Bipolar androgen therapy as platform for personalized medicine in castration-resistant prostate cancer

BACKGROUND: Bipolar androgen therapy (BAT) with supraphysiologic testosterone (SPT) could be a therapeutic platform to keep the “endocrine interference” going in men with castration resistant prostate cancer CRPC Davis ID., et al(N Engl J Med 38:121-31, 2019), Denmeade SR, Sena LA, Wang H, Antonarakis ES, Markowski MC (Oncologist 28:465-73, 2023). This concept, scientifically developed by the Johns Hopkins group, has been tested in several clinical trials Denmeade SR, Isaacs JT (Prostate 70:1600-7, 2010). CASE PRESENTATION: This case report details the diagnosis and novel treatment with BAT during the course of disease of a 68-year-old male patient with primary metastatic prostate cancer identified in November 2019. After treatment failure of standard therapy this patient commenced with SPT given intramuscularly at four weeks intervals and concurrent androgen deprivation throughout treatment with BAT (Fig. 1). He responded clinically with stable disease and without serious toxicity.