Maximum androgen blockade

Maximum or maximal androgen blockade (MAB) or complete or combined androgen blockade (CAB) is a medical treatment involving the combination of both androgen receptor (AR) antagonism and inhibition or suppression of androgen production to attain maximal effectiveness in androgen deprivation therapy (ADT).^[1] An example of MAB is the combination of bicalutamide, an AR antagonist, with a gonadotropin-releasing hormone (GnRH) analogue such as leuprorelin or cetrorelix.^[1] MAB was developed for and is employed in the treatment of prostate cancer.^[1]

Triple androgen blockade (TrAB) is a method of ADT in which a 5α-reductase inhibitor such as finasteride or dutasteride is added to CAB.^[2][3]

MAB has been found to produce higher rates of gynecomastia (7 to 28%) than orchiectomy and GnRH analogues alone (1 to 16%), but lower rates than nonsteroidal antiandrogen monotherapy such as with bicalutamide (30 to 85%).^[4]

References

1. "Maximum androgen blockade in advanced prostate cancer: an overview of the randomised trials". The Lancet. 355 (9214): 1491–1498. 2000. doi:10.1016/S0140-6736(00)02163-2. ISSN 0140-6736. S2CID 25366526.
2. Hellerstedt, Beth A; Pienta, Kenneth J (2003). "The truth is out there: an overall perspective on androgen deprivation". Urologic Oncology: Seminars and Original Investigations. 21 (4): 272–281. doi:10.1016/S1078-1439(03)00046-2. ISSN 1078-1439. PMID 12954498.
3. Leibowitz RL, Tucker SJ (2001). "Treatment of localized prostate cancer with intermittent triple androgen blockade: preliminary results in 110 consecutive patients". The Oncologist. 6 (2): 177–82. doi:10.1634/theoncologist.6-2-177. PMID 11306729.
4. Di Lorenzo G, Autorino R, Perdonà S, De Placido S (December 2005). "Management of gynaecomastia in patients with prostate cancer: a systematic review". Lancet Oncol. 6 (12): 972–9. doi:10.1016/S1470-2045(05)70464-2. PMID 16321765.