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Testosterone castration levels in patients with prostate cancer: Is there a difference between GnRH agonist and GnRH antagonist? Primary results of an open-label randomized control study

PURPOSE: To compare testosterone castration levels between patients treated with the gonadotropin-releasing hormone (GnRH) antagonist, degarelix, and GnRH agonist. MATERIALS AND METHODS: Patients with prostate cancer (PCa) of a single outpatient clinic were randomized (2:1) to receive degarelix (gro...

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Autores principales: Mytilekas, Vaios-Konstantinos, Papaefstathiou, Efstathios, Koukourikis, Periklis, Ouzounidis, Xenofon, Kazantzidis, Stavros, Hatzimouratidis, Konstantinos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Urological Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630685/
https://www.ncbi.nlm.nih.gov/pubmed/37932568
http://dx.doi.org/10.4111/icu.20230027
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author Mytilekas, Vaios-Konstantinos
Papaefstathiou, Efstathios
Koukourikis, Periklis
Ouzounidis, Xenofon
Kazantzidis, Stavros
Hatzimouratidis, Konstantinos
author_facet Mytilekas, Vaios-Konstantinos
Papaefstathiou, Efstathios
Koukourikis, Periklis
Ouzounidis, Xenofon
Kazantzidis, Stavros
Hatzimouratidis, Konstantinos
author_sort Mytilekas, Vaios-Konstantinos
collection PubMed
description PURPOSE: To compare testosterone castration levels between patients treated with the gonadotropin-releasing hormone (GnRH) antagonist, degarelix, and GnRH agonist. MATERIALS AND METHODS: Patients with prostate cancer (PCa) of a single outpatient clinic were randomized (2:1) to receive degarelix (group A) or GnRH agonist (group B). The study evaluated testosterone and prostate-specific antigen (PSA) levels, patients’ age, Gleason score and the presence of metastases (nodal or bone). Testosterone and PSA levels were measured at 1st, 6th, 12th, and 18th months. Mann–Whitney test and Spearman correlation were used to investigate independent variable while standard multiple regression was performed to explore statistically significant correlations. Kruskal–Wallis test was used to compare testosterone levels at follow-up. RESULTS: The study included 168 patients, 107 in group A and 61 in group B. Testosterone levels at 1st month were significantly lower in patients under GnRH antagonist than those receiving GnRH agonist (group A: 22 ng/dL vs. group B: 29 ng/dL, p=0.011). However, PSA values did not differ significantly between groups (group A: 0.130 ng/mL vs. group B: 0.067 ng/mL, p=0.261). In multivariate analysis, treatment with degarelix was an independent factor of lower testosterone levels at 1st month (p=0.013). Comparison of testosterone levels at 6, 12, and 18 months did not reveal any significant difference within each group. CONCLUSIONS: In patients with PCa who are candidates for androgen deprivation therapy, the administration of GnRH antagonist seems to achieve significantly lower testosterone levels compared to treatment with GnRH agonist at 1st month of treatment.
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spelling pubmed-106306852023-11-15 Testosterone castration levels in patients with prostate cancer: Is there a difference between GnRH agonist and GnRH antagonist? Primary results of an open-label randomized control study Mytilekas, Vaios-Konstantinos Papaefstathiou, Efstathios Koukourikis, Periklis Ouzounidis, Xenofon Kazantzidis, Stavros Hatzimouratidis, Konstantinos Investig Clin Urol Original Article PURPOSE: To compare testosterone castration levels between patients treated with the gonadotropin-releasing hormone (GnRH) antagonist, degarelix, and GnRH agonist. MATERIALS AND METHODS: Patients with prostate cancer (PCa) of a single outpatient clinic were randomized (2:1) to receive degarelix (group A) or GnRH agonist (group B). The study evaluated testosterone and prostate-specific antigen (PSA) levels, patients’ age, Gleason score and the presence of metastases (nodal or bone). Testosterone and PSA levels were measured at 1st, 6th, 12th, and 18th months. Mann–Whitney test and Spearman correlation were used to investigate independent variable while standard multiple regression was performed to explore statistically significant correlations. Kruskal–Wallis test was used to compare testosterone levels at follow-up. RESULTS: The study included 168 patients, 107 in group A and 61 in group B. Testosterone levels at 1st month were significantly lower in patients under GnRH antagonist than those receiving GnRH agonist (group A: 22 ng/dL vs. group B: 29 ng/dL, p=0.011). However, PSA values did not differ significantly between groups (group A: 0.130 ng/mL vs. group B: 0.067 ng/mL, p=0.261). In multivariate analysis, treatment with degarelix was an independent factor of lower testosterone levels at 1st month (p=0.013). Comparison of testosterone levels at 6, 12, and 18 months did not reveal any significant difference within each group. CONCLUSIONS: In patients with PCa who are candidates for androgen deprivation therapy, the administration of GnRH antagonist seems to achieve significantly lower testosterone levels compared to treatment with GnRH agonist at 1st month of treatment. The Korean Urological Association 2023-11 2023-10-25 /pmc/articles/PMC10630685/ /pubmed/37932568 http://dx.doi.org/10.4111/icu.20230027 Text en © The Korean Urological Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Mytilekas, Vaios-Konstantinos
Papaefstathiou, Efstathios
Koukourikis, Periklis
Ouzounidis, Xenofon
Kazantzidis, Stavros
Hatzimouratidis, Konstantinos
Testosterone castration levels in patients with prostate cancer: Is there a difference between GnRH agonist and GnRH antagonist? Primary results of an open-label randomized control study
title Testosterone castration levels in patients with prostate cancer: Is there a difference between GnRH agonist and GnRH antagonist? Primary results of an open-label randomized control study
title_full Testosterone castration levels in patients with prostate cancer: Is there a difference between GnRH agonist and GnRH antagonist? Primary results of an open-label randomized control study
title_fullStr Testosterone castration levels in patients with prostate cancer: Is there a difference between GnRH agonist and GnRH antagonist? Primary results of an open-label randomized control study
title_full_unstemmed Testosterone castration levels in patients with prostate cancer: Is there a difference between GnRH agonist and GnRH antagonist? Primary results of an open-label randomized control study
title_short Testosterone castration levels in patients with prostate cancer: Is there a difference between GnRH agonist and GnRH antagonist? Primary results of an open-label randomized control study
title_sort testosterone castration levels in patients with prostate cancer: is there a difference between gnrh agonist and gnrh antagonist? primary results of an open-label randomized control study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630685/
https://www.ncbi.nlm.nih.gov/pubmed/37932568
http://dx.doi.org/10.4111/icu.20230027
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