Prostate cancer is the most common male malignant tumor

ranking second among male malignant tumors. The incidence rate of prostate cancer is the highest in all male cancers. The incidence rate of China's prostate cancer is lower than that of western countries. However

with the westernization of lifestyle

the westernization of life habits and the prolongation of life expectancy

the incidence rate of prostate cancer is increasing year by year. Androgen receptor (AR) plays an important role in the pathophysiological mechanism of prostate cancer. Inhibiting AR signal transduction pathway is the basis of prostate cancer treatment. For example

in the treatment of castration-resistant prostate cancer (CRPC)

AR antagonists can competitively bind AR and block the binding of endogenous androgen. Thus

it interferes with the downstream response of androgen dependent cells and prevents the progression of prostate cancer. Androgen deprivation therapy (ADT) is the cornerstone in the treatment of prostate cancer. According to the consensus of domestic experts

the effective testosterone (T) level for ADT is less than 50 ng/dL. Accumulated studies have shown that patients with T ＜ 20 ng/dL have better clinical prognosis. Lower T level (less than 20 ng/dL) results in more death of androgen-sensitive and some androgen-insensitive cells. During the treatment

androgen-sensitive cell populations can be obtained

thereby prolonging the duration to castration resistance. If T ＜ 20 ng/dL cannot be achieved

some androgen-insensitive subpopulations may persist. These subpopulations will proliferate rapidly after retreatment and accelerate the progression of tumor resistance to castration. The safety and effectiveness of gonadotropin-releasing hormone agonist (GnRHa)

which controls T levels

have been verified by laboratory and clinical evidence

providing the clinical feasibility of controlling T at the level less than 20 ng/dL. This article reviewed the advances in the relationship between T level and ADT

and exhibited the drug efficacy

safety and patient benefits from the treatment of prostate cancer.