Maximum or maximal androgen blockade (MAB) or complete or combined androgen blockade (CAB) is a

medical treatment A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many different ...

involving the combination of both

androgen receptor The androgen receptor (AR), also known as NR3C4 (nuclear receptor subfamily 3, group C, member 4), is a type of nuclear receptor that is activated by binding any of the androgenic hormones, including testosterone and dihydrotestosterone in th ...

(AR)

antagonism Antagonism may refer to: *The characteristic of an antagonist *Antagonism (chemistry), where the involvement of multiple agents reduces their overall effect *Receptor antagonist or pharmacological antagonist, a substance that binds to the site an ...

and inhibition or suppression of androgen production to attain maximal effectiveness in

androgen deprivation therapy Androgen deprivation therapy (ADT), also called androgen suppression therapy, is an antihormone therapy whose main use is in treating prostate cancer. Prostate cancer cells usually require androgen hormones, such as testosterone, to grow. ADT red ...

(ADT). An example of MAB is the combination of bicalutamide, an AR antagonist, with a gonadotropin-releasing hormone (GnRH) analogue such as

leuprorelin Leuprorelin, also known as leuprolide, is a manufactured version of a hormone used to treat prostate cancer, breast cancer, endometriosis, uterine fibroids, as part of transgender hormone therapy, for early puberty, or to perform chemical castra ...

or cetrorelix. MAB was developed for and is employed in the treatment of

prostate cancer Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...

. Triple androgen blockade (TrAB) is a method of ADT in which a

5α-reductase inhibitor 5α-Reductases, also known as 3-oxo-5α-steroid 4-dehydrogenases, are enzymes involved in steroid metabolism. They participate in three metabolic pathways: bile acid biosynthesis, androgen and estrogen metabolism. There are three isozymes of ...

such as

finasteride Finasteride, sold under the brand names Proscar and Propecia among others, is a medication used to treat hair loss and benign prostatic hyperplasia (BPH) in men. It can also be used to treat excessive hair growth in women and as a part of horm ...

or dutasteride is added to CAB. MAB has been found to produce higher rates of gynecomastia (7 to 28%) than

orchiectomy Orchiectomy (also named orchidectomy, and sometimes shortened as orchi or orchie) is a surgical procedure in which one or both testicles are removed. The surgery is performed as treatment for testicular cancer, as part of surgery for transgend ...

and GnRH analogues alone (1 to 16%), but lower rates than nonsteroidal antiandrogen monotherapy such as with bicalutamide (30 to 85%).

References

Prostate cancer {{genito-urinary-drug-stub