FSH suppression and tumour control in patients with prostate cancer during androgen deprivation with a GnRH agonist or antagonist

Autor: Jan-Erik Damber, E. David Crawford, N.D. Shore, F. Boccardo, Kurt Miller, L. Collette, Thomas E. Keane, B.E. Persson, Bertrand Tombal, Judd W. Moul
Rok vydání: 2019
Předmět:
Agonist
Male
endocrine system
medicine.medical_specialty
Antineoplastic Agents
Hormonal

medicine.drug_class
Urology
030232 urology & nephrology
Gonadotropin-releasing hormone
Gonadotropin-Releasing Hormone
03 medical and health sciences
chemistry.chemical_compound
Prostate cancer
Follicle-stimulating hormone
Degarelix
0302 clinical medicine
follicle stimulating hormone
leuprolide
prostate cancer
prostate-specific antigen
Internal medicine
medicine
Humans
Aged
business.industry
Drug Substitution
Prostatic Neoplasms
Middle Aged
Prostate-Specific Antigen
medicine.disease
Androgen
Prostate-specific antigen
Endocrinology
chemistry
Nephrology
030220 oncology & carcinogenesis
Kallikreins
Follicle Stimulating Hormone
Leuprolide
business
Oligopeptides
hormones
hormone substitutes
and hormone antagonists

Hormone
Zdroj: Scandinavian journal of urology. 52(5-6)
ISSN: 2168-1813
Popis: Gonadotropin releasing hormone (GnRH) antagonists suppress follicle-stimulating hormone (FSH) to lower levels than GnRH agonists. This may partially explain the differences between these agents on prostate cancer outcomes. In this post-hoc analysis, FSH and prostate specific antigen (PSA) responses and the impact of cross-over from leuprolide to degarelix were evaluated from a 1-year comparative study (CS21) and its extension study (CS21A).Overall, 610 patients were enrolled in CS21, wherein PSA and FSH levels were evaluated monthly. CS21A evaluated 386 patients, including those previously treated with degarelix (n = 251) who continued to receive degarelix, and those previously treated with leuprolide (n = 135) who crossed-over to receive degarelix. PSA and FSH levels were evaluated in CS21A for 3 months after cross-over. The associations between measurements were assessed using Spearman's correlation coefficient. The impact of class variables on FSH suppression were evaluated using Analysis of Variance.Rapid PSA and FSH suppression was observed and maintained in the degarelix arm (CS21 and CS21A), while patients on leuprolide experienced rising PSA during CS21. Patients crossed-over from leuprolide to degarelix achieved a suppression of FSH and a significant PSA decrease. PSA and FSH levels were significantly (p .05) correlated at months 1, 3, 6, 12 and 13 in the degarelix arm.Significant FSH suppression with GnRH antagonists may explain its advantage over GnRH agonists in terms of better prostate cancer control. The effect of profound FSH suppression is analogous to the need for profound testosterone suppression for tumor control.
Databáze: OpenAIRE
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