雄激素剥夺治疗在前列腺癌患者中从每月亮丙瑞林转换为每月地加瑞克后的疗效和安全性。

Efficacy and safety of androgen deprivation therapy after switching from monthly leuprolide to monthly degarelix in patients with prostate cancer.

机构信息

AMC University Hospital-Urology, Amsterdam, The Netherlands.

出版信息

Int J Clin Pract. 2011 May;65(5):559-66. doi: 10.1111/j.1742-1241.2011.02637.x. Epub 2011 Feb 22.

Abstract

OBJECTIVES

To evaluate whether switching prostate cancer (PCa) patients from leuprolide to degarelix is associated with any change in the efficacy of testosterone suppression or safety profile during the first 3 months.

METHODS

Participants were 134 patients with histologically confirmed PCa who had completed 1 year of treatment with leuprolide 7.5 mg monthly before being switched to degarelix. These patients were re-randomised for the extension trial to receive a starting dose of 240 mg degarelix followed by monthly maintenance doses of either 80 (n = 69) or 160 mg (n = 65). For efficacy assessment, serum testosterone, prostate-specific antigen (PSA), luteinising hormone (LH) and follicle-stimulating hormone (FSH) levels measured at days 3, 7, 14, 28, 56 and 84 assessed whether treatment efficacy is sustained. Safety and tolerability assessments included adverse events (AEs), physical examinations, electrocardiograms and clinically significant changes in laboratory safety parameters.

RESULTS

Serum testosterone, LH, and PSA levels were all sustained in both treatment arms during the observation period. Interestingly, FSH levels were further decreased by 30% following the switch to degarelix. With the exception of injection site reactions, the overall prevalence and pattern of AEs during the first 3 months after the switch was comparable to that during the last 3 months leuprolide treatment in the main trial. There were five (4%) patients discontinued to treatment-related AEs including injection site pain (n = 3) and fatigue (n = 2).

CONCLUSIONS

This 3-month analysis indicates that patients with prostate cancer can be safely switched from leuprolide to degarelix treatment with sustained efficacy as measured by biochemical markers.

摘要

目的

评估将前列腺癌(PCa)患者从亮丙瑞林转换为地加瑞克是否会导致睾酮抑制的疗效或安全性发生变化。

方法

共有 134 名组织学确诊的 PCa 患者参与了该研究,他们在接受亮丙瑞林治疗 1 年后完成了该研究,每月接受 7.5mg 亮丙瑞林治疗。这些患者在扩展试验中重新随机分组,接受 240mg 地加瑞克起始剂量,然后每月接受 80mg(n=69)或 160mg(n=65)维持剂量。为了评估疗效,在第 3、7、14、28、56 和 84 天测量血清睾酮、前列腺特异性抗原(PSA)、黄体生成素(LH)和卵泡刺激素(FSH)水平,以评估治疗的疗效是否持续。安全性和耐受性评估包括不良事件(AE)、体格检查、心电图和实验室安全参数的临床显著变化。

结果

在观察期间,两种治疗组的血清睾酮、LH 和 PSA 水平均保持稳定。有趣的是,转换为地加瑞克后 FSH 水平进一步降低了 30%。除注射部位反应外,转换后前 3 个月的 AE 总体发生率和模式与主要试验中亮丙瑞林治疗的最后 3 个月相似。有 5 名(4%)患者因治疗相关 AE 停药,包括注射部位疼痛(n=3)和疲劳(n=2)。

结论

这项 3 个月的分析表明,前列腺癌患者可以安全地从亮丙瑞林转换为地加瑞克治疗,通过生化标志物测量,疗效持续。

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