Oncology. He is a Fellow of the American College of Surgeons.

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Laurence Klotz, MD, FRCSC, is a professor of surgery at the University of Toronto and the Sunnybrook Chair of Prostate Cancer Research. Dr. Klotz was the founding editor-in-chief of both the Canadian Journal of Urology and the Canadian Urology Association Journal (CUAJ), and he is now editor emeritus of the CUAJ. Dr. Klotz obtained his medical degree and completed his residency at the University of Toronto. He was also a uro-oncology fellow at Memorial Sloan Kettering Cancer Center in New York.

Dr. Klotz has 550 peer review publications and eight books. He coined the phrase “active surveillance” and successfully championed this approach for men with favorable-risk prostate cancer against substantial resistance. He was the associate editor of the Journal of Urology, responsible for prostate cancer, for eight years. Dr. Klotz received the Queen’s Jubilee Medal for outstanding public service, the University of Toronto's Lister Prize, the Society of Urologic Oncology’s SUO Medal, the American Urological Association’s Richard Williams Award, the University of Toronto's Lifetime Achievement Award, the Canadian Urological Association Lifetime Achievement Award, and the Harold Warwick Award from the Canadian Cancer Society for “outstanding contributions to cancer control.” In 2015 he was inducted as a Member of the Order of Canada, Canada’s highest civilian award.