Prostate Cancer Progression Risk Lower With Initial Degarelix Use

Pooled analysis shows initial use of degarelix versus LHRH agonists was associated with improved PSA progression-free survival.
Pooled analysis shows initial use of degarelix versus LHRH agonists was associated with improved PSA progression-free survival.

Patients with metastatic or high-risk prostate cancer (PCa) treated with degarelix have improved PSA progression-free survival compared with those treated with luteinizing hormone-releasing hormone (LHRH) agonists, investigators reported at the European Society for Medical Oncology 2016 congress in Copenhagen.

The finding is from a pooled analysis of data from patients in the Americas, Europe, and Asia. Neal Shore, MD, of Carolina Urologic Research Center in Myrtle Beach, South Carolina, and collaborators pooled data from 2 pivotal phase 3 randomized trials that included men with metastatic PCa or those with PSA relapse deemed at high risk of progression. The investigators defined PSA progression-free survival (PSA-PFS) as death from any cause or PSA recurrence (2 consecutive increases of at least 50% 2 or more weeks apart and at least a 5 ng/mL increase from nadir.

The investigators defined high-risk PCa as baseline PSA level greater than 20 ng/mL or Gleason score 8–10; they defined metastatic PCa by baseline TNM staging.

The study population included 60 patients from the Americas, 97 from Europe, and 224 from China. The patients were randomly assigned 193 patients to receive the gonadotropin-releasing hormone (GnRH) degarelix and 188 to receive an LHRH agonist (leuprolide or goserelin).

Patients who received degarelix had significantly improved PSA-PFS compared with those treated with an LHRH agonist, regardless of geographic region. Compared with European patients, however, Chinese and American patients had a significant 52% and 74% decreased risk for PSA-PFS, respectively, Dr Shore's group reported.

“These results suggest delay of disease progression with initial use of a GnRH antagonist as compared with LHRH agonists across global regions,” the investigators concluded in their study abstract.

Reference

1. Shore N et al. PSA-PFS in metastatic or high risk prostate cancer patients treated with GnRH antagonist (degarelix) versus LHRH agonists – a pooled analysis of data from the Americans, Europe and Asia. Data presented at the European Society for Medical Oncology 2016 congress in Copenhagen, October 7-11. Poster 735P. Ann Oncol 2016;27 (Suppl 6):vi250.

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