Low Testosterone in Patients With ALK-Positive Lung Cancer

D. Ross Camidge, MD, PhD, Director, Thoracic Oncology Clinical Program, University of Colorado Cancer Center, comments on ALK-positive lung cancer patients with low testosterone.

Many patients (about 30%) with advanced cancer experience low testosterone from the burden of the disease and treatment. Cytotoxic chemotherapy, brain radiotherapy, steroids, and painkillers can all affect testosterone, Camidge says.

In a recent study, only 30% of the control group (patients with advanced lung cancer) had low testosterone. In patients with ALK-positive lung cancer treated with crizotinib, 100% of patients had low testosterone. In a follow up study conducted in four countries across multiple sites, 84% of men on crizotinib experienced low testosterone.

In a second analysis, Camidge says, researchers used a questionnaire to measure androgen-related symptoms: erectile dysfunction, energy levels, and depression. Among patients with low testosterone, 80% were symptomatic and 50% of those patients felt better after replacement testosterone. Camidge notes that the older a patient, the less likely they are to benefit from testosterone replacement, while younger patients are more likely to see benefit.

Clinical Pearls

Low testosterone is easy to check for, Camidge says, and is easy to treat.

• About 30% of patients with advanced cancer will have low testosterone from the burden of the disease and treatment
• A large portion of patients with ALK-positive lung cancer have low testosterone
• Low testosterone is easy to check and easy to treat, Camidge says