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Comparative Study
. 2019 Jul;60(4):244-250.
doi: 10.4111/icu.2019.60.4.244. Epub 2019 May 21.

Effectiveness of three different luteinizing hormone-releasing hormone agonists in the chemical castration of patients with prostate cancer: Goserelin versus triptorelin versus leuprolide

Myungsun Shim  1 , Woo Jin Bang  1 , Cheol Young Oh  1 , Yong Seong Lee  1 , Jin Seon Cho  1
Affiliations
Comparative Study

Effectiveness of three different luteinizing hormone-releasing hormone agonists in the chemical castration of patients with prostate cancer: Goserelin versus triptorelin versus leuprolide

Myungsun Shim et al. Investig Clin Urol. 2019 Jul.

Abstract

Purpose: To investigate the changes in testosterone levels and rates of chemical castration following androgen-deprivation therapy (ADT) with goserelin, triptorelin, and leuprolide.

Materials and methods: We retrospectively reviewed the medical records of 125 patients with prostate cancer treated with luteinizing hormone-releasing hormone (LHRH) agonists between January 2009 and December 2015. Changes in testosterone concentration during 9 months of ADT with goserelin 11.34 mg, triptorelin 11.25 mg, and leuprolide 11.25 mg were analyzed using a mixed model. The number of patients with serum testosterone below castration levels defined as various values (<50 ng/dL, <20 ng/dL, or <10 ng/dL) at 3, 6, and 9 months were also evaluated.

Results: Of the 125 patients, 59 received goserelin, 44 received triptorelin, and 22 received leuprolide, respectively. The lowest mean testosterone levels during 9 months of treatment were achieved in patients treated with triptorelin, followed by those treated with leuprolide, and then by those treated with goserelin (p=0.001). Significant differences in chemical castration levels were observed only at <10 ng/dL, with 54.2% of goserelin, 93.2% of triptorelin, and 86.4% of leuprolide treated patients (p<0.001).

Conclusions: Three LHRH agonists showed comparable efficacy for achieving castration when the castration threshold was 50 or 20 ng/dL. However, triptorelin was the most potent LHRH agonist, achieving the lowest mean testosterone levels and the highest rate of chemical castration at <10 ng/dL testosterone.

Keywords: Antineoplastic agents; Prostate-specific antigen; Prostatic neoplasms; Testosterone.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Mean serum testosterone level after androgen-deprivation therapy according to different luteinizing hormone-releasing hormone (LHRH) agonists. (A) Total, (B) patients with LHRH monotherapy. SD, standard deviation.
See this image and copyright information in PMC

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