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Early development of castrate resistance varies with different dosing regimens of luteinizing hormone releasing hormone agonist in primary hormonal therapy for prostate cancer
- Source :
- Urology. 77(2)
- Publication Year :
- 2010
-
Abstract
- Objectives Luteinizing hormone releasing hormone (LHRH) agonist therapy is one of the mainstays of prostate cancer treatment. Three dosing regimens currently exist: calendar-based, intermittent, and a testosterone (T)-based (T-based) regimen. We investigated the differences in development of early castrate resistance rates between these different regimens. Methods We evaluated 1617 patients with prostate cancer who received LHRH-agonist monotherapy in the Kaiser Permanente Southern California Cancer Registry between January 2003 and December 2006. Patients who had undergone surgery and/or radiation were excluded. Patients were grouped according to their dosing regimen: calendar-based, intermittent dosing, and T-based. Cox proportional hazard-regression analysis was used to estimate the hazards ratio (HR) for treatment failure. Results A total of 692 patients who received an LHRH agonist as primary monotherapy for prostate cancer fit our criteria. Calendar-based dosing was used in 325 patients; 252 received T-based dosing and 115 received intermittent dosing. On multivariate analysis controlling for demographic and prostate cancer–related variables, the T-based dosing group showed a significantly lower relative risk of treatment failure (HR = 0.65, P = .02). The intermittent-dosing group trended toward a lower risk treatment failure (HR = 0.80, P = .3). Among the variables analyzed, only a Gleason score >8 (HR = 2.05, P = .01) and a pretreatment prostate-specific antigen >20 (HR = 2.00, P
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Antineoplastic Agents, Hormonal
Urology
Lower risk
Gonadotropin-Releasing Hormone
Prostate cancer
Prostate
Internal medicine
medicine
Humans
Dosing
Testosterone
Aged
Retrospective Studies
business.industry
Prostatic Neoplasms
medicine.disease
Cancer registry
Regimen
Endocrinology
medicine.anatomical_structure
Drug Resistance, Neoplasm
Hormonal therapy
Leuprolide
business
Subjects
Details
- ISSN :
- 15279995
- Volume :
- 77
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Urology
- Accession number :
- edsair.doi.dedup.....166da0546fe6ebb6917c977c1f29ca64