Abstract

Since Huggins and Hodges demonstrated the responsiveness of prostate cancer to androgen deprivation therapy (ADT), androgen-suppressing strategies have formed the cornerstone of management of advanced prostate cancer. Approaches to ADT have included orchidectomy, oestrogens, luteinizing hormone-releasing hormone (LHRH) agonists, anti-androgens and more recently the gonadotrophin-releasing hormone antagonists. The most extensively studied antagonist, degarelix, avoids the testosterone surge and clinical flare associated with LHRH agonists, offering more rapid PSA and testosterone suppression, improved testosterone control and improved PSA progression-free survival compared with agonists. The clinical profile of degarelix appears to make it a particularly suitable therapeutic option for certain subgroups of patients, including those with metastatic disease, high baseline PSA (>20 ng/mL) and highly symptomatic disease. As well as forming the mainstay of treatment for advanced prostate cancer, ADT is increasingly used in earlier disease stages. While data from clinical trials support the use of ADT neoadjuvant/adjuvant to radiotherapy for locally advanced or high-risk localized prostate cancer, it remains to be established whether specific ADT classes/agents provide particular benefits in this clinical setting.

Links

Publisher Full Text

Authors

Schröder F, Crawford ED, Axcrona K, Payne H, Keane TE

Institution

Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands. secr.schroder@erasmusmc.nl

Source

BJU international 109 Suppl 6: 2012 Jun pg 1-12

MeSH

Androgen Antagonists
Disease-Free Survival
Gonadotropin-Releasing Hormone
Hormone Antagonists
Humans
Male
Neoadjuvant Therapy
Oligopeptides
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms
Testosterone
Treatment Outcome

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22672120