Abstract Introduction Castrate resistant prostate cancer (CRPC) is progressive despite the use of androgen deprivation therapy (ADT). Recently, bipolar androgen therapy (BAT) has been investigated as a novel approach to treating metastatic CRPC. The TRANSFORMER (Testosterone Revival Abolishes Negative Symptoms, Fosters Objective Response and Modulates Enzalutamide Resistance) trial demonstrated a 32.0 month OS with BAT, compared to a 29.0 month OS with Enzalutamide. Case Presentation Though advanced CRPC typically reflects a poor prognosis even with existing treatments, the patient case discussed herein reflects a remarkable long-term complete remission in response to Bipolar Androgen Therapy (BAT). The patient presented in this case had initial responses to radiation, leuprolide, and abiraterone, but eventually progression continued. The patient was then enrolled in the TRANSFORMER Trial and received 34 cycles of BAT from 2018 to 2020. The patient demonstrated an exceptional response with continued progression free survival as of August 2025. Conclusions The long-term complete remission of metastatic CRPC after treatment with BAT represents a dramatic response. This shows promise towards the use of BAT in advanced CRPC, indicating encouragement for future investigation and trials.
Knopf et al. (Thu,) studied this question.
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