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LGD-4033 stacked up against Testosterone very well in the preclinical models with a greater than 500x tissue selectivity of muscle to prostateadenylate cyclase inhibition. This would allow these drugs to be used as adjuvant treatment for prostate cancer. It's also worth noting that the use of the PDE inhibitors in the treatment of metastatic prostate cancer is already accepted by the FDA and the National Institute of Health as having potential to be beneficial but is, for now, being pursued in an experimental setting with no safety data on large numbers of patients or for long duration.[17]
Other Prostate-Specific Antigen Receptor Inhibitors
Other PSA Inhibitors and NSCAs have also been tested in combination with testosterone replacement therapy against non-primary prostate cancers. The evidence on these compounds is very sparse. There are reports of treatment-related adverse events with at least one of these compounds and PSA and NSCA combination therapy should be regarded as experimental, as many of the compounds do not have enough data for an effective clinical use.[18][19]
Adjunctive Treatment vs Regimen Based on Testosterone Inhibitors
A number of studies have also investigated the use of testosterone replacement therapy as adjuvant treatment for primary malignancies.[20][21] One of these studies demonstrated improvements in cancer progression of primary tumors in males treated with exogenous testosterone for 6 weeks after initiation of testosterone therapy.[11] One randomized, placebo-controlled study in which 10 prostate cancer patients were treated with testosterone or an placebo for 4 weeks before adjuvant treatment with exogenous testosterone had improvements in overall survival rates of 44% vs. 12% and of 30% vs. 13%, respectively.[21] These findings support the use of adjuvant therapy when testosterone therapy is not satisfactory. The benefits might be greater for lower doses, as was found in one pilot study with a higher dose of testosterone when compared to an active control.[22] The findings should be interpreted cautiously because the study was randomized and the group that had higher doses was older, with a higher incidence of malignancies in prostate cancer, and with significantly more progression-free survival rates.[22]
The first study to report the use of testosterone as adjuvant treatment for metastatic prostate cancer treated with NSCA in this way included a total of 40 patients treated with exogenous testosterone from the age of 14 days. They compared a control group of patients for 8 months (from baseline to week 9) that were treated with placebo.[11] In both groups, the mean duration of treatment was 4 years. Patients randomized to exogenous testosterone
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