(O-05) Testosterone recovery after cessation of androgen deprovation therapy for prostate cancer: a single-arm meta-analysis of prospective trials

Abstract Introduction Androgen deprivation therapy (ADT) is crucial in treating prostate cancer (PCa), yet many patients suffer from low testosterone (T) long after treatment ends. Low T leads to adverse health outcomes. Rates of T recovery post-ADT vary widely in studies. Thus, we performed a systematic review and meta-analysis to evaluate T recovery after ADT cessation. Methods We searched PubMed, Embase, and Cochrane databases in November 2024 for prospective studies on T recovery post-ADT, defined as T levels ≥240 ng/dL (≥ 8.32 nmol/L), assessed at intervals (≤ 6 months, 6–24 months, ≥ 24 months). Studies were included regardless of definitive treatment modality. We pooled event prevalence and 95% confidence intervals (CIs) for binary outcomes. Subgroup analyses by ADT drug class and meta-regression for ADT duration and age impact on T recovery were conducted using R version 4.4.1 with a random-effects model. Results A total of 12 prospective trials with 1264 patients (median age 59-77) were included. Pooled analysis showed T recovery in 36.88% of patients at ≤6 months (95% CI: 21.95—54.82), 64.15% at 6-24 months (95% CI: 49.41—76.63), and 45.06% at ≥24 months (95% CI: 30.76—60.23). Subgroup analyses revealed significant differences by ADT drug class at all intervals. Meta-regression found no impact of ADT duration (p = 0.43), nor age (p = 0.61) on recovery rates. Conclusions Our analysis indicates that T recovery rates vary by assessment timepoint and is significantly influenced by ADT drug class. Neither ADT duration nor age correlated with T recovery. These findings underscore the need for standardized definitions and further research on long-term ADT outcomes and T recovery post-ADT cessation. Financing No conflict.