Degarelix Therapy for Prostate Cancer in a Real-world Setting

Experience From the German IQUO (Association for Uro-Oncological Quality Assurance) Firmagon Registry

Götz Geiges; Thomas Harms; Gerald Rodemer; Ralf Eckert; Frank König; Rolf Eichenauer; Jörg Schroder

Disclosures

BMC Urol. 2015;15(122) 

In This Article

Background

The gonadotropin-releasing hormone (GnRH) antagonist, degarelix, is an effective and well tolerated treatment for advanced prostate cancer (PCa).[1–3] As an antagonist, degarelix benefits from a direct mechanism of action that inhibits GnRH without causing an initial surge in gonadotropins or consequently testosterone.[4] Degarelix displays similar efficacy to the luteinizing hormone-releasing hormone (LHRH) agonist, leuprolide, for testosterone suppression in PCa.[1] However, testosterone reduction was more rapid with degarelix and, unlike leuprolide, occurred without a testosterone surge or microsurges; in advanced disease, the testosterone surge associated with LHRH agonists can produce symptom flare.[5] Degarelix also displayed superior prostate-specific antigen (PSA) progression-free survival (PFS) compared with leuprolide[6] and in metastatic disease was associated with better control of the bone formation marker serum alkaline phosphatase (S-ALP), suggesting that it might offer prolonged control of skeletal metastases.[7]

While degarelix has been well studied in clinical trials, it is important to examine its efficacy and tolerability in everyday clinical practice. Clinical trials give important data about treatment effects in controlled conditions, but patient registries offer additional data from a wide population (with few excluded patients), allowing evaluation of care as actually provided.[8] Consequently, registry data are likely to provide a more representative indication of the real-world patient experience with degarelix. Therefore, the current study investigated the use of degarelix in patients from uro-oncology practices in Germany by analysing data from the IQUO (Association for uro-oncological quality assurance) Firmagon® patient registry.

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