Degarelix as an intermittent androgen deprivation therapy for one or more treatment cycles in patients with prostate cancer

Laurent Boccon-Gibod, Peter Albers, Juan Morote, Hendrik Van Poppel, Jean De La Rosette, Arnauld Villers, Anders Malmberg, Anders Neijber, Francesco Montorsi

Research output: Contribution to journalArticle

Abstract

Background Guidelines for prostate cancer treatment suggest that intermittent androgen deprivation (IAD) can be considered for certain patients. Objective To evaluate the efficacy and safety of degarelix as IAD for one or more treatment cycle(s) in prostate cancer patients requiring androgen deprivation. Design, setting, and participants This open-label uncontrolled multicenter study included patients with prostate-specific antigen (PSA) >4 to 50 ng/ml or PSA doubling time 4 ng/ml. Intervention Each induction period included a starting dose of degarelix 240 mg, and thereafter 80 mg once a month for 6 mo, followed by off-treatment periods. Outcome measurements and statistical analysis The primary end point was time to PSA >4 ng/ml. Secondary end points were subgroup analysis of the primary end point, time to testosterone >0.5 and >2.2 ng/ml, quality of life (QoL), and sexual function during the first off-treatment period. Results and limitations Of 213 patients in the first induction period, 191 entered the first off-treatment period, 35 patients entered the second induction, and 30 entered the second off-treatment period. Only two patients entered the third cycle. Median time to PSA >4 ng/ml and duration of first off-treatment period was 392 d each. Significant differences in time to PSA >4 ng/ml were observed between subgroups stratified by prognostic factors (previous curative treatment, cancer stage, PSA levels, and Gleason scores). Time to testosterone >0.5 and >2.2 ng/ml was 112 and 168 d, respectively. Change in QoL remained nonsignificant, and sexual function gradually improved during the off-treatment period. Adverse events were fewer during the off-treatment period and subsequent treatment cycles. Conclusions IAD with degarelix resulted in an improvement in sexual function commensurate with increased testosterone levels while PSA remained suppressed. The treatment for one treatment cycle or more was well tolerated. Patient summary Guidelines for prostate cancer treatment suggest that intermittent androgen deprivation (IAD) can be considered for certain patients. IAD with degarelix resulted in improved sexual function commensurate with increased testosterone levels while prostate-specific antigen remained suppressed. The treatment for one treatment cycle or more was well tolerated.

Original languageEnglish
Pages (from-to)655-663
Number of pages9
JournalEuropean Urology
Volume66
Issue number4
DOIs
Publication statusPublished - 2014

Keywords

  • Efficacy
  • GnRH antagonist
  • Intermittent androgen deprivation
  • Prostate cancer
  • safety

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

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    Boccon-Gibod, L., Albers, P., Morote, J., Van Poppel, H., De La Rosette, J., Villers, A., Malmberg, A., Neijber, A., & Montorsi, F. (2014). Degarelix as an intermittent androgen deprivation therapy for one or more treatment cycles in patients with prostate cancer. European Urology, 66(4), 655-663. https://doi.org/10.1016/j.eururo.2014.05.037