Degarelix for treating advanced hormone-sensitive prostate cancer

Area of Science:

• Oncology
• Pharmacology
• Clinical Trials

Background:

• Degarelix is a gonadotropin-releasing hormone antagonist used for advanced prostate cancer, inducing medical castration.
• Its comparative efficacy and safety against standard androgen suppression therapy remain unclear.

Purpose of the Study:

• To assess the effects of degarelix versus standard androgen suppression therapy in men with advanced hormone-sensitive prostate cancer.
• To compare primary outcomes of overall survival and serious adverse events, and secondary outcomes including quality of life and progression.

Main Methods:

• Systematic search of multiple databases, trial registries, and conference proceedings up to late 2020.
• Inclusion of randomized controlled trials comparing degarelix with standard androgen suppression therapy.
• Meta-analyses using a random-effects model and GRADE certainty assessment for outcomes.

Main Results:

• No data were available for overall or cancer-specific survival.
• Degarelix showed little to no difference in serious adverse events (low-certainty evidence) and likely similar quality of life (moderate-certainty evidence).
• Degarelix likely increases injection site pain (moderate-certainty evidence) and cardiovascular event data are very uncertain (very low-certainty evidence).

Conclusions:

• Serious adverse events and quality of life may be similar between degarelix and standard androgen suppression therapy.
• Degarelix likely increases injection site pain; long-term survival and cardiovascular event data are limited or uncertain.
• Further methodologically sound, long-term studies are needed for men with metastatic prostate cancer.