Testosterone Suppression with Luteinizing Hormone-Releasing Hormone (LHRH) Agonists in Patients Receiving Radiotherapy for Prostate Cancer

2018 ◽  
Vol 38 (3) ◽  
pp. 327-333 ◽  
Author(s):  
Derek Wilke ◽  
Nikhilesh Patil ◽  
Helmut Hollenhorst ◽  
David Bowes ◽  
Robert Rutledge ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Luteinizing Hormone ◽  
Luteinizing Hormone Releasing Hormone ◽  
Releasing Hormone ◽  
Lhrh Agonists

scholarly journals Practical differences between luteinizing hormone-releasing hormone agonists in prostate cancer: perspectives across the spectrum of care

2017 ◽  
Vol 10 (2) ◽  
pp. 51-63 ◽  
Author(s):  
Davide Meani ◽  
Mladen Solarić ◽  
Harri Visapää ◽  
Rose-Marie Rosén ◽  
Robert Janknegt ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Luteinizing Hormone ◽  
Cancer Patients ◽  
Healthcare Management ◽  
Lhrh Agonist ◽  
Specific Storage ◽  
Luteinizing Hormone Releasing Hormone ◽  
Releasing Hormone ◽  
Lhrh Agonists ◽  
Solid Implants

Background: Androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone (LHRH) agonists is well established for the treatment of men with metastatic prostate cancer. As clear differences in efficacy, safety, or tolerability between the available LHRH agonists are lacking, the healthcare management team needs to look to practical differences between the formulations when selecting therapy for their patients. Moreover, as the economic burden of prostate cancer rises alongside earlier diagnosis and improved survival, the possibility for cost savings by using products with specific features is growing in importance. Methods: A review was conducted to summarize the information on the different LHRH agonist formulations currently available and offer insight into their relative benefits and disadvantages from the perspectives of physicians, a pharmacist, and a nurse. Results: The leuprorelin acetate and goserelin acetate solid implants have the advantage of being ready to use with no requirement for refrigeration, whereas powder and microsphere formulations have to be reconstituted and have specific storage or handling constraints. The single-step administration of solid implants, therefore, has potential to reduce labor time and associated costs. Dosing frequency is another key consideration, as administering the injection provides an opportunity for face-to-face interaction between the patient and healthcare professionals to ensure therapy is optimized and give reassurance to patients. Prostate cancer patients are reported to prefer 3- or 6-monthly dosing, which aligns with the monitoring frequency recommended in European Association of Urology guidelines and has been shown to result in reduced annual costs compared with 1-month formulations. Conclusions: A number of practical differences exist between the different LHRH agonist preparations available, which may impact on clinical practice. It is important for healthcare providers to be aware and carefully consider these differences when selecting treatments for their prostate cancer patients.

scholarly journals Luteinizing hormone-releasing hormone antagonists for urinary obstruction in prostate cancer

2013 ◽  
Vol 7 (9-10) ◽  
pp. 648 ◽  
Author(s):  
Patricia Tai ◽  
Asim Amjad ◽  
Rashmi Koul ◽  
Evgeny Sadikov ◽  
Arbind Dubey
Keyword(s):  
Prostate Cancer ◽  
Luteinizing Hormone ◽  
Serum Creatinine ◽  
Urinary Tract Obstruction ◽  
Specific Antigen ◽  
Pelvic Mass ◽  
Luteinizing Hormone Releasing Hormone ◽  
Releasing Hormone ◽  
Lhrh Agonists ◽  
Lhrh Antagonists

Luteinizing hormone-releasing hormone (LHRH) antagonists rapidly reduce testosterone and are preferred to LHRH agonists in situations when early response is important. The lack of flare reaction, as compared to LHRH agonists, is particularly desirable as it would not aggravate the problem. A 78-year-old man presented with symptoms of urinary tract obstruction. He had a prostate-specific antigen (PSA) of 91.3 ug/L and serum creatinine 146 umol/L. He had a large pelvic mass due to histologically confirmed prostate cancer, resulting in moderate left hydronephrosis and deteriorating renal function (serum creatinine of 163 umol/L). He was started on combined degarelix and bicalutamide on the day of consultation (day 0). The hydronephrosis resolved on the repeat computerized tomography scan performed on day 10. Serum creatinine normalized to under 130 umol/L on day 18. The PSA fell to 11 ug/L on day 18, 2.8 ug/L on day 28, and 0.5 ug/L on day 53. Therefore, LHRH antagonists are particularly useful in urgent situations. It is the preferred choice in these circumstances.

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