Complete and rogen blockade has a small survival benefit of about 5 % .
Intermittent and rogen deprivation ( IAD ) results in equivalent oncologic efficacy when compared with continuous and rogen-deprivation therapy ( ADT ) in well-selected population s. In locally advanced and metastatic PCa , early ADT does not result in a significant survival advantage when compared with delayed ADT .
Zoledronic acid and denusomab can be used in men with CRPC and osseous metastases to prevent skeletal-related complications .
OBJECTIVES Our aim is to present a summary of the 2010 version of the European Association of Urology ( EAU ) guidelines on the treatment of advanced , relapsing , and castration-resistant prostate cancer ( CRPC ) .
The guidelines were up date d , and the levels of evidence ( LEs ) and /or grade s of recommendation ( GR ) were added to the text based on a systematic review of the literature , which included a search of online data bases and bibliographic review s. RESULTS Luteinising hormone-releasing hormone ( LHRH ) agonists are the st and ard of care in metastatic prostate cancer ( PCa ) .
Although LHRH antagonists decrease testosterone without any testosterone surge , their clinical benefit remains to be determined .
Treatment of castration-resistant prostate cancer ( CRPC ) includes second-line hormonal therapy , novel agents , and chemotherapy with docetaxel at 75 mg/m(2 ) every 3 wk .
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.
PURPOSE 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 . MATERIAL S AND 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-r and omized 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 and rogen deprivation therapy as an alternative to a gonadotropin-releasing hormone agonist
Complete and rogen blockade has a small survival benefit of about 5 % .
Intermittent and rogen deprivation ( IAD ) results in equivalent oncologic efficacy when compared with continuous and rogen-deprivation therapy ( ADT ) in well-selected population s. In locally advanced and metastatic PCa , early ADT does not result in a significant survival advantage when compared with delayed ADT .
Zoledronic acid and denusomab can be used in men with CRPC and osseous metastases to prevent skeletal-related complications .
OBJECTIVES Our aim is to present a summary of the 2010 version of the European Association of Urology ( EAU ) guidelines on the treatment of advanced , relapsing , and castration-resistant prostate cancer ( CRPC ) .
The guidelines were up date d , and the levels of evidence ( LEs ) and /or grade s of recommendation ( GR ) were added to the text based on a systematic review of the literature , which included a search of online data bases and bibliographic review s. RESULTS Luteinising hormone-releasing hormone ( LHRH ) agonists are the st and ard of care in metastatic prostate cancer ( PCa ) .
Although LHRH antagonists decrease testosterone without any testosterone surge , their clinical benefit remains to be determined .
Treatment of castration-resistant prostate cancer ( CRPC ) includes second-line hormonal therapy , novel agents , and chemotherapy with docetaxel at 75 mg/m(2 ) every 3 wk .