Results of a Dutch trial with the LHRH agonist buserelin in patients with metastatic prostatic cancer and results of EORTC studies in prostatic cancer.
Superactive analogues of luteinizing hormone-releasing hormone (LHRH) have now widely been used in the management of metastatic prostate cancer. In a multicentric study, we have studied the effectiveness of buserelin in patients with previously untreated histologically confirmed metastatic prostate cancer. Fifty-eight patients were enrolled in the study and are now followed for at least 12 months. The treatment consisted of 500 micrograms buserelin administered subcutaneously (s.c.) 3 times daily for the first seven days and thereafter a thrice-daily dose of 400 micrograms buserelin administered intranasally (i.n.). A continuous reduction of testosterone to castrate levels could be obtained in all patients. The following objective responses were seen during the 12 months study period: 5 patients (8.6%) achieved complete regression after 3-10 months (mean 6.4 m); 24 patients (41.4%) achieved partial regression after 1-12 months (mean 4.5 m); 7 patients (12%) remained stable throughout the study; 22 patients (32.3%) developed progression after 2-12 months (mean 7.2 m). Toxicity was minimal. Only one patient dropped out of the study because of side effects. These results are comparable with results of other forms of hormonal treatment of prostate cancer. Long-term results of 3 EORTC GU group comparative studies in metastatic prostate cancer are now available. The first study, 30761, compared cyproterone acetate, medroxy-progesterone acetate, and DES. No differences between the 3 treatment arms were observed except for medroxy-progesterone acetate, which showed less therapeutic effect in the dosage used. Protocol 30762 compared DES and estramustine phosphate. No significant difference in objective response and survival was noted. Protocol 30805 studied a comparison between orchiectomy alone and orchiectomy supplemented by cyproterone acetate and DES. Again no statistically significant difference was found between the three therapeutic arms.
Debruyne
F M
FM
Department of Urology, Sint Radboud University Hospital, Nijmegen, The Netherlands.
D000368:Aged; D002064:Buserelin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003534:Cyproterone / Q000031:analogs & derivatives / Q000627:therapeutic use; D017373:Cyproterone Acetate; D004054:Diethylstilbestrol / Q000627:therapeutic use; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008525:Medroxyprogesterone / Q000031:analogs & derivatives / Q000627:therapeutic use; D017258:Medroxyprogesterone Acetate; D008875:Middle Aged; D009426:Netherlands; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D012074:Remission Induction; D013997:Time Factors
D017373:Cyproterone Acetate; D004054:Diethylstilbestrol; D017258:Medroxyprogesterone Acetate; D003534:Cyproterone; D008525:Medroxyprogesterone; D002064:Buserelin