Clin Oncol | Volume 3, Issue 1 | Research Article | Open Access

Retrospective Analysis of Clinical Efficacy of Luteinizing Hormone-Releasing Hormone Antagonist as Compared to Agonists with Combined Anti-Androgen Blockade (CAB) in Advanced Prostate Cancer

Takahiko Hashimoto^1*, Akihiro Kanematsu¹, Michio Nojima¹, Seiji Nagasawa², Koji Fukui², Kinue Aihara², Koji Kokura², Takeshi Hanasaki³, Yasuo Ueda³, Hidekazu Takiuchi³, Yoshikazu Togo⁴, Nobuyuki Kondoh⁴, Yutaka Doi⁵, Yukako Nakanishi¹, Yoshihide Higuchi⁶, Risaku Kawaguchi⁶, Takeshi Morimoto⁷ and Shingo Yamamoto¹

¹Department of Urology, Hyogo College of Medicine, Japan
²Department of Urology, Takarazuka City Hospital, Japan
³Department of Urology, Nishinomiya Municipal Central Hospital, Japan
⁴Department of Urology, Kyoritsu Hospital, Japan
⁵Department of Urology, Meiwa Hospital, Japan
⁶Department of Urology, Chibune Hospital, Japan
⁷Department of Clinical Epidemiology, Hyogo College of Medicine, Japan

^*Correspondance to: Takahiko Hashimoto 

Abstract

Purpose: we retrospectively analyzed the clinical efficacy of the LHRH antagonist degarelix and compared it with that of the LHRH agonist's leuprolide or goserelin when used in combination with a nonsteroidal antiandrogen, bicalutamide or flutamide, for patients with advanced prostate cancer classified as stage C or D. Material and
Method: We examined the efficacy of degarelix, a luteinizing hormone-releasing hormone (LHRH) antagonist, and that of leuprolide and goserelin, LHRH agonists, in combination with anti-androgens for 145 advanced prostate cancers.
Results: When Prostate-Specific Antigen (PSA) Progression-Free Survival (PFS) was set as the primary endpoint, no significant difference was seen among the 3 agents or between the LHRH antagonist and each LHRH agonist in analysis of all patients as well as after dividing them according to stage (C/D) and J-CAPRA score (intermediate/high). Multivariate analysis showed that age <75 years old, initial PSA ≥ 200 ng/dl, and bone metastasis were risk factors affecting PSA PFS, whereas Gleason's score, lymph node metastasis, and visceral metastasis were not related. Conclusions: In this retrospective analysis, we did not find a significant difference in PSA PFS between an LHRH antagonist and agonists when used with Combined Anti-androgen Blockade (CAB). Limitations include a low number of enrolled patients, lack of randomization, and retrospective nature, thus further studies with a greater number of subjects are required to confirm our results and develop an ideal protocol for hormone therapy for advanced prostate cancer.

Keywords:

Combined androgen blockade; Metastatic prostate cancer; Luteinizing hormone-releasing hormone; Antagonist; Agonist

Citation:

Hashimoto T, Kanematsu A, Nojima M, Nagasawa S, Fukui K, Aihara K, et al. Retrospective Analysis of Clinical Efficacy of Luteinizing Hormone- Releasing Hormone Antagonist as Compared to Agonists with Combined Anti-Androgen Blockade (CAB) in Advanced Prostate Cancer. Clin Oncol. 2018; 3: 1474.