Effectiveness of three different luteinizing hormone-releasing hormone agonists in the chemical castration of patients with prostate cancer: Goserelin versus triptorelin versus leuprolide

Abstract

Purpose To investigate the changes in testosterone levels and rates of chemical castration following androgen-deprivation therapy (ADT) with goserelin, triptorelin, and leuprolide. Materials and Methods We retrospectively reviewed the medical records of 125 patients with prostate cancer treated with luteinizing hormone-releasing hormone (LHRH) agonists between January 2009 and December 2015. Changes in testosterone concentration during 9 months of ADT with goserelin 11.34 mg, triptorelin 11.25 mg, and leuprolide 11.25 mg were analyzed using a mixed model. The number of patients with serum testosterone below castration levels defined as various values (<50 ng/dL, <20 ng/dL, or <10 ng/dL) at 3, 6, and 9 months were also evaluated. Results Of the 125 patients, 59 received goserelin, 44 received triptorelin, and 22 received leuprolide, respectively. The lowest mean testosterone levels during 9 months of treatment were achieved in patients treated with triptorelin, followed by those treated with leuprolide, and then by those treated with goserelin (p=0.001). Significant differences in chemical castration levels were observed only at <10 ng/dL, with 54.2% of goserelin, 93.2% of triptorelin, and 86.4% of leuprolide treated patients (p<0.001). Conclusions Three LHRH agonists showed comparable efficacy for achieving castration when the castration threshold was 50 or 20 ng/dL. However, triptorelin was the most potent LHRH agonist, achieving the lowest mean testosterone levels and the highest rate of chemical castration at <10 ng/dL testosterone.

Serum Testosterone Level as Possible Predictive Marker for Prognosis in Metastatic Castration-Resistant Prostate Cancer Patients Treated With Enzalutamide

“…22,23 In Korean population, the mean serum testosterone level in patients who treated with Goserelin for 9 months was reported at 0.13 ng/mL recently. 24 In a paper analyzing the prognosis of serum testosterone and CRPC patients published by Shiota et al, 16 median pre-ART testosterone showed 0.03 ng/mL, and Sakamoto et al 15 had a median testosterone before abiraterone or enzalutamide of 0.13 ng/mL. This is…”

Diferelin® as an effective chemical castration agent for patients with prostate cancer

“…Европейская ассоциация урологов (EAU) также признает пороговое значение 50 нг / дл, однако считает уровень 20 нг / дл (0,7 нмоль / л) более предпочтительным [10]. В ряде клинических исследований продемонстрировано, что применение трипторелина позволяет достичь минимальных значений тестостерона в сыворотке крови <20 нг / дл [11][12][13].…”

“…Все режимы продемонстрировали сопоставимую эффективность в плане достижения уровня тестостерона <20 нг / дл, в то же время трипторелин оказался наиболее эффективным аЛГРГ в отношении снижения уровня тестостерона до <10 нг / дл (p <0,001). Через 9 мес после начала терапии аЛГРГ у 54,2 % пациентов был достигнут уровень тестостерона <10 нг / дл при применении гозерилина, у 86,4 % -при применении лейпрорелина, у 93,2 %при применении трипторелина [13]. В японском исследовании с участием 225 больных РПЖ, получавших комбинированную андрогенную блокаду и наблюдавшихся в течение 45,8 мес, многофакторный анализ показал, что уровень тестостерона <20 нг / дл является наиболее значимым прогностическим фактором общей выживаемости [12].…”

Retrospektive GKV-Versorgungsforschungsstudie über GnRH-Antagonisten/-Agonisten zur initialen Therapie des fortgeschrittenen Prostatakarzinoms – Verordnungsmuster und Krankenhauskosten in Deutschland

“…In einer aktuellen retrospektiven Studie von Shim et al hat Triptorelin im Vergleich zu den Agonisten Goserelin und Leuprorelin den Testosteronwert bei PCa-Patienten am effektivsten supprimiert [31]. Dieses könnte ein möglicher Erklärungsansatz für die positiveren Überlebensdaten für Triptorelin sein.…”