New treatment paradigm for prostate cancer: abarelix initiation therapy for immediate testosterone suppression followed by a luteinizing hormone-releasing hormone agonist
| Autor: | Marc B. Garnick, Nicolas Mottet |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Agonist
medicine.medical_specialty medicine.drug_class business.industry Urology Goserelin Antiandrogen Abarelix Management of prostate cancer Endocrinology Maintenance therapy Internal medicine medicine Hormonal therapy business hormones hormone substitutes and hormone antagonists Testosterone medicine.drug |
| Zdroj: | BJU International. 110:499-504 |
| ISSN: | 1464-4096 |
| DOI: | 10.1111/j.1464-410x.2011.10708.x |
| Popis: | Study Type – Therapy (prospective cohort) Level of Evidence 2a What's known on the subject? and What does the study add? The sequential administration of a GnRH antagonist followed by an LHRH agonist in the management of prostate cancer patients has not been studied, but such a program would provide a more physiologic method of achieving testosterone suppression and avoid the obligatory testosterone surge and need for concomitant antiandrogens that accompany LHRH agonist therapy. The current study which uses abarelix initiation therapy for 12 weeks followed by either leuprolide or goserelin demonstrates the ability to more rapidly achieve testosterone suppression, avoid the obligatory LHRH induced testosterone surge, avoid the necessity of antiandrogens, all of which were accomplished safely, without inducing either additional or novel safety issues. OBJECTIVE • To demonstrate the safety and endocrinological and biochemical efficacy of initiating treatment with the gonadotropin-releasing hormone (GnRH) antagonist, abarelix, followed by administration of an luteinizing hormone-releasing hormone (LHRH) agonist in patients with advanced and metastatic prostate cancer. PATIENTS AND METHODS • A multicentre, open-label design study was conducted at 22 centres in the US involving patients with: localized, locally advanced or metastatic disease; with a rising prostate-specific antigen (PSA) after definitive local treatment; patients undergoing neoadjuvant hormonal therapy before local therapy (radical prostatectomy, radiation therapy or cryosurgery); and patients in whom intermittent therapy was the planned treatment. • All patients received abarelix for 12 weeks followed by an LHRH agonist (either leuprolide or goserelin) for 8 weeks • The primary efficacy endpoint was achievement and maintenance of castration defined as testosterone |
| Databáze: | OpenAIRE |
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