Selection criteria for initiation and renewal of luteinizing hormone-releasing hormone agonist therapy in patients with prostate cancer: a French prospective observational study. (December 2014)

• Record Type: Journal Article
• Authors: Lebret, Thierry; Davin, Jean-Louis; Hennequin, Christophe; Latorzeff, Igor; Mignard, Jean-Pierre; Moreau, Jean-Luc; Rossi, Dominique; Ruffion, Alain; Zerbib, Marc; Culine, Stéphane
• Is Part Of: Therapeutic advances in urology. Volume 6:Number 6(2014:Dec.)
• Page Start: 205
• Page End: 214
• Publication Date: 2014-12
• Subjects: hormonotherapy -- luteinizing hormone-releasing hormone agonists -- prostate cancer -- slow-release formulations; Urology -- Periodicals; Urologic Diseases -- therapy -- Periodicals; Genital Diseases, Male -- therapy -- Periodicals; Urologie -- Périodiques; 616.6005
• DOI: 10.1177/1756287214542418
• Languages: English
• ISSNs: 1756-2872

Abstract

Objectives: To define the profile of patients with prostate cancer (PCa) receiving a 3-month or 6-month formulation of luteinizing hormone-releasing hormone (LHRH) agonist in France and the reasons for choosing between formulations. Methods: This prospective 1-year observational study included patients with PCa starting LHRH agonist therapy in everyday practice. Reasons for prescription and patient preference were recorded at inclusion, 3 or 6 months, and 12 months. The percentage of patients with a renewed initial prescription was recorded during follow up. Results: A total of 1438 patients with PCa were included. Hormonotherapy was initiated more frequently with a 6-month ( n = 903; 62.8%) than with a 3-month formulation ( n = 535; 37.2%). The initial prescription was renewed in most patients after 3 or 6 months (86.1%) and 12 months (71%); 170 patients switched from a 3-month to a 6-month formulation during follow up. Presence of metastases influenced initial prescription (odds ratio 0.439; 95% confidence interval 1.095–1.892), with a 3-month formulation more often prescribed than a 6-month formulation to men with metastatic PCa at diagnosis (21.3% versus 15.8%, respectively). The most frequent reasons given by physicians for choosing the 6-month formulation were 'simplification of therapeutic regimen' (86.9%) or 'fewer unnecessary visits' (46.8%). Similar reasons were given for switching from a 3-month to a 6-month formulation during follow up. The most frequent reasons given by physicians to initiate therapy with a 3-month formulation were 'usual practice/habit' (55.5%) or 'closer patient management' (46.2%). 'Closer patient management' and 'reassuring effect upon patient' were the main reasons for switching from a 6-month to a 3-month formulation during follow up. Approximately 80% of patients were satisfied with the formulation they were prescribed and patients' reasons for preferring one formulation over another were similar to the physicians' reasons for prescribing these formulations. Conclusions: Slow-release formulations of LHRH agonists are useful therapies for physicians treating patients with PCa and there may be a preference for the 6-month formulation.