[The role of a 6-month depot form of hormone therapy in the treatment of advanced hormone-dependent prostate cancer: Results from the 'ELIRE' observational study].
OBJECTIVE
Androgen-deprivation therapy modalities are on continuing evolution. Leuprolide Acetate (LA) Eligard(®)45mg was the first 6-monthly LHRH agonist (agoniste luteinizing hormone-releasing hormone [LHRHa]) treatment available for use in prostate cancer. The objective of this study was to assess the use of the 3-monthly and the 6-monthly LHRHa in patients with prostate cancer.


METHODS
A two-step survey (registration and follow-up) was held between July 2008 and January 2009. One hundred and sixty doctors included patients treated with LHRHa for prostate cancer. Then, a follow-up registry was implemented for patients who had been prescribed a 3- or 6-monthly LHRHa.


RESULTS
Data analysis showed that the 1853 registered patients had a mean age of 75 years old. Time to diagnosis was 7 months. Among them, 26.4% had an N+ and/or M+ cancer. The most tumor node metastasis (TNM) stage represented was T3N0M0 with Gleason score 7. High prostate specific antigen (PSA) level and metastatic stage were the main motives for LHRHa prescription. Choice criteria for a 3 or a 6-monthly LHRHa were patient autonomy (3.2 vs 18.4%), age (27.2 vs 44%) and anxiety (28 vs 16.8%). Patients for 6-monthly LHRHa were likely to be with low urinary symptoms, older, less autonomous and less anxious. The reported advantage of the 3-monthly LHRHa was the high satisfying quality of medical follow-up. For the 6-monthly form, the advantages were the flexibility and the freedom to stop worrying about their cancer for up to 6 months.


CONCLUSIONS
The 6-monthly LHRHa provides more flexibility in the management and follow-up of patients with locally advanced or metastatic prostate cancer.
Service d'urologie et de transplantation rénale, hôpital de la Pitié-Salpêtrière, AP-HP, université Pierre-et-Marie-Curie, université Paris VI, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
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D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D003692:Delayed-Action Preparations; D005500:Follow-Up Studies; D005602:France; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D019538:Health Care Surveys; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009376:Neoplasms, Hormone-Dependent / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D003692:Delayed-Action Preparations; C493311:luprolide acetate gel depot; D007987:Gonadotropin-Releasing Hormone; D017430:Prostate-Specific Antigen; D016729:Leuprolide