title: Effective long-term androgen suppression in men with prostate cancer using a hydrogel implant with the GnRH agonist histrelin.
abstract: OBJECTIVE
  To evaluate the effectiveness of a hydrogel implant containing the gonadotropin-releasing hormone (GnRH) agonist histrelin in suppressing testosterone production in men with prostate cancer and to determine the effective dose (one, two, or four implants).
  
  
  METHODS
  Forty-two men with prostate cancer and indications for androgen ablation were treated with one, two, or four implants. In two of the clinics, comprising 27 subjects, the treatment period was 12 months, with replacement with the same number of implants at 12-month intervals. In a third clinic, which treated 15 subjects, the implants were left in place for up to 30 months. The total experience was 605 treatment months.
  
  
  RESULTS
  The histrelin levels were detected in serum proportional to the number of implants placed. The response, however, was similar among all three dose levels, with testosterone and luteinizing hormone essentially completely suppressed. Serum testosterone levels decreased from 21.9 +/- 17.6 nmol/L to 0.93 +/- 1.57 nmol/L within 1 month and were maintained at 0.55 +/- 0.24 nmol/L at 6 months and 0.60 +/- 0.28 nmol/L after 12 months of treatment. Of the 38 assessable patients, 35 (92%) had castrate levels of testosterone within 4 weeks of the initial implant placement. All patients followed for up for 12 months after placement of the initial set of implants maintained suppression of testosterone production while the implant was in place.
  
  
  CONCLUSIONS
  The histrelin hydrogel implant provided adequate and reliable delivery of the potent GnRH agonist histrelin during at least 1 year using a single implant in men with prostate cancer. No apparent advantages were found in using more than one implant, and the question of the possible effectiveness of even lower doses remains open. This treatment modality appears to be both safe and effective.
authors.affiliation: James Buchanan Brady Foundation, Department of Urology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York 10021, USA.
authors.forename: P N
authors.initials: PN
authors.lastname: Schlegel
authors.forename: P
authors.initials: P
authors.lastname: Kuzma
authors.forename: J
authors.initials: J
authors.lastname: Frick
authors.forename: A
authors.initials: A
authors.lastname: Farkas
authors.forename: A
authors.initials: A
authors.lastname: Gomahr
authors.forename: I
authors.initials: I
authors.lastname: Spitz
authors.forename: B
authors.initials: B
authors.lastname: Chertin
authors.forename: D
authors.initials: D
authors.lastname: Mack
authors.forename: A
authors.initials: A
authors.lastname: Jungwirth
authors.forename: P
authors.initials: P
authors.lastname: King
authors.forename: H
authors.initials: H
authors.lastname: Nash
authors.forename: C W
authors.initials: CW
authors.lastname: Bardin
authors.forename: A
authors.initials: A
authors.lastname: Moo-Young
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004343:Drug Implants; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood; D006801:Humans; D020100:Hydrogels; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013739:Testosterone / Q000097:blood
chemical_list: D004343:Drug Implants; D020100:Hydrogels; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D017430:Prostate-Specific Antigen; C029256:histrelin