Open Access

ARTICLE

Utility of LHRH antagonists for advanced prostate cancer

Judd W. Moul

Division of Urologic Surgery, Department of Surgery and Duke Cancer Institute, Duke University, Durham, North Caroline, USA
Address correspondence to Dr. Judd W. Moul, Division of Urologic Surgery, DUMC 3707-Room 1562, Duke South, Duke University Medical Center, Durham, NC 27710 USA

Canadian Journal of Urology 2014, 21(Suppl.2), 22-27.

Abstract

instruction: Introduction: Androgen deprivation therapy (ADT) is the lynchpin of treatment for advanced prostate cancer. Prescribing physicians and patients have a choice between orchiectomy, luteinizing hormone-releasing hormone (LHRH) agonists, combined androgen deprivation (CAD) or LHRH antagonists.
instruction: Materials and methods: Literature relating to the use of LHRH antagonists in the management of prostate cancer was reviewed.
instruction: Results: Abarelix was the first-in-class LHRH pure antagonist that was Food and Drug Administration (FDA) approved in 2003. Due to a variety of concerns including hypersensitivity reactions it was withdrawn from the United States (U.S.) market in 2005. The only currently commercially available LHRH antagonist in the U.S. is degarelix available as a once-a-month depot injection. The potential clinical advantage of degarelix compared to the LHRH agonists is the very rapid and sustained testosterone suppression with no identifiable physiological or clinical testosterone surge or flare. The main disadvantage of degarelix compared to the LHRH agonists is the monthly dosing and the inconvenience for some patients and practices. Recent studies tout improved disease control for degarelix compared to monthly leuprolide acetate; however, these results remain controversial.
instruction: Conclusions: The rapid testosterone suppression achieved with degarelix may provide a clinical benefit for various groups of men with advanced or locally advanced disease.

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