Optimal testosterone control and Eligard (R)

Tombal, Bertrand [UCL] Berges, Richard

Objectives: This review paper discusses the importance of optimal testosterone control in prostate cancer (PCa) and the advantages of the luteinising hormone-releasing hormone (LHRH) agonist Eligard (R) in this respect. Methods: During an expert meeting in Marbella, Spain, in October 2006, PCa experts discussed optimal testosterone control and the role of Eligard. An interactive voting on these topics was held among the delegates. This paper reports on this meeting. Results: LHRH agonists should suppress testosterone levels to an extent equivalent to surgical castration. A significant proportion of patients on conventional LHRH agonists do not achieve surgical castration levels. In addition, a significant percentage of patients experience hormonal escape during treatment. Eligard uses a modern delivery system and offers 1-, 3- and 6-mo depot formulations. The Eligard 1-mo, 3-mo, and 6-mo formulations achieve testosterone levels <= 20 ng/dl in up to 98% of patients. Injection-related and breakthrough testosterone escapes seldom occur. Eligard 6-mo formulation (45 mg; Eligard 6) is the first LHRH agonist able to extend treatment for 6 mo. Eligard 6 allows flexible monitoring of patients because the need for visits solely to administer injections is removed. In addition, reducing the number of injections may help reduce psychological burden in patients who then are less often reminded of their condition. Conclusions: Eligard provides optimal testosterone control in PCa patients, that is, achieves castration testosterone levels and is associated with a very low percentage of hormonal escapes. Eligard 6 offers flexibility in follow-up of patients and may help reduce emotional distress. (c) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.