Combined Apalutamide, Radiotherapy and LHRH Agonist in Prostate Cancer Patients After Prostatectomy

9093 Background: Growing numbers of prostate cancer patients survive for extended periods of time after initial diagnosis and treatment. Many experience a biochemical relapse (“PSA failure”) some time after prostatectomy or pelvic radiation. LhRH agonist therapy can reduce PSA levels, but its impact on survival time and quality of life (QOL) is unclear. We evaluated these concerns among Veterans who experienced PSA Failure. Methods: Eligibility criteria included: receipt of primary therapy for prostate cancer followed by a PSA nadir and subsequent PSA rise to at least 0.2 ng/ml. Data sources include patients (interviewer administered survey instruments on health-related QOL at baseline, 3 and 12 months) and medical records (clinical and laboratory findings). Results: 69 patients from the Jesse Brown VA Medical Center in Chicago have enrolled in the study to date. At their baseline interviews, 30 patients (43.5%) were receiving LhRH agonists (46.1% of 39 African-American patients and 48.0% of 25 White patients). LhRH agonist patients reported worse health-related QOL in domains relevant to prostate cancer than watchful waiting (WW) patients ( Table ), including increased frequency of urination, difficulty controlling urination, greater erectile dysfunction, and more limits on sexual activity. LhRH agonist and WW patients reported similar levels of sexual satisfaction. Conclusion: Of the PSA failure patients studied in this sample, those receiving LhRH agonist therapy experience more problems with urinary and sexual function than those who opted for WW. Longitudinal study will provide information about whether the LhRH therapy causes these side effects, or whether symptomatic patients are more likely to choose LhRH therapy than those with few prostate cancer symptoms. [Table: see text] No significant financial relationships to disclose.

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Surgical Castration in Hormone-Refractory Metastatic Prostate Cancer Patients Can Be an Alternative for Medical Castration

Advances in Urology ◽

10.1155/2012/979154 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Masayoshi Zaitsu ◽

Mariko Yamanoi ◽

Koji Mikami ◽

Yuta Takeshima ◽

Naohiko Okamoto ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Metastatic Prostate Cancer ◽

Reduction Rate ◽

Case Series ◽

Total Testosterone ◽

Lhrh Agonist ◽

Hormone Refractory Prostate Cancer ◽

Testosterone Levels ◽

Hormone Refractory

Background. Most patients with metastatic prostate cancer are endocrinologically treated with LHRH agonist, but finally castration-refractory and hormone-refractory cancers occur. Serum testosterone levels get low to “the castration level” by LHRH agonists but may not get low enough against castration-refractory prostate cancer.Methods. As case series, twelve patients suffering from hormone-refractory prostate cancer continuously on LHRH agonist underwent surgical castration. Additionally, one hundred and thirty-nine prostate cancer patients on LHRH agonist or surgical castration were tested for serum total testosterone levels.Results. Surgical castration caused decrease in serum PSA in one out of 12 hormone-refractory prostate cancer patients with PSA reduction rate 74%. Serum total testosterone levels were below the sensitivity threshold (0.05 ng/mL) in 40 of 89 (44.9%) medically castrated patients and 33 of 50 (66.0%) surgically castrated patients (P=.20).Conclusion. Even hormone-refractory prostate cancer patients are candidates for surgical castration because of endocrinological, oncological, and economical reasons.

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Clinical endocrinological evaluation of the gonadal axis (testosterone, LH and FSH) in prostate cancer patients switched from a GnRH antagonist to a LHRH agonist

Basic and Clinical Andrology ◽

10.1186/s12610-015-0023-2 ◽

2015 ◽

Vol 25 (1) ◽

pp. 7 ◽

Cited By ~ 6

Author(s):

Yoshiyuki Miyazawa ◽

Haruo Kato ◽

Seiji Arai ◽

Yosuke Furuya ◽

Yoshitaka Sekine ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Gnrh Antagonist ◽

Lhrh Agonist

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

Therapeutic Advances in Urology ◽

10.1177/1756287217738985 ◽

2017 ◽

Vol 10 (2) ◽

pp. 51-63 ◽

Cited By ~ 1

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.

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Quality-of-life and LhRH agonist therapy among prostate cancer patients following PSA failure

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16083 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16083-e16083

Author(s):

N. Undevia-Yedavalli ◽

N. Dandade ◽

T. Luu ◽

A. Samaras ◽

O. Sartor ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Sexual Activity ◽

Cancer Patients ◽

Lhrh Agonist ◽

Psa Failure ◽

Health Related Qol ◽

Health Related ◽

Activity Report

e16083 Background: Growing numbers of prostate cancer patients experience biochemical relapse (PSA failure) after initial treatment. LhRH agonist (hormonal) therapy can reduce PSA levels, but there is no clear evidence that it slows disease progression or reduces mortality. Quality of Life (QoL) issues are essential when deciding between observation (OBS) versus hormonal castration following biochemical relapse. We evaluated health related quality of life and treatment satisfaction among prostate cancer patients who experience PSA failure. Methods: Eligibility criteria were receipt of primary therapy for prostate cancer followed by a PSA nadir and subsequent PSA rise to at least 0.2 ng/ml. Data sources include medical records and interviewer administered surveys on health- related QoL at baseline, 3 and 12 months. Results: Castrated versus observed patients who are satisfied with their sexual activity report similar health-related QoL, with the exception of higher rates of maintaining an erection (73.3% vs. 32.0%) and not having prostate cancer affect sexual activity (66.7% vs. 28.6%). Castrated and expectant management patients with low levels of satisfaction and sexual activity report similar health-related QoL. Conclusions: Among patients with PSA Failure, the only health-related QOL difference is reflected in sexual activity related to erectile dysfunction, but not sexual satisfaction among patients who all have a high level of treatment decision satisfaction and sexual activity. [Table: see text] [Table: see text]

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