Clinical Effect of Switching from a Luteinizing Hormone-Releasing Hormone Agonist to an Antagonist in Patients with Castration-Resistant Prostate Cancer and Serum Testosterone Level ≥ 20 ng/dl.

The efficacy of conversion from a luteinizing hormone-releasing hormone agonist to an antagonist was evaluated prospectively in patients with castration-resistant prostate cancer.

From October 2012 to December 2014, 8 cases with a serum testosterone level ≥ 20 ng/dl during following androgen deprivation therapy were enrolled and received degarelix monthly.

The primary end-pointgoal was to determine the effective prostate-specific antigen response rate. The secondary end-pointgoal was to assess the proportion of cases with a decrease in serum testosterone level to < 20 ng/ml.

One patient achieved a complete response, with a prostate-specific antigen level of 0.02 ng/ml at the nadirend of the study. The effective response rate was 25.0% (2/8), and the proportion of cases with prostate-specific antigen decline was 62.5% (5/8). In 5/8 cases (5/8, 62.5%), serum testosterone levels declined to < 20 ng/dl.

Switching to a luteinizing hormone-releasing hormone antagonist in patients with testosterone levels ≥ 20 ng/dl may be an option in sequential androgen deprivation therapy for some patients.

Current urology. 2016 Feb 10 [Epub]

Norihito Soga, Takumi Kageyama, Yuji Ogura, Tomomi Yamada, Norio Hayashi

Department of Urology, Aichi Cancer Center Hospital, Nagoya, Japan., Department of Urology, Aichi Cancer Center Hospital, Nagoya, Japan., Department of Urology, Aichi Cancer Center Hospital, Nagoya, Japan., Department of Clinical Epidemiology and Biostatistics Graduate School of Medicine, Osaka University, Suita, Japan., Department of Urology, Aichi Cancer Center Hospital, Nagoya, Japan.

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