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, Akihiro Kanematsu, Michio Nojima, Seiji Nagasawa, Koji Fukui, Kinue Aihara, Koji Kokura, Takeshi Hanasaki, Yasuo Ueda, Hidekazu Takiuchi, Yoshikazu Togo, Nobuyuki Kondoh, Yutaka Doi, Yukako Nakanishi, Yoshihide Higuchi, Risaku Kawaguchi, Takeshi Morimoto and Shingo Yamamoto

Department of Urology, Hyogo College of Medicine, Japan
Department of Urology, Takarazuka City Hospital, Japan
Department of Urology, Nishinomiya Municipal Central Hospital, Japan
Department of Urology, Kyoritsu Hospital, Japan
Department of Urology, Meiwa Hospital, Japan
Department of Urology, Chibune Hospital, Japan
Department of Clinical Epidemiology, Hyogo College of Medicine, Japan

^*Correspondance to: Takahiko Hashimoto 

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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

Cite the Article:

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.