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A switch from GnRH agonist to GnRH antagonist in castration-resistant prostate cancer patients leads to a low response rate on PSA.
- Source :
-
World journal of urology [World J Urol] 2013 Apr; Vol. 31 (2), pp. 339-43. Date of Electronic Publication: 2012 Apr 15. - Publication Year :
- 2013
-
Abstract
- Purpose: At the time of castration resistance, it is recommended to realize hormonal manipulations before chemotherapy. We evaluated the impact of a switch from GnRH agonist to antagonist in patients with castration-resistant prostate cancer on PSA and testosterone levels at 3 months.<br />Methods: Retrospectively, 17 patients from 5 different centers undergoing androgen deprivation therapy and presenting rising PSA confirmed on 3 blood samples 2 weeks apart and despite a castrate testosterone level (<0.5 ng/ml) were reviewed. Antiandrogen withdrawal syndrome had been tested before the switch. Degarelix was administered as followed: 240 mg for the first injection and then 80 mg every month, subcutaneously. We evaluated the PSA and testosterone level variation 3 months after the switch. Patients who experienced a variation in PSA of less than 10% compared to the baseline or who had a more than 10% PSA decrease were defined as responders.<br />Results: Mean PSA level at the switch was 34.3 ± 50.3 ng/ml, with a mean testosterone level of 0.21 ± 0.13 ng/ml. Three months after the switch, mean PSA level was 59.9 ± 81.6 ng/ml (P = 0.061), with a mean testosterone level of 0.19 ± 0.08 ng/ml (P = 0.086). At 3 months, 4 patients (23%) responded to therapy. Thirteen patients (77%) experienced a rise in PSA of more than 10% compared to baseline; 41% of patients decreased their testosterone level. The limitations of this study are its retrospective nature and the limited number of patients.<br />Conclusion: Switch from an agonist to an antagonist of GnRH has a limited impact on PSA at 3 months in castration-resistant prostate cancer patients.
- Subjects :
- Aged
Aged, 80 and over
Disease Progression
Drug Substitution
Gonadotropin-Releasing Hormone agonists
Humans
Kallikreins blood
Male
Prostate-Specific Antigen blood
Retrospective Studies
Testosterone blood
Treatment Outcome
Antineoplastic Agents, Hormonal therapeutic use
Gonadotropin-Releasing Hormone antagonists & inhibitors
Oligopeptides therapeutic use
Prostatic Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1433-8726
- Volume :
- 31
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- World journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 22527669
- Full Text :
- https://doi.org/10.1007/s00345-012-0841-1