Real-World OPTYX Study: Sustained Castration and Rapid Testosterone Recovery with Relugolix

Relugolix (Orgovyx), the first oral androgen deprivation therapy approved for advanced prostate cancer, continues to show consistent performance in real-world settings. New data from the OPTYX study, a prospective observational analysis, provide further evidence on testosterone suppression, recovery, and PSA control in routine clinical practice.

The study included 999 patients, predominantly with nonmetastatic disease and a median age of 71 years. Most received relugolix as monotherapy. After six months of treatment, over 92% of patients achieved castration levels of testosterone (<50 ng/dL), and nearly 70% reached deeper suppression below 20 ng/dL, closely matching results from the phase 3 HERO trial.

Following treatment discontinuation, testosterone levels recovered relatively quickly, reaching a mean of 214 ng/dL at three months and approaching baseline levels by six months (267 ng/dL). However, recovery was variable, with only about 42% of patients exceeding 280 ng/dL at six months.

Notably, PSA control persisted in many patients despite testosterone recovery. At six months off therapy, 66% maintained PSA levels below 0.2 ng/mL. This finding suggests a potential role for relugolix in intermittent ADT strategies, where treatment breaks may reduce toxicity without immediately compromising disease control.

Overall, OPTYX confirms that relugolix delivers reliable testosterone suppression with relatively rapid recovery in real-world practice, while also highlighting its potential utility in more flexible, individualized treatment approaches.

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