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LHRH Agonist and Antagonist for Prostate Cancer

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Management of Advanced Prostate Cancer

Abstract

ADT is the main treatment for advanced prostate cancer. Combination therapy with radiotherapy in early stage prostate cancer is increasing. LHRH agonists are the most frequently used type of ADT for several years, and they have suppressed the serum testosterone to castration level in almost all patients. Furthermore, LHRH antagonist was developed recently as an alternative form of ADT with direct and immediate suppression of testosterone without initial testosterone flare phenomenon. Therefore, in this chapter, we will describe the comparative efficacy and safety between LHRH agonists and LHRH antagonists for prostate cancer.

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References

  1. Tolis G, Ackman D, Stellos A, Mehta A, Labrie F, Fazekas AT, et al. Tumor growth inhibition in patients with prostatic carcinoma treated with luteinizing hormone-releasing hormone agonists. Proc Natl Acad Sci U S A. 1982;79(5):1658–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Mathe G, Schally AV, Comaru-Schally AM, Mauvernay RY, Vovan ML, Machover D, et al. Phase II trial with D-Trp-6-LH-RH in prostatic carcinoma: comparison with other hormonal agents. Prostate. 1986;9(4):327–42.

    Article  CAS  PubMed  Google Scholar 

  3. Tsushima T, Nasu Y, Saika T, Maki Y, Noda M, Suyama B, et al. Optimal starting time for flutamide to prevent disease flare in prostate cancer patients treated with a gonadotropin-releasing hormone agonist. Urol Int. 2001;66(3):135–9.

    Article  CAS  PubMed  Google Scholar 

  4. Rick FG, Block NL, Schally AV. Agonists of luteinizing hormone-releasing hormone in prostate cancer. Expert Opin Pharmacother. 2013;14(16):2237–47.

    Article  CAS  PubMed  Google Scholar 

  5. Gonzalez-Barcena D, Vadillo-Buenfil M, Gomez-Orta F, Fuentes Garcia M, Cardenas-Cornejo I, Graef-Sanchez A, et al. Responses to the antagonistic analog of LH-RH (SB-75, Cetrorelix) in patients with benign prostatic hyperplasia and prostatic cancer. Prostate. 1994;24(2):84–92.

    Article  CAS  PubMed  Google Scholar 

  6. Gonzalez-Barcena D, Vadillo-Buenfil M, Cortez-Morales A, Fuentes-Garcia M, Cardenas-Cornejo I, Comaru-Schally AM, et al. Luteinizing hormone-releasing hormone antagonist cetrorelix as primary single therapy in patients with advanced prostatic cancer and paraplegia due to metastatic invasion of spinal cord. Urology. 1995;45(2):275–81.

    Article  CAS  PubMed  Google Scholar 

  7. Rick FG, Block NL, Schally AV. An update on the use of degarelix in the treatment of advanced hormone-dependent prostate cancer. Onco Targets Ther. 2013;6:391–402.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Klotz L, Boccon-Gibod L, Shore ND, Andreou C, Persson BE, Cantor P, et al. The efficacy and safety of degarelix: a 12-month, comparative, randomized, open-label, parallel-group phase III study in patients with prostate cancer. BJU Int. 2008;102(11):1531–8.

    Article  CAS  PubMed  Google Scholar 

  9. Clinton TN, Woldu SL, Raj GV. Degarelix versus luteinizing hormone-releasing hormone agonists for the treatment of prostate cancer. Expert Opin Pharmacother. 2017;18(8):825–32.

    Article  CAS  PubMed  Google Scholar 

  10. Albertsen PC, Klotz L, Tombal B, Grady J, Olesen TK, Nilsson J. Cardiovascular morbidity associated with gonadotropin releasing hormone agonists and an antagonist. Eur Urol. 2014;65(3):565–73.

    Article  CAS  PubMed  Google Scholar 

  11. Radu A, Pichon C, Camparo P, Antoine M, Allory Y, Couvelard A, et al. Expression of follicle-stimulating hormone receptor in tumor blood vessels. N Engl J Med. 2010;363(17):1621–30.

    Article  CAS  PubMed  Google Scholar 

  12. Klotz L, Miller K, Crawford ED, Shore N, Tombal B, Karup C, et al. Disease control outcomes from analysis of pooled individual patient data from five comparative randomised clinical trials of degarelix versus luteinising hormone-releasing hormone agonists. Eur Urol. 2014;66(6):1101–8.

    Article  CAS  PubMed  Google Scholar 

  13. Lee D, Nielsen SK, van Keep M, Andersson F, Greene D. Quality of life improvement in patients treated with degarelix versus leuprorelin for advanced prostate cancer. J Urol. 2015;193(3):839–46.

    Article  CAS  PubMed  Google Scholar 

  14. Tombal B, Miller K, Boccon-Gibod L, Schroder F, Shore N, Crawford ED, et al. Additional analysis of the secondary end point of biochemical recurrence rate in a phase 3 trial (CS21) comparing degarelix 80 mg versus leuprolide in prostate cancer patients segmented by baseline characteristics. Eur Urol. 2010;57(5):836–42.

    Article  CAS  PubMed  Google Scholar 

  15. Mason M, Maldonado Pijoan X, Steidle C, Guerif S, Wiegel T, van der Meulen E, et al. Neoadjuvant androgen deprivation therapy for prostate volume reduction, lower urinary tract symptom relief and quality of life improvement in men with intermediate- to high-risk prostate cancer: a randomised non-inferiority trial of degarelix versus goserelin plus bicalutamide. Clin Oncol. 2013;25(3):190–6.

    Article  CAS  Google Scholar 

  16. Anderson J, Al-Ali G, Wirth M, Gual JB, Gomez Veiga F, Colli E, et al. Degarelix versus goserelin (+ antiandrogen flare protection) in the relief of lower urinary tract symptoms secondary to prostate cancer: results from a phase IIIb study (NCT00831233). Urol Int. 2013;90(3):321–8.

    Article  PubMed  Google Scholar 

  17. Axcrona K, Aaltomaa S, da Silva CM, Ozen H, Damber JE, Tanko LB, et al. Androgen deprivation therapy for volume reduction, lower urinary tract symptom relief and quality of life improvement in patients with prostate cancer: degarelix vs goserelin plus bicalutamide. BJU Int. 2012;110(11):1721–8.

    Article  CAS  PubMed  Google Scholar 

  18. Sciarra A, Fasulo A, Ciardi A, Petrangeli E, Gentilucci A, Maggi M, et al. A meta-analysis and systematic review of randomized controlled trials with degarelix versus gonadotropin-releasing hormone agonists for advanced prostate cancer. Medicine. 2016;95(27):e3845.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Lu L, Peters J, Roome C, Stein K. Cost-effectiveness analysis of degarelix for advanced hormone-dependent prostate cancer. BJU Int. 2012;109(8):1183–92.

    Article  PubMed  Google Scholar 

  20. Garnick MB, Mottet N. New treatment paradigm for prostate cancer: abarelix initiation therapy for immediate testosterone suppression followed by a luteinizing hormone-releasing hormone agonist. BJU Int. 2012;110(4):499–504.

    Article  CAS  PubMed  Google Scholar 

  21. Miyazawa Y, Kato H, Arai S, Furuya Y, Sekine Y, Nomura M, et al. Clinical endocrinological evaluation of the gonadal axis (testosterone, LH and FSH) in prostate cancer patients switched from a GnRH antagonist to a LHRH agonist. Basic Clin Androl. 2015;25:7.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Jun Sung Koh .

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Choi, J.B., Koh, J.S. (2018). LHRH Agonist and Antagonist for Prostate Cancer. In: Kim, C. (eds) Management of Advanced Prostate Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-6943-7_15

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  • DOI: https://doi.org/10.1007/978-981-10-6943-7_15

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6942-0

  • Online ISBN: 978-981-10-6943-7

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