The TRANSFORMER Study: Bipolar Androgen Therapy vs. Enzalutamide in Asymptomatic Men With mCRPC

Samuel R. Denmeade, MD, presented “The TRANSFORMER Study: Bipolar Androgen Therapy vs. Enzalutamide in Asymptomatic Men With mCRPC” for the Grand Rounds in Urology audience in May 2021.

Main Discussion – Summary:

E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at University of California, San Diego discusses the TRANSFORMER study and bipolar androgen therapy with Samuel R. Denmeade, MD, Professor of Oncology and Urology at Johns Hopkins University and co-leader of the Prostate Cancer Program for the Johns Hopkins Kimmel Cancer Center. Dr. Denmeade presents the study results, outlines the conceptual background, and notes the benefits of bipolar androgen therapy. TRANSFORMER compared enzalutamide with bipolar androgen therapy, a treatment in which testosterone levels are oscillated between low and high levels in order to prevent the adaptation of prostate cancer cells to a low-androgen environment. Results indicate that while bipolar androgen therapy may not have superior progression free survival rates when compared with enzalutamide, it can improve patient response to enzalutamide, suggesting that further research on sequential treatment is warranted. Notably, some men undergoing bipolar androgen therapy experienced a return in sexual function and also better physical functioning which contributed to improved quality of life.

Q&A – Summary:

Following the overview of the study results, Dr. Crawford interviews Dr. Denmeade on the conceptual approach of high and low hormone therapy and how this paradigm may impact future treatment. It is important to note that the study focused on men with mCRPC, in part because it may have an anti-tumor effect. Dr. Denmeade also mentions a new pilot trial that will pair radium with testosterone therapy to examine whether the testosterone will enhance the effectiveness of radium.

How to cite: Denmeade, Samuel R. “The TRANSFORMER Study: Bipolar Androgen Therapy vs. Enzalutamide in Asymptomatic Men With mCRPC” May 2021. Accessed Apr 2024. https://dev.grandroundsinurology.com/the-transformer-study-bipolar-androgen-therapy-vs-enzalutamide-in-asymptomatic-men-with-mcrpc/