Young male cancer survivors may benefit from testosterone replacement

November 12, 2019

In young male cancer survivors with low testosterone levels, testosterone replacement therapy is associated with an improvement in body composition, according to a new study published this week in PLOS Medicine by Richard Ross of University of Sheffield, UK, and colleagues.

Young male cancer survivors have lower testosterone levels than the healthy population, associated with increased trunk fat mass and worse quality of life than matched controls. In the new study, researchers randomized 136 male cancer survivors aged 25 to 50 years old with borderline low testosterone levels to either receive a placebo gel or Tostran 2% testosterone gel. Participants applied the gel to their skin daily for 26 weeks.

At the conclusion of the study period, men treated with testosterone had an average decrease of 1.8 kg fat mass (95% CI -2.9 to -0.7, p=0.0016) and an average increase of 1.5 kg lean mass (95% CI 0.9 to 2.1, p<0.0001) compared to placebo. The decrease in fat mass was greatest in those with the highest truncal fat mass at baseline. Despite the change in body composition, there was no effect on quality of life as measured by a questionnaire.

"This study provides a relevant evidence base for clinicians faced with a young adult male cancer survivor with borderline low testosterone level," the authors say. "We suggest that in these patients testosterone replacement be considered in the context of other interventions to improve body composition."
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Research Article

Funding:

This study was funded by Cancer Research UK. The Grant Number was R/126349; the PI was RJR. URL: https://www.cancerresearchuk.org. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

I have read the journal's policy and the authors of this manuscript have the following competing interests: JSW receives speaker's honoraria from Eli Lilly and Sandoz, grant funding from Alexion and Immunodiagnostic Systems, donations of drug from Eli Lilly, Prostrakan (Kyowa Kirin) and Consilient for clinical studies, donations of assay kits from Biomedica, and consulting fees from Shire, Mereo Biopharma, Kyowa Kirin, UCB Pharma and PharmaCosmos. JMB received CRUK research grant funding for this project. JAS is Chair of the NHS England Specialised Commissioning Clinical Reference Group for Blood and Marrow Transplantation. REC has received consulting and speaker fees from Amgen, Astellas, Eisai, Genomic Health, Inbiomotion and Scancell; he is a patent holder for a biomarker developed by Inbiomotion; he is a former employee of prIME Oncology. RH is a member of Partnership in Cancer Centre London, Wimbledon. RJR is a Director of Diurnal Plc and owns stock. No other authors have competing interests.

Citation:

Walsh JS, Marshall H, Smith IL, Greenfield DM, Swain J, Best E, et al. (2019) Testosterone replacement in young male cancer survivors: A 6-month double-blind randomised placebo-controlled trial. PLoS Med 16(11): e1002960. https://doi.org/10.1371/journal.pmed.1002960

Image Credit: avi_acl, Pixabay

Author Affiliations:

Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom

Clinical Trials Research Unit, University of Leeds, Leeds, United Kingdom

Specialised Cancer Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

TRYMS Trial Management Group, Sheffield, United Kingdom

Institute for Cancer Research, London, United Kingdom

Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

In your coverage please use this URL to provide access to the freely available paper: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002960

PLOS

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