There are different methods of administering hormone therapy (ADT) to achieve the goal of castrating a man with recurrent or metastatic prostate cancer. These methods including using estrogen, the surgical removals of the testicles, administering an LHRH agonist like Lupron or using a gonadotrophin-releasing hormone (GnRH) antagonist like Firmagon (degarelix).
More often than not the choice is between using the LHRH agonist drug (Lupron, Trelstar) or using the gonadotrophin-releasing hormone (GnRH) antagonist like Firmagon.
This brings us to the question, which of these two drugs is superior?
Degarelix produces a faster suppression of testosterone and prostate-specific antigen (PSA), without any testosterone surges or micro-surges we would see with the use of an LHRH agonist, thus preventing the risk of dangerous clinical flares in advanced disease.
Also, recent clinical trials have demonstrated that treatment with degarelix results in improved disease control when compared with an LHRH agonist in terms of superior PSA progression-free survival, suggesting that degarelix likely delays progression to castration-resistant disease and has a more significant impact on bone serum alkaline phosphatase and follicle-stimulating hormone.
https://www.medpagetoday.com/meetingcoverage/ascogu/24969
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633549/
Firmagon does cost more money than the LHRH agonists and there is a common painful side effect, injection site pain and swelling, that can be bothersome and discourage its use.
Joel T. Nowak, MA, MSW wrote this Post. Joel is the CEO/Executive Director of Cancer ABCs. He is a Cancer Thriver diagnosed with five primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma, and the rare cancer Appendiceal cancer.
