Table 3.

Monitoring serum testosterone levels in mCSPC

Testosterone levels should be checked: 1. At baseline, before initiating ADT 2. 1‐4 mo after initiation of ADT, regardless of PSA levels 3. GOAL: <20 ng/dL 4. If PSA rises If T > 20 ng/dL, check luteinizing hormone (to differentiate between incorrect administration [nonsuppressed LH level] vs ineffective castration [suppressed LH level but nonsuppressed T level]) Consider switching to an alternative agent or offering bilateral orchiectomy

Abbreviations: ADT, androgen deprivation therapy; mCSPC, metastatic castrate‐sensitive prostate cancer; PSA, prostate‐specific antigen.