A randomized comparison of the clinical and hormonal effects of two GnRH agonists in patients with prostate cancer

Eur Urol. 1997;32(4):397-403.

Abstract

Objective: The aims of the study were (i) to compared the efficacy of the two long-acting GnRH agonists (GnRHa) triptorelin (Trp) and leuprolide (Leu) in men with prostate cancer and (ii) to assess the pattern of plasma testosterone levels following each injection of GnRHa.

Patients and methods: 67 patients referred for prostate cancer not suitable for surgery were randomly allocated to two treatment regimens: 33 patients received 3.75 mg Trp i.m. at 4-week intervals for 3 months and 34 patients were treated with 3.75 mg Leu s.c. at the same rhythm of administration for 3 months.

Results: Clinical data at entry and assessed monthly during follow-up did not differ between the two groups. Plasma prostate-specific antigen (PSA) and testosterone were measured before, 24 and 72 h after each injection of GnRHa. During treatment, PSA dropped similarly in both groups. By month 2, testosterone was < 1.0 nmol/l in 77 and 48% of patients treated with Trp and Leu, respectively (p = 0.02). 24 and 72 h after GnRHa injection, 77 (Trp) and 56% (Leu) of patients had testosterone < 1.0 nmol/l (p < 0.05).

Conclusions: The second and third injections of GnRHa were not followed by a significant increase in testosterone. Trp induced a higher decrease in testosterone than did Leu. The implications in terms of survival should, however, be studied in a larger and longer study.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Leuprolide / therapeutic use*
  • Male
  • Middle Aged
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / drug therapy*
  • Testosterone / blood
  • Triptorelin Pamoate / therapeutic use*
  • Ultrasonography

Substances

  • Antineoplastic Agents, Hormonal
  • Triptorelin Pamoate
  • Gonadotropin-Releasing Hormone
  • Testosterone
  • Prostate-Specific Antigen
  • Leuprolide