Multicenter study confirms low testosterone in 84 percent of lung cancer patients taking crizotinib

April 16, 2013

A previous study by the University of Colorado Cancer Center reported the common side effect of low testosterone in men treated with the recently approved lung cancer agent, crizotinib. A new study published this week in the journal Cancer confirms this finding in a multi-national sample, details the mechanism of reduced testosterone, and provides promising preliminary evidence that widely available hormone replacement therapies can alleviate this side effect in many patients.

"This was a wonderful collaboration between multiple centers confirming a side effect that had not been noted when the drug was initially approved by the FDA," says Ross Camidge, MD, PhD, investigator at the CU Cancer Center, director of the thoracic oncology clinical program at University of Colorado Hospital, and the paper's senior author.

Specifically, the study – which included researchers in the United States, Hong Kong, Italy and the UK – found that in 84 percent of men treated with crizotinib, were below the lower limit of normal. Importantly, this study also showed, for the first time, that approximately 80 percent of these men had symptoms associated with their low such as or depression.

Testosterone levels seemed to fall for two main reasons. First, the proteins and SHBG that bind testosterone in the blood and act as a storage depot for the hormone dropped rapidly with crizotinib use. Additionally, free testosterone – the functional form of the hormone that is liberated from these proteins – was also reduced, implying that in addition to challenging the body's ability to store testosterone, crizotinib also challenges the body's ability to produce it. Camidge and colleagues went on to show that when low levels are found, testosterone replacement therapy may alleviate these symptoms.

"With advances in targeted therapies and in the we can use to select who to best give these new treatments to, we're starting to see drugs being approved more quickly and based on the results from far smaller numbers of patients than ever before. That's great: it helps streamline the path of these drugs into clinics where they can benefit patients who desperately need them. However, it also puts the onus on clinicians who then start using these drugs in day-to-day practice to recognize either subtle or later onset side effects that may have been missed during the initial testing," Camidge says.

For example, he says, it's perhaps not surprising that the potential for lowered testosterone was overlooked during the lightning-fast approval process for crizotinib: "If you don't specifically ask a man about symptoms of low testosterone, unless you know the patient very well, he may not feel comfortable bringing these issues up himself," Camidge says.

Now with the possibility of low testosterone in mind, clinicians who prescribe crizotinib to their male patients will know to ask about these symptoms and to test their testosterone levels. "With each breakthrough we're really trying to put people with advanced cancer back in control of their own lives," says Camidge. "The more we can make these highly effective new treatments tolerable, the closer we are to achieving that goal."

Explore further: Football strengthens the bones of men with prostate cancer

Related Stories

Football strengthens the bones of men with prostate cancer

November 23, 2015

Men with prostate cancer run the risk of brittle bones as a side-effect of their treatment. But one hour's football training a few times a week counters many of the negative effects of the treatment, according to University ...

Promising drug combination for advanced prostate cancer

November 25, 2015

A new drug combination may be effective in treating men with metastatic prostate cancer. Preliminary results of this new approach are encouraging and have led to an ongoing international study being conducted in 196 hospitals ...

Recommended for you

Combination therapy can prevent cytostatic resistance

November 26, 2015

Researchers at Karolinska Institutet have found a new way of preventing resistance to cytostatics used in the treatment of cancers such as medulloblastoma, the most common form of malignant brain tumour in children. The promising ...

Forecasting the path of breast cancer in a patient

November 23, 2015

USC researchers have developed a mathematical model to forecast metastatic breast cancer survival rates using techniques usually reserved for weather prediction, financial forecasting and surfing the Web.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.