Testosterone suppression by androgen deprivation therapy is the cornerstone of prostate cancer treatment. New-generation hormone therapies improved overall survival in castration-resistant prostate cancer. More recent trials showed a further increase in overall survival when enzalutamide or abiraterone are associated with androgen deprivation therapy in hormone-sensitive disease. However, a higher clonal pressure may lead to the upregulation of alternative pathways for cancer progression and to dedifferentiated diseases that would probably respond poorly to subsequent treatments. In this contest, new strategies that could be able to delay or even revert resistance are needed. The bipolar androgen therapy is an under-investigation treatment that consists in periodical oscillation between castration levels and supraphysiological levels of testosterone in order to prevent the adaptation of prostate cancer cells to a low-androgen environment. This review aims to underline the biological rationale of bipolar androgen therapy and gather evidences from the most recent clinical trials.

通过雄激素剥夺疗法抑制睾丸激素是前列腺癌治疗的基石。新一代激素疗法可改善去势抵抗性前列腺癌的总体生存率。最近的试验表明，将恩杂鲁胺或阿比特龙与激素敏感性疾病中的雄激素剥夺治疗相关联时，总生存率进一步提高。但是，较高的克隆压力可能会导致癌症进展的替代途径上调，并导致去分化的疾病，可能对后续治疗反应差。在这场比赛中，需要可以延迟甚至恢复抵抗的新策略。双极雄激素疗法是一种研究不足的疗法，其在于去势水平和睾丸超生理水平之间周期性振荡，以防止前列腺癌细胞适应低雄激素环境。这篇综述旨在强调双极雄激素疗法的生物学原理，并从最新的临床试验中收集证据。