Prostate cancer is the second most common type of cancer diagnosed in American men and it occurs when the cells of the prostate start to grow out of control. The prostate gland is a part of men’s reproductive system and it is located below the bladder, near the rectum and around the urethra. When men suffer from prostate cancer, both the reproductive and urinary systems are affected, causing symptoms like urinary problems including a slow or weak urinary stream or the need to urinate more often, especially at night, blood in the urine, erectile dysfunction, pain in the hips, back, chest, or other areas from cancer spread to bones, and weakness or numbness in limbs.
About 27,540 people die every year in the US from prostate cancer, but there are treatment options to address the disease. These include watchful waiting or active surveillance, surgery, radiation therapy, cryotherapy, hormone therapy, chemotherapy, vaccine treatment, and bone-directed treatment. The choice of a treatment option depend on numerous factors like the patient’s age and expected lifespan, other severe diseases, cancer stage and grade, patients’ and physicians’ feeling and opinions regarding treatment and potential side effects, as well as the probability of curing the cancer.
How Degarelix Works
Degarelix (Firmagon) is a type of drug classified as gonadotrophin-releasing hormone (GnRH) antagonist, which is used as first-line of treatment for patients who suffer from androgen-dependent advanced prostate cancer. The compound is included in the treatment option hormone therapy or medical castration, which is based on the reduction of hormones to stop cancer growth. Degarelix works by blocking and binding the GnRH receptors inside the pituitary gland near the hypothalamus. This results in a decrease of the follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion, and consequently reduces the production of testosterone.
“It [degarelix] has a direct mechanism of action that blocks the action of GnRH on the pituitary with no initial surge in gonadotrophin or testosterone levels. Degarelix is the most extensively studied and widely available GnRH antagonist worldwide. Clinical studies have demonstrated similar efficacy to the GnRH agonist leuprolide in achieving testosterone suppression in patients with prostate cancer. However, degarelix produces a faster suppression of testosterone and prostate-specific antigen (PSA), with no testosterone surge or microsurges, thus preventing the risk of clinical flare in advanced disease,” revealed the authors of the study “Experience with degarelix in the treatment of prostate cancer.”
Degarelix to Treat Prostate Cancer
Degarelix was approved by the U.S. Food and Drug Administration (FDA) on December 24, 2008 and it is commercialized under the brand name Firmagon by the pharmaceutical company Ferring Pharmaceuticals Inc. “This indication is based on degarelix’s effectiveness in attaining and maintaining serum testosterone suppression to medical castration levels during 12 months of treatment in an open-label, randomized, multicenter, parallel-group study,” explain the National Cancer Institute based on the FDA indications. The study used to confirm the approval included 620 prostate cancer patients who were randomly administered one of two dosing regimens of degarelix or leuprolide for a year.
The main purpose of the study, demonstrating the effectiveness of degarelix in achieving and maintaining testosterone suppression to castration, was achieved. The medical castration rates were 98.3 in the degarelix 240/160 mg arm, 97.2% in degarelix 240/80 mg arm and 96.4% in the leuprolide 7.5 mg arm. Therefore, degarelix is currently recommended as an injectable treatment for patients with prostate cancer. However, the company adverts that “hypersensitivity reactions, including anaphylaxis, urticaria and angioedema, have been reported post-marketing with FIRMAGON. In case of a serious hypersensitivity reaction, discontinue FIRMAGON immediately if the injection has not been completed, and manage as clinically indicated. Patients with a known history of serious hypersensitivity reactions to FIRMAGON should not be re-challenged with FIRMAGON.”
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