Bipolar Androgen Therapy

Bipolar Androgen Therapy (BAT) is an investigational hormonal strategy for the treatment of metastatic castration-resistant prostate cancer (mCRPC), pioneered by researchers at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. The therapy involves the cyclical administration of supraphysiologic doses of testosterone (typically 400 mg of testosterone cypionate via intramuscular injection every 28 days) to patients who are concurrently maintained on continuous androgen deprivation therapy (ADT) with LHRH agonists or antagonists. This regimen creates rapid oscillations between supraphysiologic and near-castrate serum testosterone levels. The therapeutic rationale is based on the paradoxical observation that high-dose androgens can induce growth arrest and double-strand DNA damage in prostate cancer cells that have adapted to low-androgen environments through androgen receptor (AR) overexpression. By alternating these extremes, BAT aims to prevent or reverse resistance to standard AR-targeted therapies and has been studied both as a monotherapy and in combination with other agents such as Radium-223.

Other names

testosterone cypionate