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Erschienen in: Clinical Drug Investigation 12/2009

01.12.2009 | Original Research Article

Triptorelin 6-Month Formulation in the Management of Patients with Locally Advanced and Metastatic Prostate Cancer

An Open-Label, Non-Comparative, Multicentre, Phase III Study

verfasst von: Dr Eija A. Lundström, Rupert K. Rencken, Johann H. van Wyk, Lance J.E. Coetzee, Johann C.M. Bahlmann, Simon Reif, Erdam A. Strasheim, Martin C. Bigalke, Alan R. Pontin, Louis Goedhals, Douw G. Steyn, Chris F. Heyns, Luigi A. Aldera, Thomas M. Mackenzie, Daniela Purcea, Pierre Y. Grosgurin, Hervé C. Porchet

Erschienen in: Clinical Drug Investigation | Ausgabe 12/2009

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Abstract

Background and Objectives: Triptorelin 6-month formulation was developed to offer greater convenience to both patients and physicians by reducing the injection frequency. The efficacy, pharmacokinetics and safety of a new 6-month formulation of triptorelin were investigated over 12 months (48 weeks). The primary objective was to evaluate the formulation in achieving castrate serum testosterone levels (≤1.735 nmol/L or ≤50 ng/dL) on day 29 and in maintaining castration at months 2–12. Absence of luteinizing hormone (LH) stimulation and change in prostate-specific antigen (PSA) level were also assessed.
Methods: An open-label, non-comparative, phase III study in 120 patients with advanced prostate cancer was conducted from July 2006 to August 2007 in private and public institutions in South Africa. Each patient received two consecutive intramuscular injections of triptorelin embonate (pamoate) 22.5 mg at an interval of 24 weeks. In all patients, testosterone (primary outcome measurement) was measured at baseline and then every 4 weeks; LH was measured before and 2 hours after the two injections. PSA was measured on day 1 and at weeks 12, 24, 36 and 48. Adverse events were recorded at each visit.
Results: In the intent-to-treat population, 97.5% (95% CI 92.9, 99.5) of patients achieved castrate serum testosterone levels by day 29, and 93.0% (95% CI 86.8, 97.0) maintained castration at months 2–12. After the second injection, 98.3% of patients showed absence of LH stimulation. The most frequent drug-related adverse events were hot flushes (71.7% of patients). No patient withdrew from the study as a result of an adverse event.
Conclusions: The triptorelin 6-month formulation was well tolerated and was able to achieve and maintain castration for the treatment of locally advanced and metastatic prostate cancer. By reducing the frequency of required injections, this new formulation offers a more convenient treatment regimen. (Clinical Trial Registration, NCT00751790 at www.​clinicaltrials.​gov)
Literatur
1.
Zurück zum Zitat Palmberg C, Koivisto P, Visakorpi T, et al. PSA decline is an independent prognostic marker in hormonally treated prostate cancer. Eur Urol 1999; 36: 191–6PubMedCrossRef Palmberg C, Koivisto P, Visakorpi T, et al. PSA decline is an independent prognostic marker in hormonally treated prostate cancer. Eur Urol 1999; 36: 191–6PubMedCrossRef
2.
Zurück zum Zitat McLeod AG. Hormonal therapy: historical perspective to future directions. Urology 2003; 61: 3–7PubMedCrossRef McLeod AG. Hormonal therapy: historical perspective to future directions. Urology 2003; 61: 3–7PubMedCrossRef
3.
Zurück zum Zitat Cassileth BR, Soloway MS, Vogelzang NJ, et al. Patient’s choice of treatment in stage D prostate cancer. Urology 1989; 33Suppl. 5: 57–62PubMedCrossRef Cassileth BR, Soloway MS, Vogelzang NJ, et al. Patient’s choice of treatment in stage D prostate cancer. Urology 1989; 33Suppl. 5: 57–62PubMedCrossRef
4.
Zurück zum Zitat Coy DH, Vilchez-Martinez JA, Coy EJ, et al. Analogs of luteinizing hormone-releasing hormone with increased biological activity produced by D-amino acid substitutions in position 6. J Med Chem 1976; 19: 423–5PubMedCrossRef Coy DH, Vilchez-Martinez JA, Coy EJ, et al. Analogs of luteinizing hormone-releasing hormone with increased biological activity produced by D-amino acid substitutions in position 6. J Med Chem 1976; 19: 423–5PubMedCrossRef
5.
Zurück zum Zitat Lahlou N. Pharmacokinetics and pharmacodynamics of triptorelin [in French]. Ann Urol (Paris) 2005 Oct; 39Suppl. 3: 78–84 Lahlou N. Pharmacokinetics and pharmacodynamics of triptorelin [in French]. Ann Urol (Paris) 2005 Oct; 39Suppl. 3: 78–84
6.
Zurück zum Zitat Barron JL, Millar RP, Searle D. Metabolic clearance and plasma half-disappearance time of DTrp6 and exogenous luteinizing hormone-releasing hormone. J Clin Endocrinol Metab 1982; 54: 1169–73PubMedCrossRef Barron JL, Millar RP, Searle D. Metabolic clearance and plasma half-disappearance time of DTrp6 and exogenous luteinizing hormone-releasing hormone. J Clin Endocrinol Metab 1982; 54: 1169–73PubMedCrossRef
7.
Zurück zum Zitat Csernus VJ, Szende B, Schally AV. Release of peptides from sustained release delivery systems (microcapsules and microparticles) in vivo: a histological and immunohistochemical study. Int J Pept Protein Res 1990 Jun; 35(6): 557–65PubMedCrossRef Csernus VJ, Szende B, Schally AV. Release of peptides from sustained release delivery systems (microcapsules and microparticles) in vivo: a histological and immunohistochemical study. Int J Pept Protein Res 1990 Jun; 35(6): 557–65PubMedCrossRef
8.
Zurück zum Zitat National Comprehensive Cancer Network clinical practice guidelines in oncology: prostate cancer [online]. Available from URL: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp [Accessed 2009 Jun 16] National Comprehensive Cancer Network clinical practice guidelines in oncology: prostate cancer [online]. Available from URL: http://​www.​nccn.​org/​professionals/​physician_​gls/​f_​guidelines.​asp [Accessed 2009 Jun 16]
9.
Zurück zum Zitat Greene FL, Page DL, Fleming ID, et al., editors. AJCC cancer staging manual. 6th ed. New York: Springer-Verlag, 2002 Greene FL, Page DL, Fleming ID, et al., editors. AJCC cancer staging manual. 6th ed. New York: Springer-Verlag, 2002
10.
Zurück zum Zitat Wang C, Catlin DH, Demers LM, et al. Measurement of total serum testosterone in adult men: comparison of current laboratory methods versus liquid chromatographytandem mass spectrometry. J Clin Endocrinol Metab 2004; 89: 534–43PubMedCrossRef Wang C, Catlin DH, Demers LM, et al. Measurement of total serum testosterone in adult men: comparison of current laboratory methods versus liquid chromatographytandem mass spectrometry. J Clin Endocrinol Metab 2004; 89: 534–43PubMedCrossRef
11.
Zurück zum Zitat Sacks S. Are routine testosterone assays good enough? Clin Biochem Rev 2005; 26: 43–5PubMed Sacks S. Are routine testosterone assays good enough? Clin Biochem Rev 2005; 26: 43–5PubMed
12.
Zurück zum Zitat Clinical study report. Comparative testosterone pharmacodynamics and therapeutic efficacy of 1-month and 3-month formulations of triptorelin pamoate in patients with advanced prostate cancer, DEB-96-TRI-01 (first phase). Lausanne: Debiopharm SA, July 1999 Clinical study report. Comparative testosterone pharmacodynamics and therapeutic efficacy of 1-month and 3-month formulations of triptorelin pamoate in patients with advanced prostate cancer, DEB-96-TRI-01 (first phase). Lausanne: Debiopharm SA, July 1999
13.
Zurück zum Zitat Tornoe CW, Agerso H, Senderovitz T, et al. Population pharmacokinetic/pharmacodynamic (PK/PD) modeling of the hypothalamic-pituitary-gonadal axis following treatment with GnRH analogues. Br J Clin Pharmacol 2006; 63: 648–64PubMedCrossRef Tornoe CW, Agerso H, Senderovitz T, et al. Population pharmacokinetic/pharmacodynamic (PK/PD) modeling of the hypothalamic-pituitary-gonadal axis following treatment with GnRH analogues. Br J Clin Pharmacol 2006; 63: 648–64PubMedCrossRef
14.
Zurück zum Zitat Smith MR. Obesity and sex steroids during gonadotropin-releasing hormone agonist treatment for prostate cancer. Clin Cancer Res 2007; 13: 241–5PubMedCrossRef Smith MR. Obesity and sex steroids during gonadotropin-releasing hormone agonist treatment for prostate cancer. Clin Cancer Res 2007; 13: 241–5PubMedCrossRef
15.
Zurück zum Zitat Tunn UW, Wiedey K. Safety and clinical efficacy of a new 6-month depot formulation of leuprorelin acetate in patients with prostate cancer in Europe. Prostate Cancer Prostatic Dis 2009; 12: 83–7PubMedCrossRef Tunn UW, Wiedey K. Safety and clinical efficacy of a new 6-month depot formulation of leuprorelin acetate in patients with prostate cancer in Europe. Prostate Cancer Prostatic Dis 2009; 12: 83–7PubMedCrossRef
16.
Zurück zum Zitat Commission de la transparence evaluation, Republique Francaise: Evaluation: Enantone LP (leuprorelin) 30 mg. Avis de transparence: Haute Autorité de Santé (HAS), St Denis de la Plaine; 2008 14 May Commission de la transparence evaluation, Republique Francaise: Evaluation: Enantone LP (leuprorelin) 30 mg. Avis de transparence: Haute Autorité de Santé (HAS), St Denis de la Plaine; 2008 14 May
17.
Zurück zum Zitat Crawford ED, Sartor O, Chu F, et al. A 12-month clinical study of LA-2585 (45.0mg): a new 6-month subcutaneous delivery system for leuprolide acetate for the treatment of prostate cancer. J Urol 2006; 175: 533–6PubMedCrossRef Crawford ED, Sartor O, Chu F, et al. A 12-month clinical study of LA-2585 (45.0mg): a new 6-month subcutaneous delivery system for leuprolide acetate for the treatment of prostate cancer. J Urol 2006; 175: 533–6PubMedCrossRef
Metadaten
Titel
Triptorelin 6-Month Formulation in the Management of Patients with Locally Advanced and Metastatic Prostate Cancer
An Open-Label, Non-Comparative, Multicentre, Phase III Study
verfasst von
Dr Eija A. Lundström
Rupert K. Rencken
Johann H. van Wyk
Lance J.E. Coetzee
Johann C.M. Bahlmann
Simon Reif
Erdam A. Strasheim
Martin C. Bigalke
Alan R. Pontin
Louis Goedhals
Douw G. Steyn
Chris F. Heyns
Luigi A. Aldera
Thomas M. Mackenzie
Daniela Purcea
Pierre Y. Grosgurin
Hervé C. Porchet
Publikationsdatum
01.12.2009
Verlag
Springer International Publishing
Erschienen in
Clinical Drug Investigation / Ausgabe 12/2009
Print ISSN: 1173-2563
Elektronische ISSN: 1179-1918
DOI
https://doi.org/10.2165/11319690-000000000-00000

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