UroToday - Management of Advanced Prostate Cancer: Can We Improve on Androgen Deprivation Therapy? - Abstract

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Wednesday, 26 March 2008

Malmö University Hospital, Lund University, Sweden.

Gonadotrophin-releasing hormone (GnRH) agonists are currently the mainstay

in the management of advanced prostate cancer. Used either as monotherapy or

combined with antiandrogens, GnRH agonists suppress serum testosterone

levels and thus slow the growth of the tumour cells that depend on

testosterone for growth. GnRH agonists have largely replaced orchidectomy in

the management of advanced prostate cancer, because patients are reluctant

to undergo surgical castration. However, can we do better in

androgen-deprivation therapy? There is some evidence to suggest that GnRH

agonists do not achieve the level of testosterone suppression attained with

orchidectomy, or as rapidly, factors which could be expected to affect

overall survival. Together, these observations highlight the need to develop

newer agents that can achieve rapid, profound and sustained testosterone

suppression, equivalent to that with orchidectomy. Preliminary data for the

GnRH blocker, degarelix, suggest that this new agent might overcome the

shortcomings associated with GnRH agonists. Further clinical data are

therefore awaited with much interest.

Written by

J, Abrahamsson PA, Crawford D, K, Tombal B.

Reference

BJU Int. 2008 Mar 11. Epub ahead of print.

PubMed Abstract

PMID:18336613