Current data on the target value of testosterone lowering and the associated research since the first administration of LHRH (GnRH) analogues to patients 40 years ago

Abstract

When LH-RH (now: GNRH) analogues were first used for the treatment of prostate cancer, the castration level was arbitrarily defined as a testosterone level of less than 50ng/dl. Since then, numerous studies have shown that a permanent lowering of the testosterone level, e.g. by buserelin, to values lower than 20ng/dl is associated with a significant improvement in outcomes. This has been proven in recent studies. Therefore, a castration level with testosterone values of less than 20ng/dl is required. In addition, hormone withdrawal with GNRH analogues continues to provide the basic therapy for new treatment options, e.g. with abiraterone, enzalutamide or apalutamide.