Is there a role for LHRH antagonists in prostate cancer?

摘要

The recent US Food and Drag Administration (FDA) approval of degarelix, a luteinizing hormone-releasing hormone (LHRH) antagonist, has renewed interest in this class of drugs as a prostate cancer therapy. Approval was based on a prospective phase III trial of 610 patients randomized to one of two dosing schedules of degarelix, or standard-of-care monthly leuprolide acetate monotherapy, with initial antiandrogen therapy allowed at the treating physician's discretion for prevention of clinical fiare.[1] The study clearly met its primary endpoint, to demonstrate equivalence of degarelix and leuprolide in suppressing testosterone from 28 to 364 days after initiating therapy. As Crawford and Hou discuss, the primary difference between the two drugs was predictably observed within the first 28 days, in the form of an LHRH agonist-induced testosterone surge not seen with an LHRH antagonist.