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).{{cite journal|title=Maximum androgen blockade in advanced prostate cancer: an overview of the randomised trials|journal=The Lancet|volume=355|issue=9214|year=2000|pages=1491–1498|issn=0140-6736|doi=10.1016/S0140-6736(00)02163-2|s2cid=25366526 }} An example of MAB is the combination of bicalutamide, an AR antagonist, with a gonadotropin-releasing hormone (GnRH) analogue such as leuprorelin or cetrorelix. MAB was developed for and is employed in the treatment of prostate cancer.

Triple androgen blockade (TrAB) is a method of ADT in which a 5α-reductase inhibitor such as finasteride or dutasteride is added to CAB.{{cite journal|last1=Hellerstedt|first1=Beth A|last2=Pienta|first2=Kenneth J|title=The truth is out there: an overall perspective on androgen deprivation|journal=Urologic Oncology: Seminars and Original Investigations|volume=21|issue=4|year=2003|pages=272–281|issn=1078-1439|doi=10.1016/S1078-1439(03)00046-2|pmid=12954498}}{{cite journal | vauthors = Leibowitz RL, Tucker SJ | title = Treatment of localized prostate cancer with intermittent triple androgen blockade: preliminary results in 110 consecutive patients | journal = The Oncologist | volume = 6 | issue = 2 | pages = 177–82 | year = 2001 | pmid = 11306729 | doi = 10.1634/theoncologist.6-2-177| doi-access = free }}

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%).{{cite journal | vauthors = Di Lorenzo G, Autorino R, Perdonà S, De Placido S | title = Management of gynaecomastia in patients with prostate cancer: a systematic review | journal = Lancet Oncol. | volume = 6 | issue = 12 | pages = 972–9 | date = December 2005 | pmid = 16321765 | doi = 10.1016/S1470-2045(05)70464-2 }}