Selection criteria for initiation and renewal of luteinizing hormone-releasing hormone agonist therapy in patients with prostate cancer: A French prospective observational study - Abstract

OBJECTIVES: To define the profile of patients with prostate cancer (PCa) receiving a 3-month or 6-month formulation of luteinizing hormone-releasing hormone (LHRH) agonist in France and the reasons for choosing between formulations.

METHODS: This prospective 1-year observational study included patients with PCa starting LHRH agonist therapy in everyday practice. Reasons for prescription and patient preference were recorded at inclusion, 3 or 6 months, and 12 months. The percentage of patients with a renewed initial prescription was recorded during follow up.

RESULTS: A total of 1438 patients with PCa were included. Hormonotherapy was initiated more frequently with a 6-month (n = 903; 62.8%) than with a 3-month formulation (n = 535; 37.2%). The initial prescription was renewed in most patients after 3 or 6 months (86.1%) and 12 months (71%); 170 patients switched from a 3-month to a 6-month formulation during follow up. Presence of metastases influenced initial prescription (odds ratio 0.439; 95% confidence interval 1.095-1.892), with a 3-month formulation more often prescribed than a 6-month formulation to men with metastatic PCa at diagnosis (21.3% versus 15.8%, respectively). The most frequent reasons given by physicians for choosing the 6-month formulation were 'simplification of therapeutic regimen' (86.9%) or 'fewer unnecessary visits' (46.8%). Similar reasons were given for switching from a 3-month to a 6-month formulation during follow up. The most frequent reasons given by physicians to initiate therapy with a 3-month formulation were 'usual practice/habit' (55.5%) or 'closer patient management' (46.2%). 'Closer patient management' and 'reassuring effect upon patient' were the main reasons for switching from a 6-month to a 3-month formulation during follow up. Approximately 80% of patients were satisfied with the formulation they were prescribed and patients' reasons for preferring one formulation over another were similar to the physicians' reasons for prescribing these formulations.

CONCLUSIONS: Slow-release formulations of LHRH agonists are useful therapies for physicians treating patients with PCa and there may be a preference for the 6-month formulation.

Written by:
Lebret T, Davin JL, Hennequin C, Latorzeff I, Mignard JP, Moreau JL, Rossi D, Ruffion A, Zerbib M, Culine S.   Are you the author?
Hôpital Foch, service d'urologie, Université de Versailles-Saint-Quentin-en-Yvelines, 40, rue Worth, BP 36, 92151 Suresnes cedex, France; Clinique Rhône-Durance, Avignon, France; Hôpital Saint Louis, Paris, France; Clinique Pasteur, Toulouse, France; Centre Hospitalier Privé, Saint-Brieuc, France; Centre d'Urologie, Nancy, France; Hôpital Nord, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Benite, France; 9Hôpital Cochin, Paris, France.

Reference: Ther Adv Urol. 2014 Dec;6(6):205-14.
doi: 10.1177/1756287214542418


PubMed Abstract
PMID: 25435914

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