title: A phase III extension trial with a 1-arm crossover from leuprolide to degarelix: comparison of gonadotropin-releasing hormone agonist and antagonist effect on prostate cancer.
abstract: OBJECTIVE
  We investigated the efficacy and safety of degarelix treatment and the effects of switching from leuprolide to degarelix in an ongoing extension study with a median 27.5-month followup of a pivotal 1-year prostate cancer trial.
  
  
  METHODS
  Patients who completed a 1-year pivotal phase III trial continued on the same monthly degarelix maintenance dose (160 or 80 mg in 125 each), or were re-randomized from leuprolide 7.5 mg to degarelix 240/80 mg (69) or 240/160 mg (65). Data are shown on the approved degarelix 240/80 mg dose. The primary end point was safety/tolerability and the secondary end points were testosterone, prostate specific antigen, luteinizing hormone and follicle-stimulating hormone responses, and prostate specific antigen failure and progression-free survival.
  
  
  RESULTS
  During followup testosterone and prostate specific antigen suppression were similar to those in the 1-year trial in patients who continued on degarelix or switched from leuprolide. The prostate specific antigen progression-free survival hazard rate was decreased significantly after the switch in the leuprolide/degarelix group while the rate in those who continued on degarelix was consistent with the rate in treatment year 1. The same hazard rate change pattern occurred in the group with baseline prostate specific antigen greater than 20 ng/ml. Adverse event frequency was similar between the groups and decreased with time.
  
  
  CONCLUSIONS
  Data support the statistically significant prostate specific antigen progression-free survival benefit for degarelix over leuprolide seen during year 1 and the use of degarelix as first line androgen deprivation therapy as an alternative to a gonadotropin-releasing hormone agonist.
authors.affiliation: Urologic Oncology, School of Medicine, University of Colorado Denver, Aurora, Colorado 80045, USA.
authors.forename: E David
authors.initials: ED
authors.lastname: Crawford
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tombal
authors.forename: Kurt
authors.initials: K
authors.lastname: Miller
authors.forename: Laurent
authors.initials: L
authors.lastname: Boccon-Gibod
authors.forename: Fritz
authors.initials: F
authors.lastname: Schröder
authors.forename: Neal
authors.initials: N
authors.lastname: Shore
authors.forename: Judd W
authors.initials: JW
authors.lastname: Moul
authors.forename: Jens-Kristian
authors.initials: JK
authors.lastname: Jensen
authors.forename: Tine Kold
authors.initials: TK
authors.lastname: Olesen
authors.forename: Bo-Eric
authors.initials: BE
authors.lastname: Persson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D018592:Cross-Over Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use*; D011471:Prostatic Neoplasms / Q000188:drug therapy*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D009842:Oligopeptides; C431566:acetyl-2-naphthylalanyl-3-chlorophenylalanyl-1-oxohexadecyl-seryl-4-aminophenylalanyl(hydroorotyl)-4-aminophenylalanyl(carbamoyl)-leucyl-ILys-prolyl-alaninamide; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide